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Most women experience some premenstrual symptoms during their reproductive years. Yet, this is an under-researched health issue, particularly in the context of work. This study aimed to: (i) understand the prevalence and severity of premenstrual symptoms experienced by working females, and their association with key work outcomes; (ii) explore factors that may be influencing these symptoms and their severity; and (iii) examine how organizations might help staff with premenstrual symptoms that may be impacting their working lives. An online, anonymous survey collected quantitative and qualitative data from 125 working women in the UK. Over 90% of the sample reported some premenstrual symptoms; 40% experienced premenstrual symptoms moderately or severely. Higher symptom severity was significantly (p < 0.05) associated with poor presenteeism, intention to reduce working hours, and higher work absence (time off work, being late, leaving early). Moderate/severe symptoms were significantly associated with several individual-related variables: lower perceived general health, higher alcohol consumption, poorer sleep quality, anxiety, depression, hormonal contraception, and using fewer coping approaches towards premenstrual symptoms (avoiding harm, adjusting energy levels); and work-related variables: poorer work–life balance, lower levels of psychological resilience, higher perceived work demands, less control over work. Disclosure of premenstrual symptoms and sickness absence because of premenstrual symptoms was very low, typically because of perceptions of appropriateness as a reason for work absence, gender of line managers (male), and it being a personal or embarrassing topic. Staff with moderate to severe premenstrual symptoms were statistically more likely to disclose reason for absence than those with milder symptoms. Recommendations and suggestions for employers and line managers include the need to train staff to improve knowledge about women’s experience of premen

Most women experience some premenstrual symptoms during their reproductive years. Yet, this is an under-researched health issue, particularly in the context of work. This study aimed to: (i) understand the prevalence and severity of premenstrual symptoms experienced by working females, and their association with key work outcomes; (ii) explore factors that may be influencing these symptoms and their severity; and (iii) examine how organizations might help staff with premenstrual symptoms that may be impacting their working lives. An online, anonymous survey collected quantitative and qualitative data from 125 working women in the UK. Over 90% of the sample reported some premenstrual symptoms; 40% experienced premenstrual symptoms moderately or severely. Higher symptom severity was significantly (p < 0.05) associated with poor presenteeism, intention to reduce working hours, and higher work absence (time off work, being late, leaving early). Moderate/severe symptoms were significantly associated with several individual-related variables: lower perceived general health, higher alcohol consumption, poorer sleep quality, anxiety, depression, hormonal contraception, and using fewer coping approaches towards premenstrual symptoms (avoiding harm, adjusting energy levels); and work-related variables: poorer work–life balance, lower levels of psychological resilience, higher perceived work demands, less control over work. Disclosure of premenstrual symptoms and sickness absence because of premenstrual symptoms was very low, typically because of perceptions of appropriateness as a reason for work absence, gender of line managers (male), and it being a personal or embarrassing topic. Staff with moderate to severe premenstrual symptoms were statistically more likely to disclose reason for absence than those with milder symptoms. Recommendations and suggestions for employers and line managers include the need to train staff to improve knowledge about women’s experience of premen

Objective Psychosocial interventions can reduce cancer‐related fatigue effectively. However, it is still unclear if intervention effects differ across subgroups of patients. These meta‐analyses aimed at evaluating moderator effects of (a) sociodemographic characteristics, (b) clinical characteristics, (c) baseline levels of fatigue and other symptoms, and (d) intervention‐related characteristics on the effect of psychosocial interventions on cancer‐related fatigue in patients with non‐metastatic breast and prostate cancer. Methods Data were retrieved from the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) consortium. Potential moderators were studied with meta‐analyses of pooled individual patient data from 14 randomized controlled trials through linear mixed‐effects models with interaction tests. The analyses were conducted separately in patients with breast (n = 1091) and prostate cancer (n = 1008). Results Statistically significant, small overall effects of psychosocial interventions on fatigue were found (breast cancer: β = −0.19 [95% confidence interval (95%CI) = −0.30; −0.08]; prostate cancer: β = −0.11 [95%CI = −0.21; −0.00]). In both patient groups, intervention effects did not differ significantly by sociodemographic or clinical characteristics, nor by baseline levels of fatigue or pain. For intervention‐related moderators (only tested among women with breast cancer), statistically significant larger effects were found for cognitive behavioral therapy as intervention strategy (β = −0.27 [95%CI = −0.40; −0.15]), fatigue‐specific interventions (β = −0.48 [95%CI = −0.79; −0.18]), and interventions that only targeted patients with clinically relevant fatigue (β = −0.85 [95%CI = −1.40; −0.30]). Conclusions Our findings did not provide evidence that any selected demographic or clinical characteristic, or baseline levels of fatigue or pain, moderated effects of psychosocial interventions on fatigue. A specific focus on decreasing fatigue se

