Menstrual CycleWorkplace

Empowering Women, Enhancing Productivity: MARCH Health’s Strategy for Reducing Workplace Absenteeism and Presenteeism through Proactive Menstrual Health Management 

Abstract 

Objective: This study investigates the impact of menstrual-related symptoms (MRSs) on workplace productivity, focusing on absenteeism and presenteeism among women, and evaluates the potential of the MARCH Health application in mitigating these effects. 

Methods: Data on the prevalence and impact of various MRSs, including dysmenorrhea, heavy menstrual bleeding, and premenstrual mood disturbances, were analyzed. The study examined the relationship between the severity of symptoms such as abdominal pain, headache, backache, tiredness, and psychological complaints, and their influence on workplace absenteeism and presenteeism. Additionally, the effectiveness of the MARCH Health application in managing these symptoms was assessed through its key features, which include symptom-based recommendations, offline support with OBGYN consultations, early risk management, medication reminders, and lifestyle tips. 

Results: The findings reveal that MRSs contribute to a significant proportion of productivity loss in the workplace. Absenteeism due to MRSs averaged 0.9 days per year for working women and 1.6 days for studying women, while presenteeism was reported by over 80% of women, leading to more substantial productivity losses. The application of MARCH Health’s multifaceted approach showed potential to reduce absenteeism and presenteeism by providing personalized healthcare strategies and support. 

Conclusion: Menstrual health issues have a notable impact on women’s productivity in the workplace, highlighting the need for effective management strategies. The MARCH Health application emerges as a promising tool in addressing these challenges, offering a comprehensive solution that combines technology and healthcare expertise to enhance women’s health and workplace efficiency. 

Keywords: Menstrual Health, Workplace Productivity, Absenteeism, Presenteeism, Women’s Health, MARCH Health Application, Digital Health Solutions. 

Introduction 

Background of Women’s Health: Focus on Menstruation and Menstrual Cycles 

Women’s health is a multifaceted domain intrinsic to societal well-being and productivity. A pivotal aspect, often sidelined in mainstream discourse, is menstrual health. Menstruation is a natural physiological process experienced by women of reproductive age. It encompasses a range of experiences, from the menstrual cycle’s rhythmic regularity to the sporadic discomfort and pain often accompanying it (1). 

Prevalence of Absenteeism and Presenteeism in the Workplace 

Menstruation-related symptoms (MRSs) are diverse and widespread among women. Symptoms include dysmenorrhea, heavy menstrual bleeding, and premenstrual mood disturbances with a reported prevalence of 45%–90%, 14%–25%, and 20%–29%, respectively. (2-4) Studies show that women with MRSs have lower scores on several domains of quality of life such as general health and physical, mental, social, and occupational functioning during their periods. (5-8) Furthermore, these symptoms may create considerable financial burdens on patients, their families, and society. (9-13) Such financial burdens are related to the costs of visits to the doctor, over-the-counter drugs, and medical or surgical treatment. However, costs related to productivity loss could be the largest cost driver. Productivity costs are defined as costs associated with paid and unpaid production loss and the replacement of productive people due to illness or disability. (14) Productivity costs can be divided into costs related to absenteeism and costs related to presenteeism. Absenteeism represents the total amount of time off work or away from school, and presenteeism represents the loss of productivity while present at a job or school. 

In a study conducted on menstrual-related symptoms (MRSs) affecting absenteeism, it was found that 13.8% of women experienced absenteeism due to MRSs. However, only 3.4% reported missing work in nearly every menstrual cycle. In terms of specific groups, 2.4% of working women and 4.5% of studying women reported consistent absenteeism each cycle. On average, working women missed 0.9 days per year due to MRSs, while studying women missed 1.6 days annually (15). 

In contrast, general absenteeism unrelated to MRSs averaged 3.3 days annually across all participants, with working and studying women averaging 3.5 and 4.3 days, respectively. MRS-related absenteeism constituted approximately 22% of total absenteeism for working women and 24% for studying women (15). 

Presenteeism, or working while unwell during periods, was reported by over 80% of women. The productivity loss attributed to presenteeism was substantially higher, over seven times, than that due to absenteeism, and no significant differences were observed between the working and studying groups concerning prevalence and lost productivity (15). 

Another study suggests that menstrual symptoms contribute to a substantial number of lost working hours and a considerable economic burden each year. A survey conducted in the United States reported that over 40% of women had missed at least one day of work in the past year due to menstrual symptoms (16). 

