Associations of employment characteristics and psychosocial work factors with severe menopausal symptoms among working women: a longitudinal study

OBJECTIVES: To investigate whether employment characteristics and psychosocial work factors are associated with the development of severe menopausal symptoms among working women. METHODS: We longitudinally analysed 648 working women aged 35-55 years without menopausal symptoms interfering with daily life at baseline (2012-2014). Employment characteristics included employment status, managerial position, shift work and working hours. Psychosocial work factors included workload, job control, job strain and effort-reward imbalance. At follow-up (2018-2020), women in the menopausal transition or postmenopause who reported menopausal symptoms that interfered with daily life during follow-up were classified as having developed severe menopausal symptoms. Associations between baseline work factors and the development of severe menopausal symptoms were examined using modified Poisson regression adjusted for age, follow-up duration, body mass index, smoking, drinking and educational attainment. Symptom domains (vasomotor, psychological and physical) were also evaluated. RESULTS: During 5.3±0.5 years of follow-up, 68 women (10.5%) developed severe menopausal symptoms. Per 1-SD increase, higher workload (risk ratio (RR) 1.34, 95% CI 1.04 to 1.73), job strain ratio (RR 1.30, 95% CI 1.10 to 1.54) and effort-reward ratio (RR 1.23, 95% CI 0.99 to 1.51) were associated with a higher risk, whereas higher job control was protective (RR 0.78, 95% CI 0.63 to 0.97). Results were similar after additional adjustment for menopausal, marital and parental status. Domain-specific analyses showed similar associations across symptoms, strongest for physical symptom severity. CONCLUSIONS: Psychosocial work factors, particularly high workload, low job control and high job strain, were associated with the development of severe menopausal symptoms. These findings highlight the importance of psychosocial work environments in supporting women during the menopausal transition.