Objectives To develop and evaluate a 30-min online training for managers, in order to improve menopause-related knowledge, attitudes and confidence in having supportive discussions with women experiencing menopausal symptoms at work. The study also explored intentions and behaviour in terms of having conversations. Study design A prospective, pre-post design involved collecting data at three time points: pre-training, immediately after training, and four weeks post-training. Three UK organizations (one public, two private sector) participated. On-line questionnaires collected sociodemographic and background data. Qualitative and quantitative evaluation data were collected in post-intervention questionnaires. Paired t-tests and McNemar tests examined statistical differences pre- and post-training; thematic content analysis was performed on qualitative data. Main outcome measures Menopause knowledge, attitudes and confidence in talking about the menopause at work, intentions, and actual behaviour. Results 270 staff were invited and 98 consented to participate; 62 and 61 provided data immediately and 4 weeks post training, respectively. Compared to pre-training scores, statistically significant improvements were found in menopause-related knowledge, attitude (not viewing the menopause as an embarrassing topic to talk about at work), confidence in talking about the menopause with staff, and intentions to discuss menopause, at both follow-up assessments. Over 90% of respondents reported that they found the training useful and would recommend it to others. Conclusions A brief menopause awareness training may be a feasible and effective way to help managers become more knowledgeable about menopause-related problems and more confident in discussing and exploring solutions with their staff.

Purpose: Women are typically reluctant to disclose menopause-related problems that may affect their working lives to line managers. Consequently, support may not be offered nor potential solutions explored. This study examines how working menopausal women would prefer to have conversations about the menopause at work. Design/methodology/approach: Using semi-structured telephone interviews working menopausal women (aged 45-60 years) were asked about their experiencing of talking about their menopause at work, and how helpful conversations might be initiated and conducted. Transcripts were analyzed thematically to identify factors that may facilitate or hinder such conversations. Findings: Two themes emerged: (i) organizational context. Facilitators included an open culture with friendly relationships, a knowledgeable and proactive manager, organization-wide awareness of the menopause and aging, and access to a nominated woman to discuss problems. Barriers included male-dominated workplaces, male line managers, fear of negative responses, stigma, discrimination, embarrassment or believing menopause is inappropriate to discuss at work; (ii) the nature of the discussion. Facilitators included managers demonstrating an understanding and acceptance of a woman's experience, jointly seeking acceptable solutions, respecting privacy and confidentiality, and appropriate use of humor, as opposed to being dismissive and using inappropriate body language. Discussions with suitable persons at work were preferred and being prepared was advised. Practical implications: These findings could inform training programs, workplace policies and practice. Originality/value: This study provides timely insights to help women and their managers discuss menopause-related difficulties at work and seek solutions together.

Objective: This individual patient data (IPD) meta‐analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention‐related characteristics. Methods: Relevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed‐effect model analyses were used to study intervention effects on the post‐intervention values of QoL, EF, and SF (z‐scores), adjusting for baseline values, age, and cancer type. We studied moderator effects by testing interactions with the intervention for demographic, clinical, personal, and intervention‐related characteristics, and conducted subsequent stratified analyses for significant moderator variables.Results: PSI significantly improved QoL (β = 0.14,95%CI = 0.06;0.21), EF (β = 0.13,95%CI = 0.05;0.20), and SF (β = 0.10,95%CI = 0.03;0.18). Significant differences in effects of different types of PSI were found, with largest effects of psychotherapy. The effects of coping skills training were moderated by age, treatment type, and targeted interventions. Effects of psychotherapy on EF may be moderated by cancer type, but these analyses were based on 2 randomized controlled trials with small sample sizes of some cancer types. Conclusions: PSI significantly improved QoL, EF, and SF, with small overall effects. However, the effects differed by several demographic, clinical, personal, and intervention‐related characteristics. Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients.

Background: Recent evidence suggests that some women experience menopausal symptoms that impact on their working lives, and that work environments can impact upon the experience of menopause. As a result, guidance for employers and other key stakeholders about this potential occupational health issue has emerged. To date there has not been a review of these documents to identify their main recommendations for policy and practice. Aims: To provide a narrative overview of such guidance and summary of content. Methods: Documents published in the United Kingdom and available in a major UK trade union library were searched systematically to identify guidance on the topic of menopause and work. An inductive thematic analysis was performed to identify the main themes addressed. Results: 25 relevant documents, on average eight pages long, were identified. A minority indicated that the use of scientific evidence informed the content. Five overarching themes were identified: 1) legislation; 2) policy; 3) information and training needs; 4) workplace support; and 5) the physical work environment. Conclusions: This overview of UK guidance revealed common areas of concern about reducing and managing difficulties experienced by working menopausal women. Possible areas for action were identified. Some recommendations were common across much of the guidance, whereas others were exclusive. Future guidance might include consideration of all these issues, while making reference both to the evidence base and sources of further information.