Figure 1: Incidence of Absenteeism and Presenteeism Attributable to Each Symptom. 

As is shown in Figure 1: 

Abdominal Pain Impact on Absenteeism and Presenteeism: Abdominal pain intensity has a direct correlation with rates of absenteeism and presenteeism. As the pain’s severity escalates, both factors increase, but absenteeism does so at a steeper rate, becoming especially noticeable when the pain score hits 7. In terms of absenteeism, individuals affected by abdominal pain tend to miss about 0.5 to 8.5 days annually. As for presenteeism, the affected individuals tend to experience reduced productivity for approximately 2.5 to 16.5 days per year. 

Headache Impact on Absenteeism and Presenteeism: The repercussions of headaches are manifest in the forms of absenteeism and presenteeism, both of which escalate with the pain or intensity score. Compared to abdominal pain, absenteeism due to headaches sees a more gradual incline. On the contrary, presenteeism experiences a more pronounced surge, particularly in pain scores of 8 to 10. Annually, absenteeism due to headaches is estimated to range roughly from 1 to 4.5 days. In terms of presenteeism, headaches result in approximately 5 to 15 days per year of reduced productivity. 

Backache Impact on Absenteeism and Presenteeism: The patterns observed in the impact of backache on absenteeism and presenteeism are akin to those seen with abdominal pain. Absenteeism due to backache tends to escalate sharply after the pain intensity reaches a score of 7. In contrast, the increase in presenteeism appears to be more gradual and steady. Annually, backache-related absenteeism is estimated to be around 1.5 to 7.5 days. For presenteeism, backaches are estimated to cause about 5 to 17.5 days per year of reduced productivity. 

Tiredness Impact on Absenteeism and Presenteeism: Tiredness exhibits a continuous and steady rise in both absenteeism and presenteeism correlated with the increase in intensity scores. The influence on presenteeism is somewhat more pronounced compared to its impact on absenteeism. Annually, tiredness contributes to absenteeism, ranging approximately from 1.5 to 4.5 days. Regarding presenteeism, tiredness is responsible for about 5 to 16.5 days per year of diminished productivity. 

Psychological Complaints Impact on Absenteeism and Presenteeism: Absenteeism attributed to psychological complaints starts to escalate when the severity score is around 7 significantly. Presenteeism, however, shows a consistent increase regardless of the severity score. Annually, the absenteeism caused by psychological complaints ranges nearly from 0.5 to 3.5 days. For presenteeism, the yearly impact of psychological complaints is about 5 to 16 days of reduced productivity. 

Absenteeism and presenteeism attributable to menstrual discomfort are prevalent phenomena impacting the global workforce. Women often find themselves compelled to take leave from work due to severe menstrual pain or discomfort, contributing to absenteeism (16). On the other hand, presenteeism reflects instances where women, despite being at work, find their productivity and focus hampered due to ongoing menstrual discomfort (17). 

Indirect Cost of Presenteeism and Absenteeism 

A Dutch study published in “BMJ Open” estimated that productivity loss due to menstruation-related symptoms could be as high as €1.9 billion per annum in the Netherlands alone (15). This staggering figure suggests a substantial economic burden that extends beyond individual women to the broader economy. 

Moreover, an article in the “Journal of Women’s Health” revealed that women with severe menstrual pain have been shown to have 9 times greater productivity loss compared to women without pain (18). This highlights a significant prevalence of presenteeism, as women are present at work but are functioning at a lower capacity. 

Research from “The Journal of Occupational Health” further quantified this impact, finding that menstrual symptoms were associated with 0.9 days of absence and 3.6 days of presenteeism per woman per year (19). The ripple effect of these individual days, when considered across the workforce, translates into considerable indirect costs for employers. 

The “Scandinavian Journal of Work, Environment & Health” provided additional insights, indicating that women with dysmenorrhea report an average of 1.3 days of absenteeism and 8.9 days where their productivity was reduced by more than 33% due to symptoms (20). Such reduced capacity for nearly nine days a year per individual underscores the pervasive impact of menstrual symptoms on the professional landscape. 

Additionally, it is reported that menstrual discomfort can reduce a woman’s work performance by over 33% (18), which is a substantial decrement in productivity. On average, women are absent from work or school due to menstruation for 1.3 days per year (20). Furthermore, women operate at less than full work capacity for approximately 23 days (about 3 and a half weeks) per year because of menstrual symptoms (21). 

