OBJECTIVES: The majority of working women of menopausal age experience vasomotor (VMS) and other bothersome symptoms with multifaceted impacts on society and economic activity. We aim to synthesize quantitative and qualitative evidence related to work impairment and reflect on the estimated productivity losses due to menopausal symptoms.

METHODS: An economic systematic literature review (SLR) (protocol registered with PROSPERO [CRD42022312194]) and a targeted burden of illness review were conducted. MEDLINE®, Embase®, MEDLINE in-Process, EconLit®, HTAD, DARE, NHS EED were searched systematically to identify studies assessing productivity loss and menopausal symptoms. Searches were conducted in accordance with PRISMA. Reports from Labor organizations and relevant public institutions were also screened; supplemental hand searches related to qualitative evidence of SLR references were conducted to contextualize the reported productivity impacts and costs.

RESULTS: The annual productivity loss costs in the US range from $1,116.76 to $7,658.79 (2021 USD) per individual. Women with VMS also experience sleep problems, fatigue, anxiety and depression. Disruption of sleep can lead to impaired alertness and mental acuity, forgetfulness, and therefore decreased productivity, as well as being associated with depression. The most common occupations for women aged 45 to 54 in the US (Labor Statistics, 2021) were education, healthcare, business and social services; these professions are likely to be disproportionately affected by poorly controlled menopausal symptoms. Education, healthcare and the social sector all have acknowledged issues of burn-out, early retirement or presenteeism relating to menopausal women.

CONCLUSIONS: The evidence clearly demonstrates the reduced productivity due to untreated menopausal symptoms in working women. Additional substantial economic and social implications are associated with menopausal women leaving the workforce. The reported impacts are likely to be underestimated due to social stigma. Increased awareness and effective policies are needed to support menopausal women in the workplace.