The consequences of early menopause and menopause symptoms for labour market participation. Alex Bryson et al. Social Science & Medicine, Volume 293, January 2022, 114676. https://doi.org/10.1016/j.socscimed.2021.114676
Highlights
• Early natural menopause substantially reduces employment rates among women.
• The number of menopause symptoms women face is also associated with lower employment rates.
• These effects are larger for symptoms which women say “bother me a lot”.
• Psychological problems due to menopause are associated with the biggest employment effects.
Popular version: How does early menopause and menopause symptoms affect women’s careers? Mar 8 2022. https://blog.ukdataservice.ac.uk/how-does-early-menopause-and-menopause-symptoms-affect-womens-careers
Abstract: Using a difference-in-difference estimator we identify the causal impact of early menopause and menopause symptoms on the time women spend in employment through to their mid-50s. We find the onset of early natural menopause (before age 45) reduces months spent in employment by 9 percentage points once women enter their 50s compared with women who do not experience early menopause. Early menopause is not associated with a difference in full-time employment rates. The number of menopause symptoms women face at age 50 is associated with lower employment rates: each additional symptom lowers employment rates and full-time employment rates by around half a percentage point. But not all symptoms have the same effects. Vasomotor symptoms tend not to be associated with lower employment rates, whereas the employment of women who suffer psychological problems due to menopause is adversely affected. Every additional psychological problem associated with menopause reduces employment and full-time employment rates by 1–2 percentage points, rising to 2–4 percentage points when those symptoms are reported as particularly bothersome.
Keywords: MenopauseEarly menopauseMenopausal symptomsVasomotor symptomsEmploymentFull-time employmentBirth cohort
5. Conclusions
Our paper is the first to estimate the effects of early menopause and menopausal symptoms on employment and full-time employment rates among women. We exploit prospective birth cohort data for all women born in a particular week in 1958 to estimate the causal effects of menopause on employment rates using a difference-in-difference strategy. This technique compares the gap in employment rates during their 20s and early 30s with the employment gap in their 50s for women who went onto experience early menopause versus those who did not. We make similar comparisons between women according to the intensity with which they experienced menopausal symptoms when aged 50. In doing so we control for a rich array of variables collected at birth, in childhood, and in early adulthood which can affect employment prospects and experiences of menopause. We show employment and full-time employment trends during their 20s and early 30s did not differ significantly between the ‘treated’ group – those who went on to experience early menopause or more menopausal symptoms – and their ‘control’ groups who did not experience early menopause or did not suffer many menopausal symptoms. This provides some assurance that their employment rates may have trended in similar fashions later in their lives if they had not experienced menopause differently.
We find women's employment rates, and their full-time employment rates fall as the number of menopausal symptoms they report rises. Effects are larger for symptoms that are reported as ‘bothersome’. The effects are quantitatively large. For instance, a woman who experiences the mean number of menopausal symptoms at age 50 can expect to have an employment rate in her 50s that is 4 percentage points lower than a woman who has no menopausal symptoms.
Different types of menopause symptom have different employment effects. For instance, vasomotor symptoms do not affect full-time employment rates, and they only affect employment rates where they are considered ‘bothersome’. In contrast, psychological health problems associated with menopause significantly lower employment and full-time employment rates, and effects are much larger when those symptoms are ‘bothersome’.
Early menopause is associated with a very large (9 percentage point) reduction in employment rates once women reach their 50s, yet it has no statistically significant effect on women's full-time employment rates. It is unclear why early menopause should affect employment rates, but not full-time employment rates. This issue is worthy of further investigation.
It is striking that the inclusion and exclusion of potential confounders makes very little difference to the impact of early menopause and menopause symptoms on employment and full-time employment rates. Even though their inclusion increases the variance in employment rates explained by our models (as indicated by the adjusted R-squared) the coefficient and statistical significance of the interaction capturing the impact of menopause are nearly identical in all cases. Following Oster (2019) we take coefficient stability in the face of adjustments to conditioning covariates as an indication that results are unlikely to be biased by omitted variables.
There are some limitations to this study. First, although women are asked specifically to identify health-related symptoms due to the menopause, in some cases those symptoms may be due to other changes women are going through at the same time which are not directly linked to the menopause. Second, our data only collect information on symptoms related to menopause in the year leading up to the survey interview at age 50. Some women may have experienced symptoms earlier which did not persist to age 50, leading to some error in our ability to accurately capture symptoms related to menopause. Some women who experienced symptoms, but not at age 50, will be misclassified as having no symptoms. However, assuming symptoms experienced earlier than age 50 also have a detrimental impact on employment, this will mean our estimates of symptoms’ effects on employment are downwardly biased. Third, it is worth recalling that the Great Recession hit when the women in the study reached age 50. This was a very severe recession creating what were, at the time, unprecedented labour market problems for many. It would be valuable to see whether our results are replicated in more benign labour market conditions.
These negative employment effects of early menopause and menopausal symptoms are cause for some concern, not only because the size of the effects is large, but also because so many women suffer these problems. As we have shown, the mean number of menopausal symptoms experienced by women in this birth cohort when aged 50 was 8, including 2 particularly ‘bothersome’ symptoms. Five percent of women in the estimation sample had experienced early menopause.
These employment effects of early menopause and menopause symptoms add to the personal costs they have for women suffering from them in terms of their physical and mental health, and potentially their effects on women's private lives, although we do not quantify them here. They also have costs for society, in terms of the health care costs of treating women's symptoms, potential productivity losses from women's lost hours of work and ability to work productively. It is conceivable that they will also affect women's retirement decisions and thus pension entitlements.
Having identified the size and extent of the problem government and employers should consider steps that could be taken to ameliorate the problems women face in their working lives due to the menopause. That said, this is the first study of its kind, so there is value in seeking to replicate and extend research investigating the impact of early menopause and menopausal symptoms on labour market outcomes. First, it would be valuable to know whether the effects we identify might vary for other cohorts of women including more recent entrants to the labour market. Second, there would be value exploring the heterogeneity of menopausal effects and whether there are aspects of women's experiences that may ameliorate the effects of menopause. For instance, it may be that women are better able to manage menopause symptoms where they have greater opportunities to manage working patterns or working hours, as might be the case among self-employed women or employees in workplaces with policies and practices expressly intended to assist women affected by menopause. Third, we know very little about the effects of early menopause and menopausal symptoms on other aspects of women's labour market experiences. We would have a better picture if studies were undertaken to investigate the impacts of menopause on women's wellbeing at work, their job satisfaction and their earnings. Finally, we know of no studies piloting policies or practices in the workplace that might assist women in raising health-related problems they may have during menopause, nor in coping with those problems. These evaluations are needed to provide the evidence base employers and government need so they know what actions to take to improve women's working lives.
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