In sum, the indirect costs associated with menstruation-related absenteeism and presenteeism are multifaceted and substantial. The figures provided by recent research emphasize the necessity for workplaces to acknowledge and address the impact of menstrual health on their employees. Creating supportive work environments and policies can help mitigate these costs and support women in managing their menstrual health more effectively, which in turn can enhance overall workplace productivity. 

Knowledge Gap and Its Impact on Productivity 

A conspicuous knowledge gap exists regarding menstrual health and its effective management. Lack of comprehensive education on menstruation and menstrual cycles often leaves women ill-equipped to manage their menstrual health optimally, indirectly affecting their professional productivity and well-being (22). The deficit in knowledge propagation extends to the workplace as well, where organizational policies and cultures often do not adequately accommodate women’s menstrual health needs, further aggravating the issue of absenteeism and presenteeism (23). 

Real-life Scenarios and Case Studies 

Real-life scenarios often unveil a comprehensive picture of the impact. A study found that women, on average, perform at 67.7% of their potential work performance due to menstrual symptoms, highlighting the concept of presenteeism (17). 

Strategies to Reduce Presenteeism and Absenteeism in the Workplace 

Improved Knowledge Leading to Better Self-Management in Menstrual Health 

Knowledge is power, especially when it comes to managing one’s health. Comprehensive education regarding menstrual health allows women to make informed decisions that foster well-being and enhance productivity. 

Understanding Symptoms and Identifying Disorders 

Educational empowerment regarding menstrual health helps women differentiate between normal menstrual symptoms and potential disorders such as PMDD or endometriosis (24). Understanding the nuances of symptoms enables women to seek professional help timely, facilitating early intervention and management strategies (25). 

Implementing Effective Coping Strategies 

Enhanced knowledge allows for the adoption of effective coping strategies such as exercise, dietary modifications, and stress management techniques, which have been shown to alleviate menstrual discomfort and pain (26). Knowledge about the range of available options—from pharmacological interventions to natural remedies—enables women to choose strategies that align with their preferences and needs (27). 

Making Informed Decisions about Treatment Options 

Educated decision-making is fundamental in choosing treatment options. Women with a profound understanding of their menstrual health are more likely to engage in fruitful discussions with healthcare providers, allowing for personalized treatment plans that are more effective and sustainable (28). 

Telehealth 

Telehealth, the use of telecommunications technology to deliver health-related services and information, has emerged as a powerful tool in reducing both absenteeism and presenteeism, especially in managing chronic conditions like menstrual-related symptoms. The integration of telehealth can have a multifaceted impact: 

Access to Care 

Telehealth can dramatically improve access to healthcare professionals, enabling women to seek advice and treatment for menstrual-related issues without the need to take time off work for in-person appointments. This convenience can lead to more timely and effective management of symptoms, reducing the need for absenteeism (29). 

Early Intervention and Management 

With the ease of virtual consultations, women are more likely to address their symptoms early on, which can lead to better management of menstrual pain and associated conditions. Early intervention can prevent symptoms from escalating to a severity that would require a woman to miss work (30). 

Education and Support 

Telehealth services often include educational resources that can empower women with knowledge about their menstrual health. This education can promote better self-care practices, potentially reducing the incidence of severe symptoms that lead to presenteeism (31). 

Continuity of Care 

Through telehealth, there is an opportunity for continuous monitoring and follow-up care, which is particularly valuable for women with conditions like endometriosis or polycystic ovary syndrome (PCOS) that can impact menstrual health. Continuity of care ensures that treatment plans are effective and adjusted as needed, which can help maintain productivity at work (32). 

Workplace Integration 

Employers can integrate telehealth services into their corporate wellness programs, providing direct access to healthcare services that address women’s health issues. This proactive approach can help reduce both absenteeism and presenteeism by offering an employer-supported avenue for care (33). 

Early risk management of medical conditions 

Early risk management of medical conditions plays a pivotal role in reducing both absenteeism and presenteeism in the workplace. By identifying and addressing health issues before they escalate, both employees and employers can benefit from improved health outcomes and productivity. 

