By Dr. Ekta Kapoor 4-Minute Read
Along with her colleagues at Mayo Clinic, Womaness expert Dr. Ekta Kapoor recently published a landmark study evaluating the impact of menopause symptoms on work outcomes and assessing the estimated economic impact. Here she gives us an insightful look at their findings.
The average age of menopause in the United States is about 52 years. This universal change for midlife women, and the years to follow, can be marked by important health changes. A woman can expect to experience multiple menopause-related symptoms, including hot flashes, night sweats, sleeping difficulties, memory problems, and mood-related concerns. This is in addition to some long-term health changes that relate to her heart, brain, and bone health.
Menopause-related symptoms can impact a woman's quality of life significantly. To make matters worse, women often do not discuss these problems with anyone, which further enhances the associated psychological burden. Moreover, there is a misperception among many that effective and safe treatments for menopause-related symptoms are not available.
As a result, many women do not seek care for these symptoms with their physicians and choose to endure them, or manage them “naturally.” The use of hormone therapy, the most effective treatment for menopause-related symptoms, has declined over the last two decades because of safety concerns that were raised in a large study, The Women's Health Initiative (WHI) Trials. Even though subsequent analyses of these data have refuted some of the original conclusions regarding potential risks associated with hormone therapy use in the recently postmenopausal women, the fear of hormone therapy use has lingered, and we continue to live in the shadows of the WHI. This hesitation to utilize hormone therapy has resulted in a high burden of menopause symptoms, with many women remaining undiagnosed and untreated.
“This is the time when many midcareer women are being offered leadership positions. To have yet another obstacle in their career path at this crucial juncture in their life can be detrimental.”
A relatively new aspect of the social and economic impact of menopause-related symptoms that is recently receiving significant attention is the effect on women in the workplace. As can be imagined, mood problems and cognitive difficulties can adversely impact a woman's ability to function optimally in the workplace. Many studies, including a recent large study from our group at the Mayo Clinic, have shown substantial impact on work productivity among women affected by menopause symptoms. In the Mayo Clinic study, 32,000 women between the ages of 45 and 60 years who were receiving primary care at the institution were invited to participate in a survey study. More than 5,000 women responded to the survey, out of which 4,440 reported current employment and were included in the study.
Most of the women in the study reported at least a moderate symptom burden due to menopause. We found that the severity of menopause symptoms correlated with the odds of an adverse work outcome: missing days, cutting back hours, being laid off or fired, quitting, retiring, or change of job. The women who experienced the most severe symptoms were 16 times more likely to report an adverse work outcome. More than 13% of the women reported at least one adverse outcome due to their menopause symptoms. About 11% women were missing days of work because of these symptoms. A little over 1% reported severe symptoms that caused them to quit their jobs or to be laid off in the six months prior to completing the survey.
Race and ethnicity-based differences in the menopause experience are well recognized. African American and Hispanic are known to report worse menopause symptoms, and they are also less likely to receive care for them. In this study, too, we found that women belonging to racial and ethnic minority groups had more severe menopause symptoms, with a substantially higher impact on their work productivity.
“...such significant impact on overall work productivity due to menopause symptoms is very likely to have a noticeable effect on the nation’s economy.”
These are very disturbing and shocking findings. To put in perspective for a woman's career trajectory, these symptoms surface at a very critical time: this is when a majority of women are past their childbearing and childrearing responsibilities, allowing them to devote time to their professional growth. This is the time when many midcareer women are being offered leadership positions. To have yet another obstacle in their career path at this crucial juncture in their life can be detrimental. This is likely one of the reasons for the sex-based disparity in leadership roles.
In addition to the impact on individual women in the workplace, such significant impact on overall work productivity due to menopause symptoms is very likely to have a noticeable effect on the nation’s economy as well. In the Mayo Clinic study, we estimated the financial burden of untreated menopause symptoms. Based on the lost workdays alone, we project the annual loss in the US to be $1.8 billion. If we add the medical care related costs to this, the total annual loss is estimated to be about $26 billion. These are staggering numbers! And they do not even include the losses due to reduction in work hours, early retirement, or loss of a job. These calculations also do not include the “unpaid” jobs women commonly perform, for example, caregiving.
What are these findings telling us? They are reiterating the pressing need to provide better care to women experiencing menopause symptoms. Healthcare professionals caring for midlife women should be actively querying them about menopause symptoms and discussing appropriate treatment options. The value in educating women regarding these symptoms and treatment options is tremendous, such that they are active participants in their care, rather than resigning and surrendering to these symptoms as is often the case.
“We need workplace policies that promote a supportive environment, where women can talk about their concerns without fearing any negative consequences.”
The second question is what can be done specifically in the workplace? Women often hesitate to talk about menopause in general, and even more so at the workplace. They fear discrimination, stigmatization, and do not want to be labeled as “complainers” or “whiners.” The inability to openly discuss their problems only adds to the psychological burden associated with the menopause symptoms. Ironically enough, this situation only worsens their already compromised work performance. Therefore, we need to educate supervisors and managers regarding the impact of menopause in the workplace. We need to work to reduce the stigma that is associated with discussion of menopause related symptoms at the workplace. We need workplace policies that promote a supportive environment, where women can talk about their concerns without fearing any negative consequences. Other potential strategies including flexibility regarding building temperature control, work hours, and time away from work when needed are highly desirable as well.
Our hope with studies like these is to positively impact the care of women experiencing menopause symptoms in general, and specifically in the workplace, so women can enjoy the personal and professional growth at a crucial time in their lives, when they are finally able to free themselves somewhat from family-related responsibilities.
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