Work environment may moderate menopause misery

Women experiencing menopause symptoms like hot flashes and sleeping problems do better if they have a comfortable workplace and a supportive boss, according to an Australian study.

By offering support to menopausal women, such as trained managers and temperature controls, workplaces can improve the employee experience and help themselves by boosting productivity, the researchers write in the journal Menopause.

“Women in midlife and older adulthood now constitute a large proportion of the workforce and many women transition through menopause while they are in paid employment,” said lead author Emily Bariola, a researcher at La Trobe University in Melbourne.

“Despite this, very little research has considered whether workplace and organizational factors can affect menopausal symptom experience for women,” Bariola told Reuters Health by email.

To determine how workplace conditions affect the experience of women going through menopause, the study team used data from Women at Work, an online survey conducted between 2013 and 2014 in Australia.

Nearly 500 women in their 40s and older answered questions about their general health as well as menopause symptoms like hot flashes, sleep and attention issues and headaches. The number and severity of their symptoms were scored using a menopause index.

About two thirds of the women were postmenopausal, and one third were in the transitional stage known as perimenopause.

The women also answered questions about whether their worksites had features that would help them deal with their symptoms, including a flexible schedule, access to temperature control, job autonomy and whether they felt valued by their supervisors.

More than two thirds of women worked full-time and most had flexible working hours. But less than a third of women reported having control over the temperature in their immediate work environment.

Women who had more supportive supervisors and women who were employed full-time tended to report significantly fewer severe menopause symptoms than women without these work conditions.

On average, women who had control over the temperature of their workplace also had significantly lower symptom scores than those without temperature control.

Having more job autonomy or being able to work flexible hours did not seem to have an effect on menopause symptoms, the study found.

“Menopausal symptoms can affect both productivity at work and quality of life of women,” said Rehab Hammam, a professor at Zagazig University in Egypt who studies menopause and the workplace.

“Stress at work can exacerbate menopausal symptoms,” Hammam, who was not involved in the study, added by email.

Bariola noted that one way employers can ensure supervisor support for menopausal women is to provide training for managers, including guidance on how to start conversations about the issue.

“Practical measures such as the capacity to adjust air conditioner temperature controls or request the installation of desk fans may also ease women’s experience of menopausal symptoms,” Bariola said.

“Women need to know that menopause is not a stigma that they should hide,” Hammam said. “It is a stage in their life that needs certain strategies and awareness from both employers and the working women.”

“Organizational policies and culture have a positive and important role to play in ensuring women feel supported by their organizations during menopausal transition,” Bariola said.


Early menopause linked to higher heart disease, death risks


Women who enter menopause early may be at greater risk for heart disease and premature death, a new analysis suggests.

To reach this conclusion, Dutch researchers reviewed 32 studies involving more than 300,000 women. The investigators compared women who were younger than 45 at the start of menopause with those who were 45 and older when it began.

Overall, heart disease risk appeared to be 50 percent greater for the women who were under 45 when menopause began.

Early menopause also appeared to boost the risk of cardiovascular death and death from all causes. But, it showed no association with stroke risk, the study authors said.

However, the study only uncovered an association — not a cause-and-effect connection — between early menopause and heart and death risk.

The study findings were published online in September in JAMA Cardiology.

“These findings suggest that women with early onset of menopause may be a group to target for proactive cardiovascular prevention strategies,” said study author Dr. Taulant Muka, of Erasmus University Medical Center in Rotterdam, the Netherlands.

For women in early or premature menopause, that may mean hormone therapy, the researchers said. Long-term use of the female hormone estrogen has been associated with cancer and stroke risks. Many experts believe the risks outweigh the benefits.

But the advice is different for women who enter menopause before age 45, explained JoAnn Manson. She is co-director of the Connors Center for Women’s Health and Gender Biology at Brigham & Women’s Hospital in Boston.

Since these women have a higher risk of heart disease and osteoporosis, unless there is a “clear reason” to avoid it, experts recommend treatment with estrogen until at least the average age of natural menopause, Manson said.

Menopause typically begins at age 51. However, as many as one in 10 women experiences natural menopause by age 45, the study authors noted.

Also, certain cancer treatments or surgical removal of a woman’s ovaries cause premature menopause.

One in three women worldwide dies from cardiovascular disease. And, for reasons not entirely clear, that risk accelerates in menopause.

Could the dramatic decline in levels of estrogen following menopause be to blame? It’s probably more complicated than that, say the co-authors of an editorial that accompanied the study.

“We don’t know definitively whether the reproductive system is influencing cardiovascular health or cardiovascular disease is influencing the ovary,” said Teresa Woodruff, one of the editorial writers. She is vice chair for research in obstetrics and gynecology at Northwestern University.

Manson, her co-author, said the link probably goes in both directions: Early menopause boosts heart disease risk, and risk factors such as high blood pressure and high cholesterol can damage the blood supply to the ovary and lead to early menopause.

Study author Muka, a postdoctoral researcher, offers a possible explanation for the heightened risk facing women with early menopause: Early loss of ovarian function may activate a system in the body that regulates blood pressure, body fluids and inflammation, he said.

“The inappropriate activation of this system causes hypertension and can damage your heart,” Muka said.

It’s also possible that there may be shared genetic or environmental risk factors that lead to early onset menopause and boost the risk of poor health outcomes, the researchers added.

Muka and his colleagues picked observational studies for their analysis that evaluated women’s age at onset as well as time since onset of menopause.

Only four studies assessed time since the onset of menopause in relation to cardiovascular risks, and the results were inconsistent.

However, the age-related findings showed a clear link, the investigators said. While early menopausal women faced increased heart and premature death risks, women ages 50 to 54 at the onset had a lower risk of fatal heart disease than women younger than 50.

Based on the findings, “age at menopause might be a predictor of future cardiovascular events and mortality in postmenopausal women,” Muka said.