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He X, Hou F, Shen X, Zhao D, Zhao X, Qi M, Li P. Individual and additive-effect relationships of menopausal symptoms and subjective cognitive decline among nurses during menopausal transition: a cross-sectional study. Menopause 2024; 31:617-625. [PMID: 38860940 DOI: 10.1097/gme.0000000000002368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE This study aimed to examine the individual and additive-effect relationships between menopausal symptoms and subjective cognitive decline among nurses during menopausal transition. METHODS Between February and September 2019, a convenience sampling strategy was used, involving 1,335 Chinese nurses undergoing menopausal transition. A general information survey that included the Subjective Cognitive Decline Scale and the Menopause Rating Scale was completed. Based on a cut-off point of the subjective cognitive decline score of 7.5, the overall sample was divided into mild and severe groups. Propensity score matching was performed to balance covariates of mild and severe subjective cognitive decline. The individual and cumulative effects of menopausal symptoms and subjective cognitive decline were analyzed using binary logistic regression and the Cochran-Armitage trend test, respectively. RESULTS After propensity score matching, none of the parameters showed significant differences between the groups. Logistic regression analysis revealed that four menopausal symptoms were closely associated with severe subjective cognitive decline. The Cochran-Armitage trend test indicated odds ratios linking the presence of these symptoms with increased severe subjective cognitive impairment. In addition, nurses simultaneously experiencing two or more core menopausal symptoms were over six times more likely to have severe subjective cognitive decline than nurses experiencing none or one core menopausal symptom during menopausal transition. CONCLUSIONS Individual and additive numbers of menopausal symptoms significantly influenced subjective cognitive decline in nurses during their menopausal transition. These findings suggest that interventions aimed at enhancing the cognitive performance of nurses experiencing menopause should consider menopausal symptoms.
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Affiliation(s)
- Xudong He
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Fangyan Hou
- Shandong Youth Political College, Jinan, Shandong, China
| | - Xiaona Shen
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Di Zhao
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xiangyu Zhao
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Meiling Qi
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Ping Li
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
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Safwan N, Saadedine M, Shufelt CL, Kapoor E, Kling JM, Chaudhry R, Faubion SS. Menopause in the workplace: Challenges, impact, and next steps. Maturitas 2024; 185:107983. [PMID: 38581822 DOI: 10.1016/j.maturitas.2024.107983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/23/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Menopause is a natural part of a woman's life that coincides with a time when many women play significant roles in the workforce. Menopause symptoms, such as hot flashes, fatigue, and difficulty with concentration and memory, can have a negative effect on work productivity and efficiency. OBJECTIVES This paper summarizes the impact of menopause in the workplace, with an emphasis on the impact of symptoms on employed women and how the workplace influences their experiences. It highlights economic implications, promotes awareness, and suggests potential next steps. METHODS A search for papers was conducted between August and November 2023 in the PubMed and Medline databases. Papers were selected based on personal experience and interpretation of the findings. Recommendations for managing menopause symptoms in the workplace and guidance on an optimal workplace intervention strategy were provided. RESULTS Women experiencing severe menopause symptoms are more likely to report adverse work outcomes, including absenteeism and job-related decisions such as quitting, retiring early, or declining promotions than women experiencing few symptoms. Factors such as a lack of awareness about menopause, inflexible work conditions, and high-stress jobs can exacerbate the severity of these symptoms. Additionally, unaddressed menopause symptoms contribute to both direct and indirect economic costs, including medical resource utilization and lost work productivity, resulting in a substantial economic burden. CONCLUSION Menopause symptoms impair women's work experiences and productivity. In addition to dismantling the stigma associated with menopause, it is critical to create and implement menopause workplace policies and interventions aimed at supporting women in this universal life stage.
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Affiliation(s)
- Nancy Safwan
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States of America; Mayo Clinic Center for Women's Health, Rochester, MN, United States of America
| | - Mariam Saadedine
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States of America; Mayo Clinic Center for Women's Health, Rochester, MN, United States of America
| | - Chrisandra L Shufelt
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States of America; Mayo Clinic Center for Women's Health, Rochester, MN, United States of America; Women's Health Research Center, Mayo Clinic, Rochester, MN, United States of America
| | - Ekta Kapoor
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States of America; Mayo Clinic Center for Women's Health, Rochester, MN, United States of America; Women's Health Research Center, Mayo Clinic, Rochester, MN, United States of America; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, United States of America
| | - Juliana M Kling
- Mayo Clinic Center for Women's Health, Rochester, MN, United States of America; Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States of America
| | - Rajeev Chaudhry
- Mayo Clinic Center for Women's Health, Rochester, MN, United States of America; Division of Community Internal Medicine, Mayo Clinic, Eau Claire, WI, United States of America
| | - Stephanie S Faubion
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States of America; Mayo Clinic Center for Women's Health, Rochester, MN, United States of America.
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Kiss P, Depypere H, De Meester M, Vingerhoets I, Van Hoecke M, Braeckman L. Need for recovery after work and associated risk factors in working menopausal women. Maturitas 2024; 187:108054. [PMID: 38905864 DOI: 10.1016/j.maturitas.2024.108054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 06/02/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES To explore relationships between 'need for recovery' (NFR), a strong predictor of burnout, and menopause symptoms and to identify work-related factors that are associated with a high NFR in Belgian menopausal women. STUDY DESIGN 760 menopausal women took part in a cross-sectional questionnaire study. NFR, presence of menopause symptoms, job type, age category, work activity, physical workload, psychosocial and physical work environment, balance of work and private life and the opportunity to discuss menopause at work were assessed. MAIN OUTCOME MEASURES Uni- and multivariate logistic regression analyses were used to calculate the odds ratios for the presence of a high NFR. RESULTS Of menopausal women currently experiencing menopause symptoms, 53.3 % reported problems while performing their work. The overall prevalence of a high NFR in menopausal women was 41.2 %. Women who experienced problems at work had the highest prevalence of a high NFR (61.1 %), and constituted a separate risk group for having a high NFR (OR 3.31 vs. never symptoms; 95%CI 1.72-6.38). The following factors were significantly associated with a high NFR: poor balance of work and private life (OR 7.89; 95%CI 4.32-14.39), physical workload (OR 1.17; 95%CI 1.08-1.28), discomfort from cognitive demands (OR 1.17; 95%CI 1.09-1.26), organizational justice (OR 0.86; 95%CI; 0.78-0.94), and social support from colleagues (OR 0.87; 95%CI 0.79-0.96). CONCLUSIONS Maintaining a good balance of work and private life, reducing physical workload, addressing discomfort from cognitive work demands and assuring a fair work distribution are measures that require a culture where open and easy discussion about menopause is possible.
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Affiliation(s)
- Philippe Kiss
- Securex Occupational Health Service, Verenigde Natieslaan 1, Gent, Belgium; Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Gent, Belgium.
| | - Herman Depypere
- Department of Human Structure and Repair, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Gent, Belgium.
| | - Marc De Meester
- Securex Occupational Health Service, Verenigde Natieslaan 1, Gent, Belgium; Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Gent, Belgium.
| | - Ilse Vingerhoets
- Securex Occupational Health Service, Verenigde Natieslaan 1, Gent, Belgium.
| | | | - Lutgart Braeckman
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Gent, Belgium.
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Valadares ALR, Hipólito Rodrigues MA. Menopausal women struggling with symptoms at work - a conundrum unsolved? Women Health 2024; 64:295-297. [PMID: 38644573 DOI: 10.1080/03630242.2024.2331263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Affiliation(s)
- Ana L R Valadares
- Department of Obstetrics and Gynecology, School of Medicine, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Márcio Alexandre Hipólito Rodrigues
- Obstetrics and Gynecology Department School of Medicine, UFMG, Belo Horizonte, Brazil
- Endocrine Gynecology Unit, Hospital Cochin, Paris, France
- Women & Health
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Saarinen T, Savukoski SM, Pesonen P, Vaaramo E, Laitinen J, Varanka-Ruuska T, Ala-Mursula L, Niinimäki M. Climacteric status at age 46 is associated with poorer work ability, lower 2-year participation in working life, and a higher 7-year disability retirement rate: a Northern Finland Birth Cohort 1966 study. Menopause 2024; 31:275-281. [PMID: 38412401 DOI: 10.1097/gme.0000000000002327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To study the association between an advanced climacteric status at 46 years of age and current perceived work ability, the consequent 2-year accumulation of disability and unemployment days, and the 7-year incidence of disability pensions. METHODS Study participants (n = 2,661) were recruited from the Northern Finland Birth Cohort 1966 study's 46-year follow-up in 2012. The participants' perceived work ability was investigated using the Work Ability Score (0-7 = poor vs 8-10 = good), along with potential covariates. Data concerning their consequent disability days, unemployment days, and disability pensions were collected from national registers. The association between their climacteric status at age 46 years, work ability, and working life participation was assessed using regression models. RESULTS The climacteric women were more often smokers and more often had a lower level of education. The odds ratio for poor perceived work ability was 1.41 (95% CI, 1.06-1.87), and the incidence rate ratios for disability and unemployment days during the 2-year follow-up were 1.09 (95% CI, 1.07-1.11) and 1.16 (95% CI, 1.14-1.18), respectively, for the climacteric women compared with the preclimacteric women in models adjusted for smoking and education. The 7-year hazard ratio for disability pensions was 1.72 (95% CI, 1.02-2.91) for the climacteric women. CONCLUSIONS An earlier menopausal transition is associated with poorer perceived work ability, and it predicts lower recorded work participation and a higher disability pension rate in subsequent years.
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Affiliation(s)
| | | | - Paula Pesonen
- Northern Finland Birth Cohorts, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Eeva Vaaramo
- Northern Finland Birth Cohorts, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Leena Ala-Mursula
- Research Unit of Population Health, University of Oulu, Oulu, Finland
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Alzueta E, Menghini L, Volpe L, Baker FC, Garnier A, Sarrel PM, de Zambotti M. Navigating menopause at work: a preliminary study about challenges and support systems. Menopause 2024; 31:258-265. [PMID: 38442310 DOI: 10.1097/gme.0000000000002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Women's increasing workforce participation necessitates understanding unique life phases like menopause for enhanced workplace inclusivity. This research investigates the challenges and needs of peri-menopausal women in work settings, using the Job Demands-Resources model as a foundation. METHODS A cross-sectional survey was administered to 351 working women aged 40 to 65 years in the United States. Hierarchical multiple regression models were employed to assess the relationship between the severity of menopausal symptoms, emotional exhaustion, work engagement, and turnover intentions. RESULTS Most of the respondents reported moderate (38.46%) to severe (35.9%) menopausal symptoms. Notably, 54% of the women were caregivers for children or adults. About 77.7% of participants reported work-related challenges due to menopause, with a perceived reduction in productivity (56.8%) being the most common issue. The severity of menopausal symptoms was found to significantly predict more emotional exhaustion ( P < 0.001), less work engagement ( P < 0.001), and greater turnover intentions ( P = 0.03). Concerns about being perceived as less capable in the workplace due to menopausal symptoms were reported by 51.2% of respondents. A striking gap exists between the workplace measures desired by women, such as formal menopause policies and managerial training (65.4%-68%), and their actual implementation (2%-6.3%). CONCLUSIONS This study reveals an exigent need for increased awareness and structural changes to support working women going through menopause. The findings have far-reaching implications for not just promoting gender equity and well-being but are also pivotal for maintaining a diversified, engaged, and effective workforce.
