If you think that the physical and psychological discomforts that can accompany the days of menstrual flow and those leading up to it are a minor thing, you are either a man or a very lucky woman. Even when one does not suffer from actual conditions associated with the menstrual cycle such as endometriosis, in fact, the symptoms that most women have to deal with periodically throughout all or part of their fertile lives are quite challenging to endure and manage. Cramps and pain in the lower abdomen, which may radiate to the legs; back pain; nausea and intestinal discomfort; difficulty concentrating and headache; fatigue and general malaise; irritability, nervousness; depression or anxiety. Although benign and transient, combined in various ways in type and intensity, these manifestations can significantly interfere with daily activities for one or more days, preventing one from fulfilling one’s study and work commitments to the best of one’s ability. With socioeconomic repercussions as well, given the loss of productivity. A nationwide Dutch study involving nearly 33 thousand women, recruited from the general female population of childbearing age (15-45 years), assessed this impact through the administration of online questionnaires that investigated both the loss of productivity associated with menstrual flow-related absences from school or the workplace and that associated with “presenteeism,” i.e., being present in less than excellent mental and physical condition. The responses obtained showed that 13.8 percent of women of childbearing age occasionally have to take time off work or study commitments due to menstrual disorders, losing an average of 1.3 days per year. While this figure may appear reassuring (but it is not, considering that this is an average value and that menstrual flow is a physiological phenomenon and not a disease), the same cannot be said of the percentage of related presenteeism and reduced productivity, experienced by as many as 80.7 percent of the study participants for an average of 23.2 days per year (i.e., about 2 days per cycle). The researchers calculated that a loss of productivity of one-third (33 percent) of that secured under optimal psychophysical conditions for the average recorded period of presenteeism corresponds to a total annual loss of productivity of nearly 9 days: on a par with real illness. In addition, it should be considered that the absenteeism found among the women involved in the survey is likely to be lower than the actual absenteeism, since those responding to the online questionnaire were predominantly women with higher levels of education and engaged in activities that require less physical exertion than those performed by women with lower levels of education. The study also confirms that despite the considerable discomfort caused by menstrual flow, only a minority of women turn to the doctor for a satisfactory solution (45 percent according to the Dutch research, but around 15 percent in other surveys), resigning themselves to living with periodic discomfort. This is a situation that should be sought to be changed through increased education of both women and physicians in the protection of women’s well-being and reproductive health, and by developing labor policies geared toward providing greater flexibility of hours and tasks, with a view to reducing inconvenience and loss of productivity during the most critical phase of the cycle. For the benefit of all.
Source: Schoep ME et al. Productivity loss due to menstruation-related symptoms: a nationwide crosssectional survey among 32748 women. BMJ Open 2019;9:e026186. doi:10.1136/bmjopen-2018-026186
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