Increased menopausal symptoms are
related to decreased work ability
M. Geukes, M.P. van Aalst,
H. Oosterhof
Department of Obstetrics and Gynecology, Nij Smellinge Hospital, Drachten, The
Netherlands
Van Aalst Arbo Advies, Bakkeveen,The Netherlands
Women & work; The Netherlands
• Half the total workforce; 4 million
• Age > 50 years; 2.7 million
• Increase from 22% to 41% last decade
• Expected increase in next decade
Work ability
• Built on the balance between a persons
resources and work demands
• Can predict both future impairment and
duration of sickness absence
• The Finnish Institute of Occupational Health
developed the Work Ability Index (WAI)
lmarinen J. Towards a Longer Worklife! Ageing and the Quality of Worklife in the European Union. Helsinki, Finland: Finnish Institute of Occupation Health,
Ministry of Social Affairs and Health, 2005.
Ilmarinen J, Tuomi K, Klockars M. Changes in the work ability of active employees over an 11-year period. Scand J Work Environ Health 1997; 23:49-57.
Reiso H, Nygard JF, Brage S, Gulbrandsen P, Tellnes G. Work ability and duration of certified sickness absence. Scand J Public Health 2001; 29:218-225.
Tuomi K, Ilmarinen J, Jakhola A, Katajarinne L, Tulkki A. Work Ability Index, 2nd revised ed. Helsinki, Finland: Finnish Institute of Occupational Health,
1998.
Work Ability Index (WAI)
1. Current work ability compared with best of
lifetime;
2. Work ability in relation to job demand;
3. Number of current diseases diagnosed by a
physician;
4. Estimated work impairment due to disease;
5. Sickness absence during the past 12 months;
6. Own prognosis of work ability 2 years from
now;
7. Mental resources (refers to the worker’s life in
general, both at work and during leisure-time).
Work Ability Index
• Score runs from 7 to 49 points
• < 37 points indicate “poor” work ability
• ≥ 37 points indicate “good/excellent” work
ability
Determinants of poor work ability
• Older age
• Lower education
• Being overweight
• Smoking
• Lack of exercise
van den Berg TI, Elders LA, de Zwart BC, Burdorf A. The effects of work-related and individual factors on the Work Ability Index: a systematic review.
Occup Environ Med 2009;66:211-220.
Work ability and menopausal
symptoms
• 33.8% of the
variance in
WAI score is
explained by
total GCS
score
Geukes M, van Aalst MP, Nauta MCE, Oosterhof H. The impact of menopausal symptoms on work ability. Menopause
2012;19:278-282.
Details of this study
• Objective: to analyze the ability to work
among women who seek help for their
menopausal symptoms
• Design: cross-sectional study
• Setting: the study was conducted in Northern
Netherlands, province Friesland
Study population
• Patients: first-time attendees of a menopause
clinic
• Controls: healthy female workers
• Inclusion criteria
• Age 44 to 60 years
• Exclusion criteria
• Currently unemployed
• Incomplete questionnaires
Methods
• Questionnaires assessing work ability (Work
Ability Index: WAI), menopausal symptoms (Greene
Climacteric Scale: GCS) and individual and lifestyle factors
• Statistics
• independent samples t test for differences
between means (GCS/WAI)
• Cramer’s V to measure differences in
individual and lifestyle factors
Population characteristics
Characteristic
Patient
n = 35
Control
n = 194
Total
n = 229
P value
Age (years) Median (range)
51 (44-59)
51 (44-60)
51 (44-60)
0.852
Education no. (%)
Primary education
Secondary education
Higher education
1 (2.9)
23 (65.7)
11 (31.4)
2 (1.0)
118 (61.1)
73 (37.8)
3 (1.3)
141 (61.8)
84 (36.8)
0.556
No significant differences in
individual and lifestyle
factors
Smoking no. (%)
Never
Quit
< 10 cigarettes/day
> 10 cigarettes/day
12 (34.3)
20 (57.1)
2 (5.7)
1 (2.9)
73
89
16
14
(38.0)
(46.4)
(8.3)
(7.3)
Exercise no. (%)
(Almost) none
1-3 times/month
1-2 times/week
3-5 times/week
6-7 times/week
8 (22.9)
5 (14.3)
14 (40.0)
6 (17.1)
2 (5.7)
61
19
85
28
1
BMI (kg/m²)
25.56 ± 4.97
25.32 ± 4.18
(31.4)
(9.8)
(43.8)
(14.4)
(0.5)
0.580
85 (37.4)
109 (48.0)
18 (7.9)
15 (6.6)
69
24
99
34
3
0.105
(30.1)
(10.5)
(43.2)
(14.8)
(1.3)
25.36 ± 4.30
0.764
Results
Patient
n = 35
Control
n = 194
P value
24.20 ± 8.41
14.20 ± 7.68
<0.001
Anxiety score
7.11 ± 2.96
3.82 ± 2.19
<0.001
Depression score
5.14 ± 2.61
3.38 ± 2.53
<0.001
Psychological score
12.26 ± 4.93
7.20 ± 4.30
<0.001
Somatic score
6.83 ± 3.79
3.99 ± 2.99
<0.001
Vasomotor score
3.71 ± 1.99
2.03 ± 1.67
<0.001
Sexual dysfunction score
1.40 ± 1.01
0.98 ± 0.86
0.025
Total GCS-score
Poor WAI-score 65.7%
34.0%
32.33 ± 6.75 versus
38.55 ± 6.24
<0.001
WAI-score
WAI no. (%)
< 37 (poor)
≥ 37 (good/excellent)
<0.001
23 (65.7)
12 (34.3)
66 (34.0)
128 (66.0)
Conclusions
• Women who seek help for their menopausal
symptoms;
• are significant more bothered by those symptoms than
their healthy controls (total GCS 24.20 vs. 14.20)
• report significant lower work ability than their healthy
controls (WAI score 32.33 vs. 38.55)
• report a poor work ability in 65.7%
• are at risk for developing sickness absence
• Menopause seems to be an important economic
burden
Further study
• Effect of (different) treatment (options) on
work ability
• Lifestyle changes
• Counseling – coping
• HRT