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Affiliation(s)
- Elisabet Alzueta
- From the Center for Health Sciences, SRI International, Menlo Park, CA
| | - Luca Menghini
- Department of General Psychology, University of Padova, Italy
| | - Laila Volpe
- From the Center for Health Sciences, SRI International, Menlo Park, CA
| | - Fiona C Baker
- From the Center for Health Sciences, SRI International, Menlo Park, CA
| | | | - Philip M Sarrel
- Obstetrics, Gynecology, and Reproductive Sciences and Psychiatry, Yale University, CT
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Gore K, Hayward SM, Flower RL, Gilbert M, Barbaro J. "Maybe No One Knows We Need Help": Understanding the Experiences of Autistic Working Mothers in Australia. AUTISM IN ADULTHOOD 2024; 6:47-59. [PMID: 38435329 PMCID: PMC10902281 DOI: 10.1089/aut.2022.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background Although there are no known studies investigating autistic working mothers, research has demonstrated that managing employment and motherhood in non-autistic populations has specific challenges, as does employment in autistic populations. This autistic-led study aimed at investigating the experience of autistic working mothers to identify benefits, challenges, and support needs. Methods We utilized a subjectivist epistemological perspective to learn about the experiences of autistic working mothers. We recruited 10 autistic working mothers (aged 34-50 years) via social media advertisements, who participated in a 45- to 60-minute semi-structured interview where we asked questions developed in consultation with a community reference group. We transcribed interviews and then analyzed them using inductive reflexive thematic analysis. Results We identified three key themes. The first theme, "Wellbeing: Work gives me purpose," discusses how employment supports mental well-being. The second theme, "Challenges: It's hard being an autistic working mother," includes the challenges of balancing work and caregiving, guilt related to being a working mother, and issues with part-time work. The third theme, "The invisible disability: Everyone thinks I look okay," discusses the lack of understanding of participants' challenges, with assumptions they are coping, and the lack of supports that led to some participants no longer seeking assistance. Conclusions The responses of the autistic women who took part support a view that autistic working mothers may experience some similar challenges to non-autistic working mothers, including stress in juggling caring and work roles. They identified additional challenges related to their gender and their autistic identity, including a lack of understanding of the female (or "internalized") presentation of autism. These findings will help autistic working mothers by promoting a better understanding of their experiences and challenges when they speak with health professionals, government, and employers seeking support and accommodations.
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Affiliation(s)
- Katherine Gore
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Susan M. Hayward
- School of Social and Political Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca L. Flower
- Department of Psychology, Counselling, and Therapy, La Trobe University, Bendigo, Victoria, Australia
| | - Melissa Gilbert
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Verburgh M, Verdonk P, Muntinga M, van Valkengoed I, Hulshof C, Nieuwenhuijsen K. "But at a certain point, the lights literally went out": A qualitative study exploring midlife women's experiences of health, wellbeing, and functioning in relation to paid work. Work 2024; 77:799-809. [PMID: 37781836 DOI: 10.3233/wor-220567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND In the Netherlands, the fact that midlife women constitute a considerable segment of the working population is relatively new. Generally paid work contributes to midlife women's wellbeing, but they also report health challenges, such as work-related fatigue and the menopause. OBJECTIVE The objective of this study is to understand how midlife women themselves perceive their health, wellbeing, and functioning in relation to paid work. METHODS In this exploratory qualitative study, 28 women participated in five ethnically homogeneous focus group discussions (FGDs). De FGDs were recorded, transcribed verbatim, and thematically analyzed using MAXQDA. RESULTS We identified exhaustion as central to our analysis. During midlife, exhaustion seems to occur once a certain limit has been reached, both physically and mentally, with women feeling to have reached the end of their rope. Besides obvious physiological challenges, we identified two major themes in which we discuss challenges both in paid work and private life: (1) work environment and working conditions, and (2) burdens in private life. Participants took various measures to manage and try to reduce exhaustion, including finding a new job or negotiating different job tasks, and reducing work hours. CONCLUSION This study indicates that the extent to which women experience exhaustion is associated with challenges in both paid work and private life. The underlying processes do not seem to reflect individual problems, but reflect a complex set of factors at the structural level. Nevertheless, women take several individual measures to reduce their exhaustion, including reducing their participation in paid work.
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Affiliation(s)
- Marjolein Verburgh
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Petra Verdonk
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije University, Amsterdam, The Netherlands
| | - Maaike Muntinga
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije University, Amsterdam, The Netherlands
| | - Irene van Valkengoed
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Carel Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Karen Nieuwenhuijsen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Schei TS, Abernethy K. An evaluation of demographic characteristics and workplace experiences of UK employees using an employer-provided menopause application. Maturitas 2023; 177:107803. [PMID: 37531870 DOI: 10.1016/j.maturitas.2023.107803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/01/2023] [Accepted: 07/16/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES The aim of the current study was to determine the demographic characteristics and workplace experiences of users of a menopause application in the UK. STUDY DESIGN A retrospective observational study of data extracted from the information submitted by 21,555 users of the Peppy Health menopause application during registration. MAIN OUTCOMES MEASURES Menopause symptoms were measured using the Menopause Rating Scale. The other questionnaire items assessed workplace impairment, work absence, thoughts about reducing hours or leaving work, feelings of support and disclosure confidence. RESULTS Users were predominately peri- and postmenopausal women between the ages of 40 and 60. The users reported menopause symptoms that were more severe than in the general population. Symptom severity was associated with work impairment and wanting to reduce hours worked or leave employment, and feeling supported was associated with less impairment. CONCLUSIONS The menopause application is reaching women in the workplace who are experiencing severe symptoms and who are likely to benefit from targeted support. Among the users of a menopause application, the presence of severe menopause symptoms can have a significantly negative effect on work and future participation in paid employment. The results also indicate the potential role of support to mitigate some of the negative impact.
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Affiliation(s)
- Thea S Schei
- Peppy Health, Kemp House, 128 City Road, London EC1V 2NX, United Kingdom.
| | - Kathy Abernethy
- Peppy Health, Kemp House, 128 City Road, London EC1V 2NX, United Kingdom
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10
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Ishimaru T, Okawara M, Tateishi S, Yasui T, Horie S, Fujino Y. Impact of menopausal symptoms on presenteeism in Japanese women. Occup Med (Lond) 2023; 73:404-409. [PMID: 37494697 DOI: 10.1093/occmed/kqad087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Menopausal symptoms are common among middle-aged women. Working women with severe menopausal symptoms are more likely to experience presenteeism-a condition where employees continue to work despite feeling unwell. However, it remains unclear as to which specific symptoms women experience during the menopausal transition and postmenopausal periods that primarily contribute to presenteeism. AIMS To evaluate the associations between types of menopausal symptoms and presenteeism among Japanese women. METHODS A cross-sectional study of 4000 women aged 40-59 years who were currently working was conducted in Japan in September 2022. We used an online self-administered questionnaire that included items on demographic characteristics, the Menopause Rating Scale for measuring menopausal symptoms and the Work Functioning Impairment Scale for measuring presenteeism. Logistic regression analysis was performed. RESULTS Women with severe overall menopausal symptoms had 12.18-fold (95% confidence interval [CI] 9.09-16.33, P < 0.001) increased odds of presenteeism compared with those without symptoms. Participants with psychological symptoms also had significantly higher presenteeism (severe: odds ratio: 9.18, 95% CI 6.60-12.78, P < 0.001). However, after controlling for psychological symptoms, there were no significant associations between somatic and urogenital symptoms and presenteeism. CONCLUSIONS The results indicate that menopausal symptoms, especially psychological symptoms, have a significant impact on presenteeism among Japanese women. Organizations need to address menopausal symptoms in the workplace, with an emphasis on reducing work-related stress for women with menopausal symptoms.
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Affiliation(s)
- T Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - M Okawara
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - S Tateishi
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - T Yasui
- Department of Reproductive and Menopausal Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - S Horie
- Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Y Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Oude Hengel KM, Soeter M, In der Maur M, van Oostrom SH, Loef B, Hooftman WE. Perimenopause: Symptoms, work ability and health among 4010 Dutch workers. Maturitas 2023; 176:107793. [PMID: 37393659 DOI: 10.1016/j.maturitas.2023.107793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/31/2023] [Accepted: 06/17/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE In this study we examined the associations between menopausal symptoms and work ability and health among a general population of Dutch female workers. STUDY DESIGN This nationwide cross-sectional study was a follow-up of the Netherlands Working Conditions Survey 2020. In 2021, 4010 Dutch female employees aged 40-67 years completed an online survey on a variety of topics, including menopausal symptoms, work ability and health. METHODS Linear and logistic regression analyses were performed to investigate the association between the degree of menopausal symptoms with work ability, self-rated health and emotional exhaustion, after adjustment for potential confounders. RESULTS Almost one-fifth of participants were in the perimenopause (n = 743). Of these women, 80 % experienced menopausal symptoms: 27.5 % 'often' and 52.5 % 'sometimes'. Experiencing menopausal symptoms was associated with lower work ability, poorer self-rated health, and more emotional exhaustion. These associations were most pronounced among perimenopausal women 'often' experiencing symptoms. CONCLUSIONS Menopausal symptoms threaten the sustainable employability of female workers. Interventions and guidelines are needed to support women, employers and (occupational) health professionals.
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Affiliation(s)
- Karen M Oude Hengel
- Netherlands Organization for Applied Scientific Research TNO, Sylviusweg 71, 2333 BE Leiden, the Netherlands.
| | - Marieke Soeter
- Netherlands Organization for Applied Scientific Research TNO, Sylviusweg 71, 2333 BE Leiden, the Netherlands
| | - Merel In der Maur
- Netherlands Organization for Applied Scientific Research TNO, Sylviusweg 71, 2333 BE Leiden, the Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O Box 1, 3720 BA Bilthoven, the Netherlands
| | - Bette Loef
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O Box 1, 3720 BA Bilthoven, the Netherlands
| | - Wendela E Hooftman
- Netherlands Organization for Applied Scientific Research TNO, Sylviusweg 71, 2333 BE Leiden, the Netherlands
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12
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Lipasti M, Jalava-Broman J, Sillanmäki L, Mäkinen J, Rautava P. Increasing climacteric symptoms in untreated perimenopausal Finnish women: a 10-year cohort study. Climacteric 2023; 26:472-478. [PMID: 37158148 DOI: 10.1080/13697137.2023.2202810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This study aimed to examine changes over a 10-year period in experiencing climacteric symptoms and their associations with sociodemographic and health-related background factors in a birth cohort of Finnish women who have never used menopausal hormone therapy (MHT). METHODS This nationwide population-based follow-up study consists of 1491 women who during the follow-up period moved from the age group 42-46 years to the age group 52-56 years. The experience of climacteric symptoms was assessed by 12 symptoms commonly associated with the climacterium. The data were analyzed using statistical techniques. RESULTS Both the intensity, expressed as a symptom score of four symptoms associated with a decrease in estrogen production (sweating, hot flushes, vaginal dryness, sleeping problems), and the prevalence of the five most common symptoms (sweating, hot flushes, sleeping problems, lack of sexual desire, depressive symptoms) increased clearly during the follow-up period. The examined sociodemographic and health-related variables did not explain the changes in experiencing the symptoms. CONCLUSIONS The results of this study can be considered in primary and occupational health care and in gynecological settings when working with symptomatic women or women with hidden climacteric problems and carrying out health promotion and counseling for them.