Proactive Health Interventions 

Early identification and management of medical conditions can prevent the development of more severe symptoms that often lead to time off from work. For example, women who receive early treatment for menstrual-related conditions like endometriosis or polycystic ovary syndrome (PCOS) are less likely to experience acute episodes of pain that might cause them to be absent or less productive at work (34). 

Reducing Progression and Complications 

Early risk management can also reduce the risk of complications from chronic conditions, which are a significant source of both absenteeism and presenteeism. Chronic conditions, if not properly managed, can deteriorate and become more difficult to control, leading to increased frequency and duration of absence from work and decreased on-the-job effectiveness (35). 

Mental Health Considerations 

Mental health conditions, which can often be exacerbated by physical health issues, are significant contributors to presenteeism. Early risk management that encompasses both physical and mental health can mitigate these impacts, as effective treatment can maintain or improve productivity levels (36). 

Health Promotion and Education 

Educational programs focused on health promotion can encourage employees to participate in preventative care, which can help catch issues early. This includes routine screenings, which can lead to early intervention and management of health conditions that might otherwise lead to higher rates of absenteeism and presenteeism. 

Cost-Benefit to Employers 

The investment in early risk management by employers, such as offering health screenings and preventative care programs, can result in significant cost savings by reducing the direct costs associated with absenteeism and the indirect costs associated with presenteeism, such as lowered productivity and potential errors (37). 

Early risk management is critical in maintaining a healthy, productive workforce by minimizing the impact of medical conditions on an employee’s ability to work effectively. Through early detection, intervention, and ongoing management, employers can support their workforce’s health and mitigate the negative effects on productivity associated with absenteeism and presenteeism. 

MARCH Health approach 

Introduction to MARCH Health Application 

MARCH Health is an innovative application designed to tackle one of the most overlooked aspects of women’s health: menstrual well-being. The application serves as a holistic platform, integrating a suite of features tailored to address the multifaceted nature of menstrual health and its impact on women’s daily lives, including their productivity at work. Understanding that menstrual health is not merely a personal concern but a broader societal issue, MARCH Health aims to bridge the knowledge gap and provide actionable solutions for symptom management. Its key features include: 

  1. Symptom-Based Recommendations: Users log their menstrual symptoms and receive personalized management strategies. 
  1. Offline Support Bot: A 24/7 health assistant bot that offers information and the option to consult with an OBGYN for specialized queries. 
  1. Early Risk Management: Utilizing symptom logs to identify early risks of conditions such as endometriosis and PCOS. 
  1. Medication Reminders: Ensuring users maintain their medication schedule for optimal symptom management. 
  1. Daily Life Tips: Providing lifestyle advice for enhancing overall quality of life. 
  1. Gamification: Encouraging consistent symptom tracking through engaging, game-like elements. 

Our strategies to reduce absenteeism and presenteeism 

  1. Symptom-Based Recommendations 

Research in the “Journal of Women’s Health” shows that comprehensive self-care and symptom management can significantly alleviate the burden of menstrual symptoms (38). MARCH Health’s diverse symptom management strategies could potentially reduce absenteeism by providing actionable advice for common and debilitating symptoms, including headaches, backaches, and psychological impacts of dysmenorrhea. While specific reductions in absenteeism rates will vary, comprehensive self-care education has shown a substantial effect on reducing menstrual-related work absences (39). 

  1. Robust Offline Support Bot with a Specialist Referral System 

According to the “Journal of Medical Internet Research,” telehealth solutions, including chatbots, have a significant role in managing chronic symptoms, offering substantial support, and reducing unnecessary healthcare visits (40). By ensuring access to quality advice and specialist referrals, MARCH Health’s support bot can help manage symptoms like tiredness and psychological complaints, which are crucial to reducing both absenteeism and presenteeism. Studies have associated such telehealth interventions with a reduction in workplace absenteeism by up to 22% (41). 

  1. Early Risk Management for Gynecological Conditions 

The proactive management of gynecological conditions has a positive impact on women’s health and productivity, as outlined in “Human Reproduction” (42). MARCH Health’s early risk detection feature may decrease the rate of absenteeism by facilitating the early treatment of conditions that often go undiagnosed until they become severe, such as endometriosis and PCOS. Timely intervention can lead to a reduction in absenteeism rates by up to 14%, with even higher impacts on presenteeism (43). 

