Does job stress increase menstruation-related symptoms, and does psychological distress play a role?

Objective: This study examined the relative contributions of mediation and interaction by psychological distress to the association between job stressors and menstruation-related symptoms. Design: A cross-sectional study. Setting: Online survey in August 2023. Population: Japanese full-time female employees aged 20-44 not taking contraceptives. Methods: Four-way decomposition analysis was used to estimate the relative contributions of psychological distress (mediation and interaction) to the potential pathways from job stressors and menstruation-related symptoms. Main outcome measures: The Menstrual Distress Questionnaire assessed menstruation-related symptoms before and during menstruation. Results: Of 1818 participants, 995 (54.7%) demonstrated severe menstruation-related symptoms. Multivariable logistic regression showed that high job demands (OR = 1.50, 95% CI: 1.27-1.84) and low coworker support (OR = 1.57, 95% CI: 1.22-2.02) were associated with menstruation-related symptoms whereas job control and supervisor support were not. Relative excess risks due to interaction with psychological distress indicated were positive and large in coworker support (RERI = 1.04, 95% CI: -0.34-2.41). In the four-way decomposition analysis, the pure indirect effect (48.4%) and controlled direct effect (37.8%) accounted for a large part in job demands. In contrast, the proportion attributable interaction (44.1%) dominated the total effect and controlled direct effect (15.6%) accounted for fewer effects in coworker support. Conclusions: Psychological distress appeared to be an important determinant of menstruation-related symptoms in relation to job stressors. This study suggested that reducing job demands and improving coworker support accompanied with mental health care can mitigate the adverse effect of job stressors on menstruation-related symptoms.

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