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Affiliation(s)
- M Lipasti
- Department of Public Health, University of Turku, Turku, Finland
| | - J Jalava-Broman
- Department of Public Health, University of Turku, Turku, Finland
| | - L Sillanmäki
- Department of Public Health, University of Turku, Turku, Finland
- Research Services, Turku University Hospital, Turku, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Mäkinen
- Department of Obstetrics and Gynaecology, University of Turku, Turku, Finland
- Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, Finland
| | - P Rautava
- Department of Public Health, University of Turku, Turku, Finland
- Research Services, Turku University Hospital, Turku, Finland
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13
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O’Neill MT, Jones V, Reid A. Impact of menopausal symptoms on work and careers: a cross-sectional study. Occup Med (Lond) 2023; 73:332-338. [PMID: 37542726 PMCID: PMC10540666 DOI: 10.1093/occmed/kqad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Women over 50 years are one of the fastest-growing employment groups. Menopausal symptoms can adversely impact quality of life, work performance and attendance; however, few studies look at the impact of individual menopausal symptoms on work and career development. AIMS To measure the prevalence of menopausal symptoms in employees in a healthcare setting, to assess the impact of individual symptoms on work, attendance and career development and to explore perceptions about workplace supports. METHODS In this cross-sectional study of Irish hospital workers, menopausal employees were asked about the frequency of 10 menopausal symptoms and the extent to which each symptom impacted them at work. Impacts on performance, attendance and career development were assessed, along with the benefits of workplace support. RESULTS Responses from 407 women showed that the most common menopausal symptoms affecting employees greater than 50% of the time while at work were fatigue (54%), difficulty sleeping (47%), poor concentration (44%) and poor memory (40%). Work performance was impacted for 65% of respondents and 18% had taken sick leave. There was a significant association between symptom severity at work and reduced work performance, career development decisions and attendance. Manager awareness about menopause (29%) and flexible working times (29%) were selected as the most important workplace supports. CONCLUSIONS Female employees are negatively impacted by menopausal symptoms while at work, particularly by psychological and neurocognitive symptoms which were associated with reduced work performance, attendance and career decisions. Manager awareness and flexible schedules were considered the most beneficial workplace supports.
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Affiliation(s)
- M T O’Neill
- Occupational Health & Wellbeing Department, Tallaght University Hospital, Dublin D24NR0A, Ireland
| | - V Jones
- Occupational Health & Wellbeing Department, Tallaght University Hospital, Dublin D24NR0A, Ireland
| | - A Reid
- Occupational Health & Wellbeing Department, Tallaght University Hospital, Dublin D24NR0A, Ireland
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14
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Geukes M, Anema JR, Vermeer M, van Aalst MP, Oosterhof H. Evaluation of a workplace educational intervention on menopause: A quasi-experimental study. Maturitas 2023; 174:48-56. [PMID: 37270889 DOI: 10.1016/j.maturitas.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/02/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To evaluate the effects of a workplace educational intervention on menopause on self-efficacy regarding working during the climacteric. METHODS Quasi-experimental design, with one intervention and one control group. Women aged 40 to 67, working in one of the two participating departments of a large municipality in the Netherlands, were recruited to participate in the study. The allocation of participants to intervention or control group was done at the departmental level. The main component of the multifaceted intervention consisted of educational workshops on menopause and work. The primary outcome was score on the Self-Efficacy to Manage Symptoms Scale. Secondary outcomes were scores on other self-efficacy scales, knowledge about the menopausal transition, menopausal symptoms, beliefs and behaviours and work-related variables. Differences between groups were analysed with Pearson's chi-square, Student's t-test or Mann-Whitney U. Analysis of covariance (ANCOVA) was used to correct for baseline and potential confounders. RESULTS Data from 54 women were analysed, 25 in the intervention group and 29 in the control group. After 12 weeks of follow-up, the mean score on the Self-Efficacy to Manage Symptoms Scale was higher in the intervention group than in the control group: 6.52 (SD 1.45) versus 5.84 (SD 1.51), respectively, adjusted mean difference 0.75 (95 % CI 0.03-1.46, p = 0.040). The educational intervention increased self-reported knowledge (scored on the range 1-10) (adjusted mean difference 0.7, 95 % CI 0.26-1.15, p = 0.002) and resulted in a lower level of presenteeism (i.e., less impaired work performance) due to menopausal symptoms, measured by the Dutch Stanford Presenteeism Scale (adjusted mean difference 2.15, 95 % CI 0.13-4.18, p = 0.038), compared to the control group. CONCLUSIONS This educational workplace intervention study shows promising positive effects on self-efficacy regarding working during the climacteric, knowledge about the menopausal transition and presenteeism due to menopausal symptoms. This is especially true for women already experiencing menopausal symptoms, while premenopausal women were harder to engage in the intervention. A larger study, with longer follow-up, preferably a randomized controlled trial, is needed to investigate the clinical relevance of these findings.
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Affiliation(s)
- Marije Geukes
- Department of Obstetrics and Gynaecology, Ziekenhuisgroep Twente (ZGT), Post box 7600, 7600 SZ Almelo, The Netherlands.
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
| | - Marloes Vermeer
- ZGT Academy, Ziekenhuisgroep Twente (ZGT), Post box 7600, 7600 SZ Almelo, The Netherlands.
| | | | - Henk Oosterhof
- Roosevelt Kliniek, Olof Palmestraat 22, 2616 LS Delft, The Netherlands.
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15
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Theis S, Baumgartner SJ, Janka H, Kolokythas A, Skala C, Stute P. Quality of life in menopausal women in the workplace - a systematic review. Climacteric 2023; 26:80-87. [PMID: 36682379 DOI: 10.1080/13697137.2022.2158729] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/28/2022] [Accepted: 12/11/2022] [Indexed: 01/24/2023]
Abstract
Menopausal women are a large and economically relevant group in the workforce. Yet their quality of life (QoL) and needs in the workplace have been neglected. Thus, the aim of this systematic review was to provide an overview of QoL of menopausal women in the workplace. Systematic literature searches were executed, yielding 1211 references. After abstract screening, 156 articles remained for full-text screening. Finally, 12 articles fulfilled the inclusion criteria and were included in this review. Age, educational level, type of work, working environment (e.g. crowding, confined spaces, noise, workstation design), permanent place of residency, mental factors (e.g. stress level, workload, work pattern), comorbidities, menopausal symptoms, time since menopause and physical activity have repeatedly been shown to affect QoL in the workplace in menopausal women. Low-threshold access to medical and psychological support as well as individual adaptation of the workplace environment are, among others, retrieved recommendations for employers from these findings. Further raising of awareness of special needs of menopausal working women as well as further systematic research programs are needed.
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Affiliation(s)
- S Theis
- Department of Obstetrics and Gynecology, University of Mainz, Mainz, Germany
| | - S J Baumgartner
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
| | - H Janka
- Medical Library, University Library Bern, University of Bern, Bern, Switzerland
| | - A Kolokythas
- Department of Obstetrics and Gynecology, Mc Gill University, Montréal, QC, Canada
| | - C Skala
- Department of Obstetrics and Gynecology, University of Mainz, Mainz, Germany
| | - P Stute
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
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16
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Resistance training prevents dynamics and mitochondrial respiratory dysfunction in vastus lateralis muscle of ovariectomized rats. Exp Gerontol 2023; 173:112081. [PMID: 36608776 DOI: 10.1016/j.exger.2023.112081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
To investigate whether ovariectomy affects mitochondrial respiratory function, gene expression of the biogenesis markers and mitochondrial dynamics of the vastus lateralis muscle, female Wistar rats divided into ovariectomized (OVX) and intact (INT) groups were kept sedentary (SED) or submitted to resistance training (RT) performed for thirteen weeks on a vertical ladder in which animals climbed with a workload apparatus. RT sessions were performed with four climbs with 65, 85, 95, and 100 % of the rat's previous maximum workload. Mitochondrial Respiratory Function data were obtained by High-resolution respirometry. Gene expression of FIS1, MFN1 and PGC1-α was evaluated by real-time PCR. There was a decrease on oxidative phosphorylation capacity in OVX-SED compared to other groups. Trained groups presented increase on oxidative phosphorylation capacity when compared to sedentary groups. For respiratory control ratio (RCR), OVX-SED presented lower values when compared to INT-SED and to trained groups. Trained groups presented RCR values higher compared to INT-SED. Exercise increased the values of FIS1, MFN1 and PGC1-α expression compared to OVX-SED. Our results demonstrated that in the absence of ovarian hormones, there is a great decrease in oxidative phosphorylation and electron transfer system capacities of sedentary animals. RT was able to increase the expression of genes related to mitochondrial dynamics markers, reversing the condition determined by ovariectomy.
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17
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Gjellestad M, Haraldstad K, Enehaug H, Helmersen M. Women's Health and Working Life: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1080. [PMID: 36673834 PMCID: PMC9859470 DOI: 10.3390/ijerph20021080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Women's health matters for participation in working life. The objective of this study was to explore female physiology in a work-life context and to investigate possible associations between women's health, sickness absence and work ability. A scoping review was conducted to develop a systematic overview of the current research and to identify knowledge gaps. The search strategy was developed through a population, concept and context (PCC) model, and three areas of women's health were identified for investigation in the context of work. A total of 5798 articles were screened by title and abstract and 274 articles were screened by full text; 130 articles were included in the review. The material included research from 19 countries; the majority of the studies used quantitative methods. The results showed an impact on the occupational setting and an association between sickness absence, work ability and all three areas of women's health, but a holistic and overall perspective on female biology in the work context is missing. This review calls for more knowledge on health and work and possible gender differences in this regard. Women's health and working life involve a complex connection that has the potential to develop new knowledge.
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Affiliation(s)
- Marianne Gjellestad
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
| | - Heidi Enehaug
- Work Research Institute, Center for Welfare and Labour Research, Oslo Metropolitan University, 0176 Oslo, Norway
| | - Migle Helmersen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
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18
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D’Angelo S, Bevilacqua G, Hammond J, Zaballa E, Dennison EM, Walker-Bone K. Impact of Menopausal Symptoms on Work: Findings from Women in the Health and Employment after Fifty (HEAF) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:295. [PMID: 36612616 PMCID: PMC9819903 DOI: 10.3390/ijerph20010295] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 05/14/2023]
Abstract
Women make up a growing proportion of the workforce and therefore many women experience menopause while in paid employment. We explored the prevalence of menopausal symptoms, the relationship between symptoms and coping with work and the risk factors associated with struggling at work during the menopause. The Health and Employment After Fifty (HEAF) community-based cohort of people aged 50-64 years was incepted 2013-2014 to study health and work. In 2019, female participants were asked to complete a questionnaire about their menopausal symptoms, and effect of those symptoms on their ability to cope at work. 409 women were eligible for inclusion. The commonest symptoms were vasomotor (91.7%); trouble sleeping (68.2%); psychological (63.6%) and urinary (49.1%). The prevalence of reporting symptoms was similar no matter which type of occupation women were performing at the time. Around one-third of women reported moderate/severe difficulties coping at work because of menopausal symptoms. Risk factors for difficulties coping at work included: financial deprivation, poorer self-rated health, depression, and adverse psychosocial occupational factors but not physical demands. More awareness is needed amongst employers in all sectors but women with financial difficulties and those with jobs in which they feel insecure, unappreciated, or dissatisfied are at greatest risk.