Objective: The aim of the study was to examine the efficacy of an unguided, self-help cognitive behavior therapy (SH-CBT) booklet on hot flush and night sweat (HFNS) problem rating, delivered in a work setting. Methods: Women aged 45 to 60 years, having 10 or more problematic HFNS a week, were recruited to a multicenter randomized controlled trial, via the occupational health/human resources departments of eight organizations. Participants were 1:1 randomized to SH-CBT or no treatment waitlist control (NTWC). The primary outcome was HFNS problem rating; secondary outcomes included HFNS frequency, work and social adjustment, sleep, mood, beliefs and behaviors, and work-related variables (absence, performance, turnover intention, and work impairment due to presenteeism). Intention-to-treat analysis was used, and between-group differences estimated using linear mixed models. Results: A total of 124 women were randomly allocated to SH-CBT (n = 60) and NTWC (n = 64). 104 (84%) were assessed for primary outcome at 6 weeks and 102 (82%) at 20 weeks. SH-CBT significantly reduced HFNS problem rating at 6 weeks (SH-CBT vs NTWC adjusted mean difference, -1.49; 95% CI, -2.11 to -0.86; P < 0.001) and at 20 weeks (-1.09; 95% CI, -1.87 to -0.31; P < 0.01). SH-CBT also significantly reduced HFNS frequency, improved work and social adjustment; sleep, menopause beliefs, HFNS beliefs/behaviors at 6 and 20 weeks; improved wellbeing and somatic symptoms and reduced work impairment due to menopause-related presenteeism at 20 weeks, compared with the NTWC. There was no difference between groups in other work-related outcomes. Conclusions: A brief, unguided SH-CBT booklet is a potentially effective management option for working women experiencing problematic HFNS.

There is growing research interest in the question of whether menopause impacts upon mid-aged women’s work outcomes, but the evidence to date is inconclusive. This paper examines whether: (i) menopausal status, and experience of hot flushes and night sweats (HFNS), and whether (ii) work stress and work environment, are associated with work outcomes (absenteeism, job performance, turnover intention, and intention to leave the labor force). An online survey (sociodemographic, menopause, health, well-being and aspects of work) was completed by 216 (pre-, peri- and postmenopausal) women aged 45–60 years. Work outcomes were not associated with menopausal status but were significantly associated with job stress and aspects of the work environment, such as demand, control and support. HFNS presence, frequency and problem-rating were not significantly associated with work outcomes. HF problem rating at work was significantly associated with intention to leave the labor force, after controlling for age (F(2,101), 6.742, p = .002). The main predictors of work outcomes in this sample of mid-aged women were aspects of the working environment (particularly role clarity and work stress). Menopausal status was not associated with work outcomes but having problematic hot flushes at work was associated with intention to stop working. These results challenge assumptions about the menopause transition by providing evidence that the menopause does not impact on women’s self-reported work performance and absence. However, support for women with problematic HFNS at work may be beneficial, as might addressing working environment issues for mid-aged women.

Background: Recent evidence suggests that some women experience menopausal symptoms that impact on their working lives, and that work environments can impact upon the experience of menopause. As a result, guidance for employers and other key stakeholders about this potential occupational health issue has emerged. To date there has not been a review of these documents to identify their main recommendations for policy and practice. Aims: To provide a narrative overview of such guidance and summary of content. Methods: Documents published in the United Kingdom and available in a major UK trade union library were searched systematically to identify guidance on the topic of menopause and work. An inductive thematic analysis was performed to identify the main themes addressed. Results: 25 relevant documents, on average eight pages long, were identified. A minority indicated that the use of scientific evidence informed the content. Five overarching themes were identified: 1) legislation; 2) policy; 3) information and training needs; 4) workplace support; and 5) the physical work environment. Conclusions: This overview of UK guidance revealed common areas of concern about reducing and managing difficulties experienced by working menopausal women. Possible areas for action were identified. Some recommendations were common across much of the guidance, whereas others were exclusive. Future guidance might include consideration of all these issues, while making reference both to the evidence base and sources of further information.

