Menopause May Cost Women Sick Days

FRIDAY, March 16 (HealthDay News) — Women who suffer the
unpleasant and sometimes debilitating symptoms of menopause are more
likely to miss days at work, a new Dutch study finds.

“If you have really bad menopausal symptoms, which could be insomnia,
mood swings, irritability, you may be calling into work sick,” says Dr.
Jennifer Wu, an obstetrician-gynecologist with Lenox Hill Hospital in New
York City.

Menopause, which typically occurs after age 45, marks the end of a
woman’s periods, when the ovaries stop producing the hormones estrogen and
progesterone.

Although previous studies have looked at work productivity, this is the
first to correlate menopausal symptoms with a broader concept known as
“work ability.” Work ability tries to take into account how well a
person’s abilities correlate with job demands while also attempting to
predict future job performance, including how often a person will miss
work.

The researchers, from Nij Smellinghe Hospital in Drachten, the
Netherlands, enlisted more than 200 women, aged 44 through 60, who worked
at the hospital or a nearby home-care organization.

Women filled out a web-based questionnaire asking about 21 symptoms
potentially related to menopause, such as anxiety, depression, hot flashes
and sexual dysfunction.

Participants also provided information on how often they called in
sick, how they rated their current work ability vs. past ability and any
diagnoses made by a physician.

Women who reported more menopausal symptoms were more likely to rate
themselves lower on the work ability index, including reporting more days
missed from work.

The findings, published in the March issue of the journal
Menopause, probably won’t surprise millions of mid-life women,
their families and health-care providers.

“What they’re trying to show intuitively probably a lot of people
know,” says Dr. Brooke Leath, a staff physician in the department of
obstetrics and gynecology at Scott White in Round Rock, Texas.

However, the physical symptoms most often associated with menopause —
hot flashes and night sweats — did not affect work ability or sick days
for women in this study.

“The majority of the questionnaire items associated with adverse
effects on the work scale are pretty general, and I don’t believe are
truly specific for menopause,” said Dr. Jan Shifren, director of the
Vincent Menopause Program at Massachusetts General Hospital in Boston.

They included depression and anxiety, as well as “somatic” symptoms
such as headaches, muscle and joint pain and dizziness. Somatic symptoms
are physical manifestations of mental states such as anxiety.

“I think [the authors’] true conclusion is that mid-life women who are
experiencing increased anxiety and depression and somaticize a lot are
more likely to have trouble at work,” said Shifren, who is also on the
board of the North American Menopause Society. “This is not necessarily
true of all menopausal women and should be reassuring to women having hot
flashes and night sweats.”

Anxiety and depression do tend to peak at mid-life, Shifren pointed
out.

“You can see that probably any depressed person, male or female, would
have trouble with work ability,” Leath added.

Also, the researchers only took into account women’s own perceptions of
their work ability, which is not an objective measure, Shifren said.

The authors themselves pointed out several limitations of the study,
including the fact that the study design could not establish
cause-and-effect. Also, participants were all in a similar field of work,
which may have biased the results.

And Leath pointed out that only 24 percent of women contacted actually
responded to the questionnaire.

The good news is that there are treatments for anxiety and depression
as well as ways to alleviate symptoms of menopause.

The antidepressant Effexor (venlafaxine), for instance, is sometimes
used to help with hot flashes, Wu said. And mild sleep aids can help with
insomnia.

Hormone therapy to ease menopausal symptoms remains controversial as it
can increase the risk of breast cancer, heart disease and other problems.
Its use should be discussed thoroughly with a doctor, said Wu.

Most doctors recommend using hormone therapy only if absolutely needed
and, even then, as a little as possible for as short a period as
possible.

More information

The U.S. Department of Health and Human Services has tips for relieving symptoms of menopause.

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