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Affiliation(s)
- Stefania D’Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO15 3BX, UK
| | - Gregorio Bevilacqua
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO15 3BX, UK
| | - Julia Hammond
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO15 3BX, UK
| | - Elena Zaballa
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO15 3BX, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton SO15 3BX, UK
| | - Elaine M. Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO15 3BX, UK
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO15 3BX, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton SO15 3BX, UK
- Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, VIC 3004, Australia
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19
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Verdonk P, Bendien E, Appelman Y. Menopause and work: A narrative literature review about menopause, work and health. Work 2022; 72:483-496. [PMID: 35570508 PMCID: PMC9277682 DOI: 10.3233/wor-205214] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND: Menopause is part of working women’s lives. In Western countries, labour market patterns are changing rapidly: women’s labour participation has increased, the percentage of full-time working women is rising, and retirement age is increasing. OBJECTIVE: This narrative literature study aims to provide an insight in the state of the art in the literature about the relationship between menopause, work and health and to identify knowledge gaps as input for further research. METHODS: The search was conducted in PubMed, CINAHL, MEDLINE and ScienceDirect. The final set includes 36 academic articles, 27 additional articles related to the topic and 6 additional sources. RESULTS: Research on menopause, work and health is scarce. Results are grouped thematically as follows: Menopause and (1) a lack of recognising; (2) sickness absence and costs; (3) work ability; (4) job characteristics; (5) psychosocial and cultural factors; (6) health; (7) mental health, and (8) coping and interventions. Work ability of women with severe menopausal complaints may be negatively affected. CONCLUSIONS: Due to taboo, menopause remains unrecognised and unaddressed within an organisational context. New theoretical and methodological approaches towards research on menopause, work and health are required in order to match the variety of the work contexts world-wide.
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Affiliation(s)
- Petra Verdonk
- Department Ethics, Law and Humanities, Amsterdam UMC, VU University, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Elena Bendien
- Department Ethics, Law and Humanities, Amsterdam UMC, VU University, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands
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20
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Xiong J, Carter S, Jay O, Arens E, Zhang H, Deuble M, de Dear R. A sex/age anomaly in thermal comfort observed in an office worker field study: A menopausal effect? INDOOR AIR 2022; 32:e12926. [PMID: 34418161 DOI: 10.1111/ina.12926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/03/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
In a field study conducted in office settings in Sydney, Australia, background survey and right-here-right-now thermal comfort questionnaires were collected from a sample of office workers. Indoor environmental observations, including air temperature, mean radiant temperature, air velocity, and relative humidity, were also recorded and matched with each questionnaire according to the time and location. During exploratory data analyses, we observed that female subjects aged over 40 and 50 or younger registered significantly warmer sensations than other subjects, male and female, from other age ranges. To further explore this phenomenon, the sample of building occupants was classified into two groups-women of perimenopausal age (over 40 and 50 or younger) while the remaining respondents served as a reference group for comparison. Women in the perimenopausal age range demonstrated an increased perception of warmth (p < 0.01) and expressed thermal dissatisfaction more frequently (p < 0.01) than the reference group respondents who were exposed to the same indoor environmental conditions. Furthermore, women of perimenopausal age also expressed preference for cooler thermal environments, that is, lower air temperature (p < 0.01) and greater air movement (p<0.01) than the reference group, and their thermal neutrality (ie, the room temperature corresponding to a neutral thermal sensation) was approximately 2°C cooler than that of the reference group (20.7°C vs 22.4°C). A potential physiological explanation for the distinct thermal perception of women aged over 40 and 50 or younger observed in this study could stem from menopausal symptoms-the presence of hot flushes and dysregulation of the thermoregulatory system.
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Affiliation(s)
- Jing Xiong
- The Indoor Environmental Laboratory, Sydney School of Architecture, Design and Planning, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Carter
- Thermal Ergonomics Laboratory, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Edward Arens
- Center for the Built Environment, University of California at Berkeley, Berkeley, CA, USA
| | - Hui Zhang
- Center for the Built Environment, University of California at Berkeley, Berkeley, CA, USA
| | - Max Deuble
- The Indoor Environmental Laboratory, Sydney School of Architecture, Design and Planning, The University of Sydney, Sydney, NSW, Australia
| | - Richard de Dear
- The Indoor Environmental Laboratory, Sydney School of Architecture, Design and Planning, The University of Sydney, Sydney, NSW, Australia
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21
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Bryson A, Conti G, Hardy R, Peycheva D, Sullivan A. The consequences of early menopause and menopause symptoms for labour market participation. Soc Sci Med 2021; 293:114676. [PMID: 34953416 DOI: 10.1016/j.socscimed.2021.114676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/06/2021] [Accepted: 12/20/2021] [Indexed: 10/19/2022]
Abstract
Using a difference-in-difference estimator we identify the causal impact of early menopause and menopause symptoms on the time women spend in employment through to their mid-50s. We find the onset of early natural menopause (before age 45) reduces months spent in employment by 9 percentage points once women enter their 50s compared with women who do not experience early menopause. Early menopause is not associated with a difference in full-time employment rates. The number of menopause symptoms women face at age 50 is associated with lower employment rates: each additional symptom lowers employment rates and full-time employment rates by around half a percentage point. But not all symptoms have the same effects. Vasomotor symptoms tend not to be associated with lower employment rates, whereas the employment of women who suffer psychological problems due to menopause is adversely affected. Every additional psychological problem associated with menopause reduces employment and full-time employment rates by 1-2 percentage points, rising to 2-4 percentage points when those symptoms are reported as particularly bothersome.
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Affiliation(s)
| | - Gabriella Conti
- UCL Social Research Institute, UK; UCL's Department of Economics, UK
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22
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Guidetti G, Viotti S, Converso D, Sottimano I. Work and health-related factors of presenteeism: a mediation analysis on the role of menopausal symptoms between job demands and presenteeism among a sample of social service women employees. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2021. [DOI: 10.1108/ijwhm-01-2021-0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeBuilding on prior studies on the role of health-related and job-related issues in affecting presenteeism, the present study tested a mediation model of the relationship between job demands and presenteeism by exploring the mediation effect of menopausal symptoms.Design/methodology/approachData were collected through a self-report questionnaire involving social service menopausal employees (N = 204) from a public municipal organization. The survey was cross-sectional and non-randomized.FindingsResults revealed that job demands, namely emotional, cognitive and physical demands, were significantly and positively associated with presenteeism. Furthermore, mediation analysis evidenced that physical job demands were also associated with higher levels of menopausal physical symptom bothersomeness, which in turn serves as a condition to increase the act of presenteeism.Originality/valueThe findings of this study widen the perspective on presenteeism research by evidencing the role of an overlooked health-related factor in relation to the act of presenteeism, that is the menopausal transition. Insights for the development of targeted preventive measures of the act of presenteeism and menopausal symptom management in the workplace may also be derived from these results.
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23
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Lipasti M, Jalava-Broman J, Sillanmäki L, Mäkinen J, Rautava P. Climacteric symptoms more severe in 2010 than in 2000 - experience of Finnish women aged 52-56 years not now or previously on menopausal hormone therapy. Maturitas 2021; 154:20-24. [PMID: 34736576 DOI: 10.1016/j.maturitas.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/15/2021] [Accepted: 09/02/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To analyze and compare the experience of climacteric symptoms and their associations with sociodemographic and health-related characteristics in two cohorts of Finnish women aged 52-56 years, born ten years apart and not now or previously on menopausal hormone therapy (MHT). STUDY DESIGN Nationwide population-based time-trend study with a large number of participants (n = 1986 + 1988). MAIN OUTCOME MEASURES The experience of climacteric symptoms was assessed by 12 commonly used menopause-related symptoms. RESULTS Women aged 52-56 experienced more moderate or severe symptoms and fewer mild symptoms in 2010 than in 2000. Being unemployed or inactive was associated with more severe symptoms (P = 0.007), but employment status had no effect on the relative odds estimates. CONCLUSIONS The influence of the birth cohort and time-period effects as well as work-related factors on the experience of climacteric symptoms in women not now or previously on MHT needs further research, particularly since the change in the experience of symptoms found in this study occurred within only ten years.
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Affiliation(s)
- Maija Lipasti
- Department of Public Health, University of Turku, Turku, Finland.
| | | | - Lauri Sillanmäki
- Department of Public Health, University of Turku, Turku, Finland; Research Services, Turku University Hospital, Turku, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Juha Mäkinen
- Department of Obstetrics and Gynaecology, University of Turku, Turku, Finland; Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, Turku, Finland; Research Services, Turku University Hospital, Turku, Finland
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24
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Carter S, Davis S, Black KI. Menopause workplace policy: The way forward or backward? Aust N Z J Obstet Gynaecol 2021; 61:986-989. [PMID: 34661905 DOI: 10.1111/ajo.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
Workplace policies regarding women's reproductive and menopausal health are garnering global attention. The peri- and post-menopause stages may be turbulent times for many women, with some experiencing debilitating symptoms and some none at all. While the symptoms of menopause should be recognised by employers due to their various impacts, the implementation of policies that pertain to all women can alienate older female workers by creating prejudice surrounding work capability. This piece identifies other avenues for the inclusion of menopausal symptoms through pre-existing policy and highlights the issues facing menopausal women in this current age.
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Affiliation(s)
- Sarah Carter
- Thermal Ergonomics Laboratory, Faculty of Medicine and Health, Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Susan Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kirsten I Black
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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25
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Viotti S, Guidetti G, Sottimano I, Travierso L, Martini M, Converso D. Do Menopausal Symptoms Affect the Relationship between Job Demands, Work Ability, and Exhaustion? Testing a Moderated Mediation Model in a Sample of Italian Administrative Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910029. [PMID: 34639331 PMCID: PMC8508446 DOI: 10.3390/ijerph181910029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/09/2021] [Accepted: 09/20/2021] [Indexed: 12/03/2022]
Abstract
(1) Background: The increasing presence of employed women undergoing menopause has stimulated a growing corpus of research highlighting the complex relationship between menopause and work. Nevertheless, little is known regarding the mechanism by which menopause affects work ability and work-related well-being. In order to fill this gap in the literature, the present study examines whether and how menopausal symptoms affect the relationship between job demands, work ability, and exhaustion. (2) Method: In total, 1069 menopausal women, employed as administrative officers in a public organization, filled out a self-report questionnaire. A moderated mediation analysis was carried out using the latent moderated structural (LMS) equation. (3) Findings: The findings of this analysis indicate that the indirect effect of work ability on the relationship between job demands and exhaustion is influenced by the exacerbating effect of menopausal symptoms on the relationship between job demands and work ability. Moreover, the conditional effect confirmed that women with high menopausal symptoms receive more exposure to the negative effects of job demands on work ability compared to women with low menopausal symptoms. (4) Conclusion: The present findings may help in addressing interventions to prevent negative outcomes for menopausal women and their organizations.