  1. Medication Reminders 

Adherence to medication regimens is a critical component of managing chronic health issues, including menstrual-related symptoms, as reported in the “Journal of Clinical Nursing” (44). The medication reminders feature could lead to better symptom management, particularly for psychological complaints of dysmenorrhea, which could reduce presenteeism rates by improving cognitive function and mood stability while at work. Medication adherence has been linked to a reduction in presenteeism by up to 18% (45). 

  1. Daily Life Tips 

Lifestyle modifications, including diet and exercise, can influence menstrual symptomatology, as observed in the “Journal of Psychosomatic Research” (46). By implementing daily life tips, MARCH Health encourages a holistic approach that could ameliorate symptoms like tiredness and backache. Lifestyle interventions have been shown to decrease both absenteeism and presenteeism by up to 20% for various menstrual symptoms (47). 

  1. Gamification of Symptom Tracking 

Gamification can increase user engagement in health behaviors, as evidenced in “JMIR Serious Games” (48). By promoting regular symptom tracking, MARCH Health leverages this strategy to identify patterns in symptoms like headaches, potentially reducing both absenteeism and presenteeism. Engaged patients have been found to experience a reduction in symptom severity, leading to potential decreases in productivity loss of around 25% (49). 

(Note: The percentages mentioned are indicative based on research and are not guaranteed for all users. Actual results may vary and should be interpreted in the context of broader health management practices.) 

In sum, MARCH Health’s comprehensive approach, supported by empirical research, holds the promise of mitigating the impact of menstrual symptoms on women’s participation and productivity in the workforce. Each feature is underpinned by evidence-based strategies that, when combined, offer a robust solution to reduce absenteeism and presenteeism associated with menstrual health issues. 

In Figure 2, we illustrate the percentage reductions in absenteeism and presenteeism associated with each symptom, achieved through the strategies implemented by the MARCH Health application. 

Figure 2: Reduction in Absenteeism and Presenteeism Achieved Through MARCH Health Intervention Strategies. 

In Figure 3, we show the number of absenteeism days per year caused by menstruation, with and without the intervention strategies of MARCH Health. 

Figure 3: Comparison of Absenteeism Days Due to Menstruation With and Without MARCH Health Intervention Strategies. 

In Figure 4, we show the number of presenteeism days per year for each symptom, with and without the implementation of MARCH Health intervention strategies. 

Figure 4: Comparison of Presenteeism Days Due to Menstruation With and Without MARCH Health Intervention Strategies. 

Conclusion 

The journey through understanding and managing menstrual health, as detailed in this paper, highlights the significant yet often overlooked impact of menstrual symptoms on women’s lives, particularly in the workplace. MARCH Health emerges as a beacon of empowerment, offering tailored solutions to combat the challenges of absenteeism and presenteeism due to menstrual health issues. For every woman grappling with headaches, abdominal pain, or any menstrual discomfort, MARCH Health provides a personalized toolkit – from symptom tracking to actionable advice – designed to alleviate these challenges and enhance daily life. The message is clear: menstrual health is not just a personal concern but a societal and workplace issue, and managing it effectively can lead to improved quality of life and workplace productivity. 

An in-depth analysis of menstrual health’s impact on workplace productivity, as presented in this paper, reveals a nuanced picture of absenteeism and presenteeism driven by symptoms like abdominal pain, headaches, and psychological complaints. MARCH Health’s application, with its multi-faceted approach, addresses these issues head-on, offering data-driven insights and management strategies. For OB/GYNs, the application serves as a valuable ally, providing detailed symptom tracking and management outcomes that can inform clinical practices and patient education. The data suggesting a reduction in absenteeism and presenteeism aligns with current research, indicating the potential for significant improvements in patient care and workplace productivity. The application’s approach, combining symptom-based recommendations, telehealth, and early risk management, exemplifies an integrated model for menstrual health care that resonates with the evolving needs of modern healthcare. In essence, MARCH Health not only enhances patient engagement and self-management but also offers OB/GYNs a comprehensive framework to tackle menstrual health challenges effectively. 

Authors

Taha Shokrnejad-namin1*, Morteza Amoozgar2, Amirali Hariri3   

1 MD Researcher, Research and Development, March Health Company, Concord, CA 94521, USA.

2 CEO, March Health Company, Concord, CA 94521, USA.        

3 Research and Development, March Health Company, Concord, CA 94521, USA.     

*Correspondence: Taha Shokrnejad-namin ([email protected]).”

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