Dysmenorrhea patients’ experience with work productivity impact and treatment in Japan

BACKGROUND: Nearly 50% of Japanese women report impaired work performance due to menstrual symptoms. Our objectives were to describe the real-world experiences of patients living with dysmenorrhea with a focus on work productivity and its association with treatments. Our exploratory objective was to understand the coping methods for menstrual pain in Japanese women. METHODS: Using an anonymized database consisting of linked Japanese health insurance claims and Work Productivity and Activity Impairment Questionnaire - General Health (WPAI-GH) responses for women aged between 18 and 50 years, we conducted descriptive analyses of work productivity impact among patients with dysmenorrhea, other chronic diseases and individuals without medical records. Analysis of work productivity impact was conducted per dysmenorrhea treatment. The analyses were descriptive and unadjusted thus the generalizability and external validity of differences between conditions and treatments are limited. RESULTS: Among 9,235 individuals in the employer-sponsored insurance claims database, 956 (10.4%) had diagnosed dysmenorrhea. The unadjusted mean WPAI-GH scores for the dysmenorrhea patient population demonstrated absenteeism at 2.5 ± 0.3% (mean ± standard error) and presenteeism at 26.8 ± 0.9%, similar to groups with mental disorders, headaches, or low back pain. Dysmenorrhea patients receiving low-dose estrogen progestin, also known as combined oral contraceptives, was the largest treatment group and had the lowest mean absenteeism and presenteeism scores among treatment groups in this unadjusted descriptive analysis. In 5,471 respondents who responded on coping methods for menstrual pain, 2,250 (41.1%) used over-the-counter medications, while 329 (6.0%) sought medical care. CONCLUSION: The productivity impact observed in patients with dysmenorrhea was substantial and found to be similar to that of patient groups with major chronic conditions such as mental disorders, headaches, and low back pain. We further found that dysmenorrhea patients' productivity outcomes varied across treatment groups. Whilst prospective studies with adjustment for confounding factors are needed to establish the generalizability of differences between treatment- and condition-based subgroups, our findings underscore the need for greater awareness of dysmenorrhea as a condition that deserves medical attention, and timely medical care may help reduce the burden and improve the quality of life.