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Affiliation(s)
- Sara Viotti
- Dipartimento di Psicologia, Università Degli Studi di Torino, 10124 Torino, Italy; (I.S.); (L.T.); (M.M.); (D.C.)
- Correspondence: (S.V.); (G.G.)
| | - Gloria Guidetti
- Dipartimento di Scienze Psicologiche, Della Salute e Del Territorio, Università di Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: (S.V.); (G.G.)
| | - Ilaria Sottimano
- Dipartimento di Psicologia, Università Degli Studi di Torino, 10124 Torino, Italy; (I.S.); (L.T.); (M.M.); (D.C.)
| | - Lucia Travierso
- Dipartimento di Psicologia, Università Degli Studi di Torino, 10124 Torino, Italy; (I.S.); (L.T.); (M.M.); (D.C.)
| | - Mara Martini
- Dipartimento di Psicologia, Università Degli Studi di Torino, 10124 Torino, Italy; (I.S.); (L.T.); (M.M.); (D.C.)
| | - Daniela Converso
- Dipartimento di Psicologia, Università Degli Studi di Torino, 10124 Torino, Italy; (I.S.); (L.T.); (M.M.); (D.C.)
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Okhai H, Sabin CA, Haag K, Sherr L, Dhairyawan R, Burns F, Gilson R, Post F, Ross J, Mackie N, Sullivan A, Shepherd J, Tariq A, Jones R, Fox J, Rosenvinge M, Tariq S. Menopausal status, age and management among women living with HIV in the UK. HIV Med 2021; 22:834-842. [PMID: 34309177 DOI: 10.1111/hiv.13138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/15/2021] [Accepted: 06/07/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND There is currently little evidence exploring menopausal status, age at last menstrual period (LMP) and management of menopause among women living with HIV aged 45-60 years in England. METHODS Socio-demographic, lifestyle and clinical data were collected through a self-completed cross-sectional survey. Longitudinal CD4 count and viral load data were available from linkage to clinical records, if consent was provided. Women were categorised as pre-, peri- or post-menopausal. Factors associated with menopausal stage were examined using ordinal logistic regression adjusting for age. Age at LMP was estimated using Kaplan-Meier survival analysis. RESULTS The 847 women had a median age of 49 [interquartile range (IQR): 47-52] years. Most were of black ethnicity (81.3%), were born outside the UK (85.0%) and had completed secondary education (88.7%); 177 (20.4%), 373 (43.0%) and 297 (34.2%) were pre-, peri- or post-menopausal, respectively. After adjusting for age, associations of menopausal status with non-cohabiting relationship [adjusted odds ratio = 0.63 (95% confidence interval: 0.43-0.91)], baseline viral load ≥ 100 000 copies/mL [2.67 (1.20-5.94)] and unemployment [1.34 (0.97-1.84)] remained significant. Median (IQR) age at LMP was 54 (51-55) years in the group. In total, 27.9% (233/836) of women reported severe menopausal symptoms; 45.6% of those with somatic symptoms had heard of hormone replacement therapy and 8.7% had used it. Only 5.6% of women with urogenital symptoms had used topical oestrogen. CONCLUSIONS Our findings highlight the importance of educating both women and their healthcare providers about menopausal symptoms and management options.
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Affiliation(s)
- Hajra Okhai
- Institute for Global Health, University College London, London, UK
| | - Caroline A Sabin
- Institute for Global Health, University College London, London, UK
| | - Katharina Haag
- Institute for Global Health, University College London, London, UK
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | | | - Fiona Burns
- Institute for Global Health, University College London, London, UK.,Royal Free London NHS Foundation Trust, London, UK
| | - Richard Gilson
- Institute for Global Health, University College London, London, UK
| | - Frank Post
- King's College Hospital NHS Foundation Trust, London, UK
| | - Jonathan Ross
- University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Ann Sullivan
- Chelsea and Westminster Healthcare NHS Foundation Trust, London, UK
| | | | - Anjum Tariq
- The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Rachael Jones
- Chelsea and Westminster Healthcare NHS Foundation Trust, London, UK
| | - Julie Fox
- King's College Hospital NHS Foundation Trust, London, UK
| | | | - Shema Tariq
- Institute for Global Health, University College London, London, UK
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Global consensus recommendations on menopause in the workplace: A European Menopause and Andropause Society (EMAS) position statement. Maturitas 2021; 151:55-62. [PMID: 34274202 DOI: 10.1016/j.maturitas.2021.06.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Worldwide, there are 657 million women aged 45-59 and around half contribute to the labor force during their menopausal years. There is a diversity of experience of menopause in the workplace. It is shaped not only by menopausal symptoms and context but also by the workplace environment. It affects quality of life, engagement, performance, motivation and relations with employers. AIM To provide recommendations for employers, managers, healthcare professionals and women to make the workplace environment more menopause supportive, and to improve women's wellbeing and their ability to remain in work. MATERIALS AND METHODS Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS Workplace health and wellbeing frameworks and policies should incorporate menopausal health as part of the wider context of gender and age equality and reproductive and post-reproductive health. Workplaces should create an open, inclusive and supportive culture regarding menopause, involving, if available, occupational health professionals and human resource managers working together. Women should not be discriminated against, marginalized or dismissed because of menopausal symptoms. Health and allied health professionals should recognize that, for some women, menopausal symptoms can adversely affect the ability to work, which can lead to reduction of working hours, underemployment or unemployment, and consequently financial insecurity in later life.
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Maas AHEM, Rosano G, Cifkova R, Chieffo A, van Dijken D, Hamoda H, Kunadian V, Laan E, Lambrinoudaki I, Maclaran K, Panay N, Stevenson JC, van Trotsenburg M, Collins P. Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists. Eur Heart J 2021; 42:967-984. [PMID: 33495787 PMCID: PMC7947184 DOI: 10.1093/eurheartj/ehaa1044] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/29/2020] [Accepted: 12/08/2020] [Indexed: 12/13/2022] Open
Abstract
Women undergo important changes in sex hormones throughout their lifetime that can impact cardiovascular disease risk. Whereas the traditional cardiovascular risk factors dominate in older age, there are several female-specific risk factors and inflammatory risk variables that influence a woman’s risk at younger and middle age. Hypertensive pregnancy disorders and gestational diabetes are associated with a higher risk in younger women. Menopause transition has an additional adverse effect to ageing that may demand specific attention to ensure optimal cardiovascular risk profile and quality of life. In this position paper, we provide an update of gynaecological and obstetric conditions that interact with cardiovascular risk in women. Practice points for clinical use are given according to the latest standards from various related disciplines (Figure 1).
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Affiliation(s)
- Angela H E M Maas
- Department of Cardiology, Director Women's Cardiac Health Program, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Route 616, 6525GA Nijmegen, The Netherlands
| | - Giuseppe Rosano
- St George's Hospitals NHS Trust University of London, Cranmer Terrace, London SW17 0RE, UK.,Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, via della Pisana, 235 Rome, Italy
| | - Renata Cifkova
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Vídeňská 800, 140 59 Prague 4, Czech Republic.,Department of Internal Cardiovascular Medicine, First Medical Faculty, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic
| | - Alaide Chieffo
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Olgettina Street, 60 - 20132 Milan (Milan), Italy
| | - Dorenda van Dijken
- Department of Obstetrics and Gynaecology, OLVG location West, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands
| | - Haitham Hamoda
- Department Gynaecology, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, M4:146 4th Floor William Leech Building, Newcastle upon Tyne NE2 4HH, UK
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Irene Lambrinoudaki
- Menopause Clinic, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, 30 Panepistimiou Str., 10679 Athens, Greece
| | - Kate Maclaran
- Department Gynaecology, Chelsea and Westminster Hospital, NHS Foundation Trust, 69 Fulham Road London SW10 9NH, UK
| | - Nick Panay
- Department of Gynaecology, Queen Charlotte's & Chelsea and Westminster Hospitals, Imperial College, Du Cane Road, London W12 0HS, UK
| | - John C Stevenson
- Department of Cardiology, National Heart & Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
| | - Mick van Trotsenburg
- Bureau Gender PRO Vienna and Department of Obstetrics and Gynaecology, University Hospital St. Poelten-Lilienfeld, Probst Führer Straße 4 · 3100 St. Pölten, Austria
| | - Peter Collins
- Department of Cardiology, National Heart & Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
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Kanadys W, Barańska A, Błaszczuk A, Polz-Dacewicz M, Drop B, Kanecki K, Malm M. Evaluation of Clinical Meaningfulness of Red Clover ( Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2021; 13:nu13041258. [PMID: 33920485 PMCID: PMC8069620 DOI: 10.3390/nu13041258] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/03/2021] [Accepted: 04/09/2021] [Indexed: 12/18/2022] Open
Abstract
The meta-analysis presented in this article covered the efficacy of red clover isoflavones in relieving hot flushes and menopausal symptoms in perimenopausal and postmenopausal women. Studies were identified by MEDLINE (PubMed), Embase, and the Cochrane Library searches. The quality of the studies was evaluated according to Cochrane criteria. A meta-analysis of eight trials (ten comparisons) demonstrated a statistically significant reduction in the daily incidence of hot flushes in women receiving red clover compared to those receiving placebo: weighted mean difference (WMD—weighted mean difference) −1.73 hot flushes per day, 95% CI (confidence interval) −3.28 to −0.18; p = 0.0292. Due to 87.34% homogeneity, the performed analysis showed substantive difference in comparisons of postmenopausal women with ≥5 hot flushes per day, when the follow-up period was 12 weeks, with an isoflavone dose of ≥80 mg/day, and when the formulations contained a higher proportion of biochanin A. The meta-analysis of included studies assessing the effect of red clover isoflavone extract on menopausal symptoms showed a statistically moderate relationship with the reduction in the daily frequency of hot flushes. However, further well-designed studies are required to confirm the present findings and to finally determine the effects of red clover on the relief of flushing episodes.
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Affiliation(s)
- Wiesław Kanadys
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
| | - Agnieszka Barańska
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
- Correspondence:
| | - Agata Błaszczuk
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Małgorzata Polz-Dacewicz
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Bartłomiej Drop
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
| | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Warsaw Medical University, 02-007 Warsaw, Poland;
| | - Maria Malm
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
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Talking about menopause in the workplace. Case Rep Womens Health 2021; 30:e00306. [PMID: 33796445 PMCID: PMC7995468 DOI: 10.1016/j.crwh.2021.e00306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 12/31/2022] Open
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Belém D, da Silva Filho CR, Jacinto AF, França AB, Conterno LO. Influence of overcommitment on the quality of life and on climacteric symptoms in nursing professionals. Rev Gaucha Enferm 2021; 42:e20190374. [PMID: 33656162 DOI: 10.1590/1983-1447.2021.20190374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 08/19/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the general characteristics of nursing professionals and assess the influence of overcommitment on perceived climacteric symptoms and on the quality of life of nursing professionals. METHOD A cross-sectional, analytical study of 152 nursing auxiliaries and assistants aged 40 years or older was conducted at 3 hospitals in the interior of São Paulo state. Sociodemographic data were collected and the Blatt-Kupperman Menopausal Index, Women´s Health Questionnaire, Medical Outcome Study 36-item Short Form Health Survey and Effort-Reward Imbalance were applied in 2017. A descriptive analysis was performed and network analysis was carried out. RESULTS Participants had a mean age of 50.23 years (SD ±7.1). Group 1 comprising 61 (40.1%) women with overcommitment had poorer quality of life as well as more severe climacteric symptoms. CONCLUSIONS Presence of overcommitment seems to influence the negative perception of climacteric symptomatology and quality of life.
