Beyond Pain-Associations Between Menstrual Symptoms, Work Productivity and Quality of Life: A Large-Scale Web-Based Cross-Sectional Study.

Abstract

To analyse the impact of a comprehensive range of menstrual symptoms-including various physical and psychological symptoms associated with menstruation-on work productivity and quality of life (QoL). A cross-sectional study. A menstrual cycle tracking application in Japan; current app users were recruited via in-app notification provided electronic informed consent from June to August 2022. Japanese women who have experienced menarche. Menstrual Distress Questionnaire (mMDQ) was used to determine severity of menstrual symptoms, and participants with mMDQ score ≥ 103 were grouped as severe. Work productivity was assessed using the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI-GH), and QoL was measured using the 36-Item Short Form Survey version 2 (SF-36v2). Differences in absenteeism, presenteeism, overall work impairment and activity impairment on the WPAI-GH between the severe and normal groups; differences in the summary scores of the SF-36v2; correlation coefficients between scores of symptom groups of the mMDQ, WPAI-GH and the summary scores of the SF-36v2. Overall, 456/1988 (23.0%) women had severe mMDQ scores (≥ 103). The median overall work impairment was 30% higher in the severe group than in the normal group. In multiple regression analysis, mMDQ severity was significantly associated with increased absenteeism, presenteeism and activity impairment, as well as reduced mental and social QoL. Negative affect, impaired concentration and behaviour change were associated with greater presenteeism, while pain showed weaker correlations. Negative affect was strongly associated with reduced mental QoL. Our findings demonstrate that, in addition to pain, mental and psychosocial symptoms are significantly associated with both work productivity and QoL.