Association between menstrual disorders and women's workforce participation: A systematic review

Abstract

<h2>Abstract</h2><h3>Background</h3> Research on the associations between menstrual disorders, including period pain, irregular periods, premenstrual syndromes, heavy bleeding and women's workforce participation has shown inconsistent findings. We aimed to systematically review the scientific evidence on the association between menstrual disorders and women's workforce participation. <h3>Methods</h3> Articles were retrieved from Embase, PubMed, CINAHL, Web of Science, PsycINFO and Scopus. Two authors independently assessed eligibility and quality using the Joanna Briggs Institute checklist. Data were extracted into custom-made reporting forms, and the results were narratively summarized. High heterogeneity in the measurement of menstrual symptoms and workforce outcomes across the studies precluded a meta-analysis, however Forest plots were produced. <h3>Results</h3> From 5256 assessed studies, 37 consisting of 72,567 working women were included. Overall, 46 % of studies (n = 17) were of moderate quality, with 44 % (n = 16) high quality. Fifteen studies (33.3 %) investigated associations between premenstrual syndrome and workforce participation. Women with moderate to severe premenstrual syndrome reported reduced workforce participation, mainly through work absenteeism (odds ratios from 2.4 to 5.2), and impaired work productivity (odds ratios from 3.1 to 6.0). Fourteen studies (31.1 %) found that women with period pain reported reduced work performance (odds ratios from 1.3 to 3.9), and work absenteeism (odds ratios from 1.9 to 12.1). Overall women with heavy periods reported reduced workplace productivity (odds ratios from 1.4 to 2.20), and reduced work performance (odds ratios from 2.8 to 8.9). In addition, ethical concerns related to research on menstrual health in workplace settings are identified throughout. <h3>Conclusion</h3> Menstrual disorders are associated with reduced workforce participation mainly through reduced work productivity, and increased work absenteeism. However, the extent to which the observed associations are due to menstrual symptoms or other confounders is not clear. High quality population-based longitudinal studies with large sample sizes and covariate adjustment will aid our understanding of the associations between menstrual disorders and women's workforce participation.