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Affiliation(s)
- Dinah Belém
- Faculdade de Medicina de Marília (FAMEMA), Departamento de Clínica Médica. Marília, São Paulo, Brasil
| | | | - Alessandro Ferrari Jacinto
- Universidade Federal de São Paulo (UNIFESP), Disciplina de Geriatria e Gerontologia. São Paulo, São Paulo, Brasil
| | - Alex Bacadini França
- Universidade Federal de São Carlos (UFSCAR), Laboratório de Desenvolvimento e Cognição Humana. São Carlos, São Paulo, Brasil
| | - Lucieni Oliveira Conterno
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Clínica Médica. Campinas, São Paulo, Brasil
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Waldorff FB, Bang CW, Siersma V, Brodersen J, Lund KS. Factors associated with a clinically relevant reduction in menopausal symptoms of a standardized acupuncture approach for women with bothersome menopausal symptoms. BMC Complement Med Ther 2021; 21:29. [PMID: 33441145 PMCID: PMC7805030 DOI: 10.1186/s12906-021-03208-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/05/2021] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about factors associated with a clinically relevant reduction in menopausal symptoms through a brief acupuncture approach for women with moderate-to-severe menopausal symptoms. Methods Post hoc analysis of a randomized controlled trial where participants were allocated to early versus late standardized acupuncture. Both the early group and the late group are included in this study. The late group got an identical intervention parallel staged by 6 weeks. By means of the relative importance, the effect was evaluated for both early versus late women with a 6-week follow-up. We included four symptom subscales from the validated MenoScores Questionnaire: hot flushes, day and night sweats, general sweating, menopausal-specific sleeping problems, as well as an overall score, which is the sum of the four outcomes in the analysis. Results 67 women with moderate to severe menopausal symptoms were included of whom 52 (77.6%) experienced a clinically relevant reduction in any of the four surveyed symptom subscales or overall score. 48 (71.6%) women experienced a clinically relevant reduction in any of the vasomotor symptom subscales: hot flushes, day and night sweats, general sweating. Women with vocational education were most likely to experience improvement compared to women with higher education. Beyond education, other factors of some importance for a clinically relevant reduction were no alcohol consumption, two or more births and urinary incontinence. Conclusions Level of education was the most consistent factor associated with improvement. Beyond education, other factors of some importance were no alcohol consumption, two or more births and urinary incontinence. Trial registration This study was registered in ClinicalTrials.gov at April 21, 2016. The registration number is NCT02746497.
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Affiliation(s)
- Frans Boch Waldorff
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. .,Department of Public Health, University of Southern Denmark, Research Unit of General Practice, Odense, Denmark.
| | - Christine Winther Bang
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Primary Health Care Research Unit, Region Zealand, Sorø, Denmark
| | - Kamma Sundgaard Lund
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Relationship between number of menopausal symptoms and work performance in Japanese working women. ACTA ACUST UNITED AC 2020; 28:175-181. [PMID: 33235035 DOI: 10.1097/gme.0000000000001698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The presence of various menopausal symptoms could decrease work performance because symptom management strategies differ, and it is difficult to control all symptoms at work. The aim of this study was to examine the relationship between the number of menopausal symptoms experienced and work performance in working women. METHODS An online cross-sectional study was conducted with 599 working Japanese women aged 45 to 65 years. To represent work performance, absolute presenteeism was measured using the Japanese version of the World Health Organization and Work Performance Questionnaire short form, and menopausal symptoms were measured using the Greene Climacteric Scale. The total number of subscales on which a participant scored more than one point represented the number of menopausal symptoms. RESULTS Participants' mean age was 54.2 years, and 60.6% were postmenopausal. Their mean Greene Climacteric Scale score and mean absolute presenteeism score were 10.5 ± 10.6 and 61.7 ± 17.9, respectively. The proportions of participants who provided care for a family member, who had chronic disease, and who undertook regular exercise were significantly different among the four groups. After adjusting for other factors, absolute presenteeism was negatively correlated with the number of menopausal symptoms experienced (β = -0.13, P < 0.001). CONCLUSIONS Higher numbers of menopausal symptoms were correlated with lower work performance. The maintenance of health and the provision of appropriate working environments would help working women and improve work performance by reducing menopausal symptoms.
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Evandrou M, Falkingham J, Qin M, Vlachantoni A. Menopausal transition and change in employment: Evidence from the National Child Development Study. Maturitas 2020; 143:96-104. [PMID: 33308643 DOI: 10.1016/j.maturitas.2020.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 09/15/2020] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study aims to investigate the impact of the menopausal transition and severe symptoms on changes in employment. STUDY DESIGN This longitudinal prospective study analysed data from a population-based cohort study, the UK National Child Development Study Wave 8 and Wave 9, when the cohort was aged 50 and 55 respectively. The analytical sample comprised 3109 employed women at age 50. MEASURES The outcome variable was the employment change from age 50 to age 55, with three categories: i) continued employed without reduced working time; ii) continued employed with reduced working hours; and iii) exit employment. The employment dynamics of women were compared using multinomial logistic regression modelling. Key independent variables included menopausal transition status and severe menopausal symptoms experienced. RESULTS 53.5 % of employed women at age 50 reported at least one severe menopausal symptom. Women experiencing severe menopausal symptoms had a higher chance of employment exit or reducing their working hours. The odds ratios contrasting severely symptomatic women with those with no severe symptoms were 1.43 (95 % CI = 1.11-1.84) between exiting employment vs continued employment without reducing working hours, and 1.23 (95 % CI = 1.02-1.48) between reducing working hours vs continued employment without reducing working hours. The strength of the association between women's severe menopausal symptoms and the risk of employment exit or reducing working hours varied according to their HRT usage and their partner's economic activity. CONCLUSIONS Menopausal symptoms can pose obstacles to some middle-aged women in terms of remaining in employment or maintaining their number of working hours.
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Affiliation(s)
- Maria Evandrou
- Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK; ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Jane Falkingham
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
| | - Min Qin
- Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK; ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
| | - Athina Vlachantoni
- Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK; ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
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Verburgh M, Verdonk P, Appelman Y, Brood-van Zanten M, Nieuwenhuijsen K. "I Get That Spirit in Me"-Mentally Empowering Workplace Health Promotion for Female Workers in Low-Paid Jobs during Menopause and Midlife. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186462. [PMID: 32899848 PMCID: PMC7558098 DOI: 10.3390/ijerph17186462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/30/2020] [Accepted: 09/01/2020] [Indexed: 12/19/2022]
Abstract
During menopause and midlife, female workers, particularly those in low-paid jobs, experience more occupational health problems than other groups of workers. Workplace interventions are often lacking, however. In the Netherlands, a workplace health promotion intervention—the work–life program (WLP)—has been developed to support female workers. Here, we tailored the WLP to the needs of female workers in low-paid jobs working at Amsterdam University Medical Center. In an exploratory mixed-methods study with a convergent design, among 56 participants, we used questionnaires before and after the intervention and semi-structured, in-depth interviews to address the following research question: What is the impact of the WLP on the women’s health and work functioning? Our quantitative data showed that menopausal symptoms improved significantly after the WLP. Our qualitative data, derived from 12 participants, showed that the WLP initiated a process of mental empowerment that initiated positive changes in four domains: behavior, physical health, mental wellbeing, and in the workplace. Taken with caution, our findings suggest that the WLP mentally empowers female workers to make choices that enhance their health and wellbeing, both at work and in their private lives, as summarized in the quote of one participant: “I get that spirit in me!”.
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Affiliation(s)
- Marjolein Verburgh
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC University of Amsterdam, Meibergdreef 9, P.O. Box 22660, 1100 DE Amsterdam, The Netherlands;
- Correspondence: ; Tel.: +31-020-566-5341
| | - Petra Verdonk
- Department Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC VU University, Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands;
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC VU University, Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands;
| | - Monique Brood-van Zanten
- Department of Gynecology, Amsterdam UMC University of Amsterdam, Meibergdreef 9, P.O. Box 22660, 1100 DE Amsterdam, The Netherlands;
- Department of Gynecology, The Netherlands Cancer Institute, Plesmanlaan 121, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Karen Nieuwenhuijsen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC University of Amsterdam, Meibergdreef 9, P.O. Box 22660, 1100 DE Amsterdam, The Netherlands;
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36
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Attitude, confidence and social norm of Dutch occupational physicians regarding menopause in a work context. Maturitas 2020; 139:27-32. [DOI: 10.1016/j.maturitas.2020.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 11/18/2022]
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Rindner L, Nordeman L, Strömme G, Svenningsson I, Premberg Å, Hange D, Gunnarsson R, Rembeck G. Prognostic factors for future mental, physical and urogenital health and work ability in women, 45-55 years: a six-year prospective longitudinal cohort study. BMC Womens Health 2020; 20:171. [PMID: 32787825 PMCID: PMC7425146 DOI: 10.1186/s12905-020-01015-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 07/07/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Impaired health due to stress is a common cause of long-term illness in women aged 45-55 years. It is a common cause for visits to primary health care (PHC) and may influence work-ability. The aim of this study was to investigate prognostic factors for future mental, physical and urogenital health as well as work-ability in a population of average women aged 45-55 years. METHODS This longitudinal cohort study initially assessed 142 women from PHC centers in southwestern Sweden. One houndred and ten accepted participation and were followed for 6 years. They were assessed using the self-reported questionnaires: the Menopause Rating Scale (MRS), the Montgomery-Asberg Depression Rating Scale (MADRS-S), the Short-Form Health Survey (SF-36). Descriptive data are presented of health, education, relationships and if they are working. Multicollinearity testing and logistic regression were used to test the explanatory variables. RESULT Severity of symptoms in the MRS somatic and urogenital domains decreased while they increased in the psychological and depressive domains. Having tertiary education was associated with decreased overall mental health, vitality and social role functioning. Living with a partner was associated with increased physical role functioning, social role functioning and emotional role functioning. CONCLUSION Quality of life seems to be enhanced by a good relationship with the partner, social support and work/life balance. Therefore, to improve women health women should early discuss ways in which these issues can be incorporated as they pursue their academic or career goals. Hence, we emphasize the importance of supporting women to gain increased awareness about a healthy life balance and to have realistic goals in work as well as in their social life.