Objective: The aim of the study was to examine the efficacy of an unguided, self-help cognitive behavior therapy (SH-CBT) booklet on hot flush and night sweat (HFNS) problem rating, delivered in a work setting. Methods: Women aged 45 to 60 years, having 10 or more problematic HFNS a week, were recruited to a multicenter randomized controlled trial, via the occupational health/human resources departments of eight organizations. Participants were 1:1 randomized to SH-CBT or no treatment waitlist control (NTWC). The primary outcome was HFNS problem rating; secondary outcomes included HFNS frequency, work and social adjustment, sleep, mood, beliefs and behaviors, and work-related variables (absence, performance, turnover intention, and work impairment due to presenteeism). Intention-to-treat analysis was used, and between-group differences estimated using linear mixed models. Results: A total of 124 women were randomly allocated to SH-CBT (n = 60) and NTWC (n = 64). 104 (84%) were assessed for primary outcome at 6 weeks and 102 (82%) at 20 weeks. SH-CBT significantly reduced HFNS problem rating at 6 weeks (SH-CBT vs NTWC adjusted mean difference, -1.49; 95% CI, -2.11 to -0.86; P < 0.001) and at 20 weeks (-1.09; 95% CI, -1.87 to -0.31; P < 0.01). SH-CBT also significantly reduced HFNS frequency, improved work and social adjustment; sleep, menopause beliefs, HFNS beliefs/behaviors at 6 and 20 weeks; improved wellbeing and somatic symptoms and reduced work impairment due to menopause-related presenteeism at 20 weeks, compared with the NTWC. There was no difference between groups in other work-related outcomes. Conclusions: A brief, unguided SH-CBT booklet is a potentially effective management option for working women experiencing problematic HFNS.

Objectives To explore women's perspectives on what employers and managers should and should not do in relation to women going through the menopause. Methods An online questionnaire was used to collect qualitative data in a cross-sectional study of working women. Three open-ended questions asked peri- and post-menopausal women, aged 45–65 years: (i) what they thought employers could do, or should do, to help menopausal women who may be experiencing difficult menopausal symptoms at work; (ii) how managers should behave; and (iii) how managers should not behave towards women going through the menopause. Results 137 women responded to the open questions in the survey. An inductive thematic analysis was conducted and three overarching themes emerged. Theme 1 related to employer/manager awareness, specifically to knowledge about the menopause and awareness of how the physical work environment might impact on menopausal women. Theme 2 related to employer/manager communication skills and behaviors, specifically those considered helpful and desired and those considered unhelpful and undesired. Theme 3 described employer actions, involving staff training and raising awareness, and supportive policies such as those relating to sickness absence and flexible working hours. Conclusions The menopause can be difficult for some women to deal with at work, partly due to the working environment. To our knowledge, this is the first study to explore women's descriptions of how they would like to be treated by employers/managers, and what would be helpful and unhelpful. The results have clear implications for communication about menopause at work and for employer-level policy and practice.

Many women are now in employment during their menopause. Evidence suggests that although most women do not take absence or perceive their job performance to be affected by their menopause, some women do. It is therefore important to understand what factors might be associated with such outcomes. This paper explores individual and work-related factors and their associations with menopause-related work absence and perceived work performance impact. 896 menopausal, working women from 10 organisations completed an electronic survey. Data included individual-related factors (sociodemographic: age, education level, dependents, level of physical activity, psychological distress; menopausal symptoms: perceived bothersomeness, duration and frequency of hot flushes), work-related factors (physical and psychosocial work environment, line manager factors: age, gender, symptom disclosure; and job satisfaction), menopause-related absence and self-perceived job performance impairment (dependent variables). Univariate and multivariate logistic and linear regression analyses were performed to examine the extent these variables significantly predicted the dependent variables of interest. Results showed the factors significantly associated with menopause-related absence were largely work-related than individual-related (accounting for 35% and 13% of variance respectively). In contrast, the factors that predicted performance detriments were largely individual-related rather than work-related (accounting for 16% and 19% of variance respectively). These findings suggest that both individual and work-related factors may be associated with work outcomes and that researchers, employers and policy makers should take a multi-perspective approach. This may be more effective in helping those women who find menopausal transition impacts negatively on their working life.

Objectives To explore women's perspectives on what employers and managers should and should not do in relation to women going through the menopause. Methods An online questionnaire was used to collect qualitative data in a cross-sectional study of working women. Three open-ended questions asked peri- and post-menopausal women, aged 45–65 years: (i) what they thought employers could do, or should do, to help menopausal women who may be experiencing difficult menopausal symptoms at work; (ii) how managers should behave; and (iii) how managers should not behave towards women going through the menopause. Results 137 women responded to the open questions in the survey. An inductive thematic analysis was conducted and three overarching themes emerged. Theme 1 related to employer/manager awareness, specifically to knowledge about the menopause and awareness of how the physical work environment might impact on menopausal women. Theme 2 related to employer/manager communication skills and behaviors, specifically those considered helpful and desired and those considered unhelpful and undesired. Theme 3 described employer actions, involving staff training and raising awareness, and supportive policies such as those relating to sickness absence and flexible working hours. Conclusions The menopause can be difficult for some women to deal with at work, partly due to the working environment. To our knowledge, this is the first study to explore women's descriptions of how they would like to be treated by employers/managers, and what would be helpful and unhelpful. The results have clear implications for communication about menopause at work and for employer-level policy and practice.