Premenstrual Syndrome Carries High Costs for Employers

The presence of premenstrual syndrome (PMS) in female workers is associated with sharply increased costs to
employers-mainly related to the indirect costs of missed work time and reduced productivity, reports a study in the January
Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and
Environmental Medicine (ACOEM).


Led by Dr. Jeff Borenstein of Cedars-Sinai Medical Center, Los Angeles, the researchers assessed PMS symptoms in 374 working
women. The women were all 18 to 45 years old and had regular menstrual cycles. Over a 2-month period, the women recorded any
PMS symptoms in symptom diaries, along with any missed work time and estimates of lost productivity related to PMS.


Based on symptom diaries, 30 percent of the women were diagnosed with PMS. Insurance claims data showed a modest increase in
direct health costs for women with PMS: an average $59 higher per year than for women without PMS, after adjustment for other
factors.


Where PMS had its greatest impact was on indirect costs for missed work time and lost productivity. Women with PMS had an
average 14 percent reduction in expected hours of work per week plus a 15 percent reduction in productivity when at work,
compared to women without PMS.


Total indirect costs related to PMS were estimated at $4,333 higher per year, compared to women without PMS. In a
hypothetical health plan including 10,000 women aged 18 to 45, PMS would increase indirect costs by nearly $13 million per
year, in addition to a $175,000 increase in direct health costs.


Previous studies have shown a high rate of PMS among women of reproductive age, with a significant impact on their personal
and work life. However, few studies have looked at the economic impact of PMS among working women. In assessing the indirect
costs of illness to employers, it is important to account not only for absenteeism, or missed work days due to illness, but
also for lost productivity. This problem, sometimes called "presenteeism," is defined as health problems that are not severe
enough to cause absence from work but still impact employees' performance while at work.


The new results show that the indirect costs of PMS are many times higher than the direct costs. Employers seeking to control
their indirect health-related costs should be aware of the potential economic impact of PMS among their female employees, as
well as the financial benefits of offering effective treatment for this condition, Dr. Borenstein and coauthors suggest. They
conclude, "[C]orporate benefits plans that support the use of clinically effective PMS therapies are likely to be a
cost-effective investment."


ACOEM, an international society of 6,000 occupational physicians and other healthcare professionals, provides leadership to
promote optimal health and safety of workers, workplaces, and environments.


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