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Affiliation(s)
- Lena Rindner
- Närhälsan, Södra Torget Health Care Center, Kvarngatan 4, SE-503 36 Borås, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Nordeman
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Institute of Neuroscience and Physiology Department of Health and Rehabilitation, Unit of Physiotherapy, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Gunilla Strömme
- Närhälsan, Södra Torget Health Care Center, Kvarngatan 4, SE-503 36 Borås, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
| | - Irene Svenningsson
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Fyrbodal, Gothenburg, Sweden
| | - Åsa Premberg
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Dominique Hange
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Närhälsan, Svenljunga Health Care Center, Svenljunga, Sweden
| | - Ronny Gunnarsson
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gun Rembeck
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Närhälsan Borås Youth Centre, Region Västra Götaland, Borås, Sweden
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Lund KS, Siersma V, Bang CW, Brodersen J, Waldorff FB. Sustained effects of a brief and standardised acupuncture approach on menopausal symptoms: post hoc analysis of the ACOM randomised controlled trial. Acupunct Med 2020; 38:396-406. [PMID: 32517477 DOI: 10.1177/0964528420920280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Our objective was to investigate whether the effect of a brief and standardised acupuncture approach persists after the end of the acupuncture treatment (post-treatment effect) and whether the anticipation of future acupuncture treatment affects menopausal symptoms (pre-treatment effect). METHOD This study is a post hoc analysis of data from a randomised controlled trial where women with moderate to severe menopausal symptoms were offered weekly acupuncture treatment over five consecutive weeks and randomised (1:1) to an early intervention group that received treatment immediately and a late intervention group with a 6-week delay. The acupuncture style was Western medical, administered at CV3, CV4 and bilateral LR8, SP6 and SP9. Acupuncturists were general practitioners. The effect was evaluated repeatedly during and after the interventions using scales from the validated MenoScores Questionnaire (MSQ) for hot flushes (HF), day and night sweats (DNS), general sweating (GS) and menopausal-specific sleeping problems (MSSP) with a 26-week follow-up period (corresponding to 21 or 15 weeks post-treatment for the early and late intervention groups, respectively). Multivariable linear mixed models were used to analyse the extent and duration of effects. RESULTS Seventy participants were included in the study. Four participants dropped out. Furthermore, one participant was excluded from the short- and long-term follow-up analyses after the insertion of a hormonal intrauterine device, and nine participants were excluded from the long-term follow-up analysis due to the initiation of co-interventions. For each of the four outcomes, the effect was sustained up to 21 weeks post-treatment with an effect size that was only slightly diminished. A small, but significant, pre-treatment effect was observed in the HF scale scores. The same trend, although not significant, was observed in the DNS and MSSP scale scores. No serious harms were reported. CONCLUSION This study demonstrated that the overall effect of a brief and standardised acupuncture treatment on menopause-relevant outcomes was sustained up to 21 weeks post-treatment and that there was a small pre-treatment effect.
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Affiliation(s)
- Kamma Sundgaard Lund
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christine Winther Bang
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Primary Health Care Research Unit, Region Zealand, Koege, Denmark
| | - Frans Boch Waldorff
- The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Stenner HT, Eigendorf J, Kerling A, Kueck M, Hanke AA, Boyen J, Nelius AK, Melk A, Boethig D, Bara C, Hilfiker A, Berliner D, Bauersachs J, Hilfiker-Kleiner D, Eberhard J, Stiesch M, Schippert C, Haverich A, Tegtbur U, Haufe S. Effects of six month personalized endurance training on work ability in middle-aged sedentary women: a secondary analysis of a randomized controlled trial. J Occup Med Toxicol 2020; 15:8. [PMID: 32391068 PMCID: PMC7201966 DOI: 10.1186/s12995-020-00261-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background To test the effects of guided endurance training on work ability in middle-aged female hospital workers of various occupations. Methods We randomized 265 healthy, sedentary, middle-aged women (45–65 years) to an endurance training group (EG 210 min/week) or a wait-list control group (CG). At baseline and at 6-month follow-up, we assessed work ability (Work Ability Index [WAI]), physical activity (Freiburger activity questionnaire) and peak oxygen uptake (VO2peak) by cardiopulmonary exercise testing. To examine the influence of baseline work ability, participants were divided into poor-moderate (WAI 1, 7–36 points, n = 83), good (WAI 2, 37–43 points, n = 136) and excellent (WAI 3, 44–49 points, n = 46) WAI subgroups. Results Cardiorespiratory fitness improved significantly after 6 months in the EG but not in the CG. The WAI total score increased significantly in the EG (38.3 ± 5.0 to 39.8 ± 4.9 points) but not in the CG (39.4 ± 4.7 to 39.3 ± 4.9 points), with a significant difference between groups (p < 0.01). In the EG, only the poor-moderate subgroup (WAI 1, 33.0 ± 2.9 to 36.6 ± 4.8 points, p < 0.05) increased the WAI total score, with this increase being significantly higher compared to the good (WAI 2, 40.2 ± 2.1 to, 40.4 ± 3.7 points) and excellent (WAI 3, 45.6 ± 1.5 to 45.7 ± 1.8 points) subgroup. Conclusions A 6-month guided exercise training intervention significantly increases cardiorespiratory fitness with concomitant improvements in work ability in middle-aged previously sedentary hospital employees. Women with low baseline work ability seem to particularly benefit from the intervention, which implies that similar interventions may be particularly beneficial for this group of individuals. Trial registration German Clinical Trails Register Identifier: DRKS00005159. Registered 25 September 2013.
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Affiliation(s)
- Hedwig T Stenner
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Julian Eigendorf
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Arno Kerling
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Momme Kueck
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Alexander A Hanke
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Johanna Boyen
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Anne-Katrin Nelius
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Anette Melk
- 2Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Dietmar Boethig
- 3Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Christoph Bara
- 3Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Andres Hilfiker
- 3Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Dominik Berliner
- 4Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Johann Bauersachs
- 4Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Denise Hilfiker-Kleiner
- 4Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Jörg Eberhard
- 5Department of Prosthetic Dentistry and Biomedical Material Sciences, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Meike Stiesch
- 5Department of Prosthetic Dentistry and Biomedical Material Sciences, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Cordula Schippert
- 6Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Axel Haverich
- 3Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Uwe Tegtbur
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Sven Haufe
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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Viotti S, Guidetti G, Converso D, Sottimano I. Fostering Work Ability Among Menopausal Women. Does Any Work-Related Psychosocial Factor Help? Int J Womens Health 2020; 12:399-407. [PMID: 32440234 PMCID: PMC7213898 DOI: 10.2147/ijwh.s230796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/21/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Due to the aging workforce, it will become even more common for organizations to count, among their employees, women who are dealing with menopause. To date, no knowledge is available regarding the work ability among menopausal women. With this view, the aim of the present study was to identify work-related psychosocial factors associated with work ability in a sample of menopausal working women. Methods A self-report questionnaire was administered to 1069 menopausal women employed as administrative officers in the Italian public sector. The study design was cross-sectional. Results Work ability was found to be negatively associated with family–work conflict (β = −0.21, p = 0.0001) and positively associated with health-oriented organizational climate (β = 0.12, p = 0.0001), job autonomy (β = 0.08, p= 0.006), and skill discretion (β = 0.08, p= 0.048). Conversely, work ability did not show significant associations with job demands, flexible working hours, and social support. Discussion From a practical point of view, our study identifies various areas of intervention that could foster job sustainability during menopause. In particular, our findings suggest that, to improve women’s job sustainability across their entire work-life span, it may be crucial to develop organizational policies, training, and activities specifically dedicated to sustaining menopausal women’s well-being.
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Affiliation(s)
- Sara Viotti
- Department of Psychology, University of Turin, Turin, Italy
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He Q, Ren Y, Wang Y, Zhang F, Zhang S. The efficacy and safety of acupuncture for perimenopause symptom compared with different sham acupuncture control groups: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e19366. [PMID: 32150082 PMCID: PMC7478674 DOI: 10.1097/md.0000000000019366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Perimenopause is a period that every woman must go through, most people are more or less affected by perimenopausal symptoms, it to affect women's health, work, life, and economy. As acupuncture treatment is more and more increasing in perimenopausal symptoms, there have also been many clinical trials about it. But the results of the trials are inconsistent. Therefore, we will conduct a systematic review and meta-analysis of the safety and efficacy of perimenopausal symptoms treated with acupuncture. METHODS The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. RCT study on different acupuncture interventions for perimenopausal symptoms will be searched in 8 databases (PubMed, EMBASE, the Cochrane Library, the web of science, CBM, CNKI, WAN FANG, and VIP). Besides, the search will also be performed on the clinical trial research platform if necessary. The primary outcome that will be extracted: the Flushes per 24 hours, the Frequency of hot flashes, the severity of hot flashes, the menopause-related symptom score, the treatment efficacy, the adverse event. Endnote software X8 will be used for study selection, STATA 13.0 and Review Manager software 5.3 will be used for analysis and synthesis. These studies selection, data extraction, and risk of bias assessment will be conducted by 2 independent reviewers. RESULTS This study will provide the results: 1. the primary and secondary outcome indicators of different acupuncture intervention measures (traditional hand acupuncture, moxibustion, ear acupuncture, laser, acupressure points) for perimenopausal symptoms. 2. The effects of different control groups (medicine control, routine care, waiting, and sham acupuncture control) on the analysis results will be reported, especially the effects of different sham acupuncture control (invasive/noninvasive) on the analysis results. CONCLUSION This systematic review and meta-analysis study hopes to provide useful evidence for better use of different types of acupuncture in treat perimenopausal symptoms and better design of control groups in related clinical trials. In addition, the research conclusion will be published in peer journals.OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/VZCKU Ethics and dissemination This conclusion of the study will be published in peer journals. The ethical approval is not required because there is no direct involvement of human.
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Affiliation(s)
- Qiujun He
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine
| | - Yajing Ren
- Chengdu University of Traditional Chinese Medicine
| | | | - Feng Zhang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Sanyin Zhang
- Chengdu University of Traditional Chinese Medicine
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Converso D, Viotti S, Sottimano I, Loera B, Molinengo G, Guidetti G. The relationship between menopausal symptoms and burnout. A cross-sectional study among nurses. BMC WOMENS HEALTH 2019; 19:148. [PMID: 31775724 PMCID: PMC6882317 DOI: 10.1186/s12905-019-0847-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/14/2019] [Indexed: 01/10/2023]
Abstract
Background Despite the growing presence of menopausal women in workplaces, studies aimed at exploring the link between menopausal symptoms and job well-being are scarce. In the interest of addressing this gap, the present study aimed to explore whether menopausal symptoms might contribute to increased levels of burnout and whether this relationship can be moderated by social or personal resources. Method The study design was cross-sectional and non-randomized. Ninety-four menopausal nurses completed a self-report questionnaire including scales aimed at measuring menopausal symptoms, burnout, social (i.e., support from superiors and colleagues) and personal (i.e., self-efficacy, resilience, and optimism) resources. Moderated regression analyses were performed to test study hypotheses. Results Whereas menopausal symptoms were associated significantly with emotional exhaustion, no social or personal resources were found to moderate this relationship. Regarding depersonalization, our study indicated that it was affected by menopausal symptoms only among nurses who reported low social support (from superiors and colleagues), optimism, and resilience. Conclusion The present study highlights the importance of organizations that employ a growing number of menopausal women to seek solutions at the individual and social levels that help these women deal with their menopausal transition while working.
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Affiliation(s)
- Daniela Converso
- Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
| | - Sara Viotti
- Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy.
| | - Ilaria Sottimano
- Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
| | - Barbara Loera
- Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
| | - Giorgia Molinengo
- Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
| | - Gloria Guidetti
- Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
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Raczkiewicz D, Bojar I, Humeniuk E. Work ability, functional exercise capacity and prevalence of obesity in perimenopausal and postmenopausal women with non-manual employment. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:970-978. [PMID: 31584355 DOI: 10.1080/10803548.2019.1676565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective. This study aimed to evaluate work ability and functional exercise capacity, and their correlation to each other and to obesity, in perimenopausal and postmenopausal women with non-manual employment. Materials and methods. The study included 300 women aged 44-66 years. The following measures were used: work ability index (WAI), 6-min walk test (6MWT), body mass index (BMI), waist-hip ratio (WHR) and adipose tissue accumulation. Regression models of the WAI and distance in the 6MWT were estimated. Results. The examined women obtained WAI 39.0 ± 5.0, BMI 26.2 ± 4.6, WHR 0.819 ± 0.060 and adipose tissue accumulation 30.1 ± 6.1%, on average. About 19% of women obtained a very good work ability score, 55% good, 23% medium and 3% poor. About 17% of women were obese, 39% overweight and 44% normal body mass, 29% had abdominal obesity, 19% had elevated accumulation of adipose tissue and 21% had high accumulation of adipose tissue. These results did not differ significantly between perimenopausal and postmenopausal women The postmenopausal women obtained a significantly lower functional exercise capacity score than perimenopausal women. Conclusion. Work ability correlates positively to functional exercise capacity, which correlates negatively to adipose tissue accumulation in perimenopausal women with non-manual employment, but not in postmenopausal cases.
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Affiliation(s)
- Dorota Raczkiewicz
- Institute of Statistics and Demography, SGH Warsaw School of Economics, Poland
| | - Iwona Bojar
- Department of Women's Health, Institute of Rural Health in Lublin, Poland
| | - Ewa Humeniuk
- Department of Pathology and Rehabilitation of Speech, Medical University of Lublin, Poland
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Bayrı Bingöl F, Demirgöz Bal M, Yılmaz Esencan T, ERTUGRUL ABBASOGLU D, Aslan B. THE EFFECTS OF LONELINESS ON MENOPAUSAL COMPLAINTS. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2019. [DOI: 10.33808/clinexphealthsci.533511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Dodda BR, Bondi CD, Hasan M, Clafshenkel WP, Gallagher KM, Kotlarczyk MP, Sethi S, Buszko E, Latimer JJ, Cline JM, Witt-Enderby PA, Davis VL. Co-administering Melatonin With an Estradiol-Progesterone Menopausal Hormone Therapy Represses Mammary Cancer Development in a Mouse Model of HER2-Positive Breast Cancer. Front Oncol 2019; 9:525. [PMID: 31355130 PMCID: PMC6636553 DOI: 10.3389/fonc.2019.00525] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/30/2019] [Indexed: 12/20/2022] Open
Abstract
Melatonin has numerous anti-cancer properties reported to influence cancer initiation, promotion, and metastasis. With the need for effective hormone therapies (HT) to treat menopausal symptoms without increasing breast cancer risk, co-administration of nocturnal melatonin with a natural, low-dose HT was evaluated in mice that develop primary and metastatic mammary cancer. Individually, melatonin (MEL) and estradiol-progesterone therapy (EPT) did not significantly affect mammary cancer development through age 14 months, but, when combined, the melatonin-estradiol-progesterone therapy (MEPT) significantly repressed tumor formation. This repression was due to effects on tumor incidence, but not latency. These results demonstrate that melatonin and the HT cooperate to decrease the mammary cancer risk. Melatonin and EPT also cooperate to alter the balance of the progesterone receptor (PR) isoforms by significantly increasing PRA protein expression only in MEPT mammary glands. Melatonin significantly suppressed amphiregulin transcripts in MEL and MEPT mammary glands, suggesting that amphiregulin together with the higher PRA:PRB balance and other factors may contribute to reducing cancer development in MEPT mice. Melatonin supplementation influenced mammary morphology by increasing tertiary branching in the mouse mammary glands and differentiation in human mammary epithelial cell cultures. Uterine weight in the luteal phase was elevated after long-term exposure to EPT, but not to MEPT, indicating that melatonin supplementation may reduce estrogen-induced uterine stimulation. Melatonin supplementation significantly decreased the incidence of grossly-detected lung metastases in MEL mice, suggesting that melatonin delays the formation of metastatic lesions and/or decreases aggressiveness in this model of HER2+ breast cancer. Mammary tumor development was similar in EPT and MEPT mice until age 8.6 months, but after 8.6 months, only MEPT continued to suppress cancer development. These data suggest that melatonin supplementation has a negligible effect in young MEPT mice, but is required in older mice to inhibit tumor formation. Since melatonin binding was significantly decreased in older mammary glands, irrespective of treatment, melatonin supplementation may overcome reduced melatonin responsiveness in the aged MEPT mice. Since melatonin levels are known to decline near menopause, nocturnal melatonin supplementation may also be needed in aging women to cooperate with HT to decrease breast cancer risk.
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Affiliation(s)
- Balasunder R Dodda
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Corry D Bondi
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Mahmud Hasan
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - William P Clafshenkel
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Katie M Gallagher
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Mary P Kotlarczyk
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Shalini Sethi
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Ethan Buszko
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Jean J Latimer
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - J Mark Cline
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Paula A Witt-Enderby
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States.,UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Vicki L Davis
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
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Lund KS, Siersma V, Brodersen J, Waldorff FB. Efficacy of a standardised acupuncture approach for women with bothersome menopausal symptoms: a pragmatic randomised study in primary care (the ACOM study). BMJ Open 2019; 9:e023637. [PMID: 30782712 PMCID: PMC6501989 DOI: 10.1136/bmjopen-2018-023637] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the efficacy of a standardised brief acupuncture approach for women with moderate-to-severe menopausal symptoms. DESIGN Randomised and controlled, with 1:1 allocation to the intervention group or the control group. The assessor and the statistician were blinded. SETTING Nine Danish primary care practices. PARTICIPANTS 70 women with moderate-to-severe menopausal symptoms and nine general practitioners with accredited education in acupuncture. INTERVENTION The acupuncture style was western medical with a standardised approach in the predefined acupuncture points CV-3, CV-4, LR-8, SP-6 and SP-9. The intervention group received one treatment for five consecutive weeks. The control group was offered treatment after 6 weeks. MAIN OUTCOME MEASURES Outcomes were the differences between the randomisation groups in changes to mean scores using the scales in the MenoScores Questionnaire, measured from baseline to week 6. The primary outcome was the hot flushes scale; the secondary outcomes were the other scales in the questionnaire. All analyses were based on intention-to-treat analysis. RESULTS 36 participants received the intervention, and 34 participants were in the control group. Four participants dropped out before week 6. The acupuncture intervention significantly decreased hot flushes: Δ -1.6 (95% CI [-2.3 to -0.8]; p<0.0001), day-and-night sweats: Δ -1.2 (95% CI [-2.0 to -0.4]; p=0.0056), general sweating: Δ -0.9(95% CI [-1.6 to -0.2]; p=0.0086), menopausal-specific sleeping problems: Δ -1.8 (95% CI [-2.7 to -1.0]; p<0.0001), emotional symptoms: Δ -3.4 (95% CI [-5.3 to -1.4]; p=0.0008), physical symptoms: Δ -1.7 (95% CI [-3 to -0.4]; p=0.010) and skin and hair symptoms: Δ -1.5 (95% CI [-2.5 to -0.6]; p=0.0021) compared with the control group at the 6-week follow-up. The pattern of decrease in hot flushes, emotional symptoms, skin and hair symptoms was already apparent 3 weeks into the study. Mild potential adverse effects were reported by four participants, but no severe adverse effects were reported. CONCLUSIONS The standardised and brief acupuncture treatment produced a fast and clinically relevant reduction in moderate-to-severe menopausal symptoms during the six-week intervention. No severe adverse effects were reported. TRIAL REGISTRATION NUMBER NCT02746497; Results.
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Affiliation(s)
- Kamma Sundgaard Lund
- Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brodersen
- Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Primary Health Care Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Frans Boch Waldorff
- The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Improvement of menopausal symptoms and the impact on work ability: A retrospective cohort pilot study. Maturitas 2019; 120:23-28. [DOI: 10.1016/j.maturitas.2018.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/25/2018] [Accepted: 10/27/2018] [Indexed: 11/19/2022]
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Dama M, Mahoney JL, Van Lieshout RJ, Frey BN, Steiner M. The Menopause Visual Analogue Scale: a new tool for measuring the severity and response to treatment of symptoms throughout the menopausal transition. Climacteric 2018; 21:502-508. [DOI: 10.1080/13697137.2018.1495705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Dama
- Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada
| | - J. L. Mahoney
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - R. J. Van Lieshout
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - B. N. Frey
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - M. Steiner
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
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Gazibara T, Rancic B, Radovanovic S, Kurtagic I, Nurkovic S, Kovacevic N, Dotlic J. Climacteric women at work: What lurks behind poor occupational quality of life? Health Care Women Int 2018; 39:1350-1365. [PMID: 29668349 DOI: 10.1080/07399332.2018.1464573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Physical and psychological changes during menopausal transition may affect various aspects of everyday functioning including women's work ability and work productivity. Presence of menopausal symptoms has been well-acknowledged to negatively affect quality of life (QOL). However, data on factors associated with occupational QOL among women at this period of life are lacking. The authors' purpose in this study was to evaluate factors affecting occupational QOL in a sample of employed mid-life women who are experiencing menopause. The authors performed a cross-sectional study among 335 employed women aged 40 to 65 years from Serbia. Socio-demographic questionnaire, Utian's Quality of Life Scale, and Beck's Depression Inventory were used in data collection. Women's average monthly household income and educational level were positively correlated, while having uterine prolapse was negatively associated with occupational QOL. Significant regression models assessing impact of gynecological illnesses and menopause-specific symptoms on occupational QOL (direct value and categories-below vs. above mean) showed that having insomnia, uterine prolapse, and genital inflammations may differentiate "good" from "poor" occupational QOL. Uterine prolapse, genital inflammation, and insomnia were associated with worse occupational QOL among working women in menopausal transition.
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Affiliation(s)
- Tatjana Gazibara
- a Institute for Epidemiology, Faculty of Medicine, University of Belgrade , Belgrade , Serbia.,b Faculty of Medicine, University of Belgrade , Belgrade , Serbia
| | - Biljana Rancic
- b Faculty of Medicine, University of Belgrade , Belgrade , Serbia
| | | | - Ilma Kurtagic
- b Faculty of Medicine, University of Belgrade , Belgrade , Serbia
| | - Selmina Nurkovic
- b Faculty of Medicine, University of Belgrade , Belgrade , Serbia
| | | | - Jelena Dotlic
- b Faculty of Medicine, University of Belgrade , Belgrade , Serbia.,c Clinic for Obstetrics and Gynecology, Clinical Center of Serbia , Belgrade , Serbia
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