Dysmenorrhea Patients’ Experience with Work Productivity Impact and Treatment in Japan

Background Nearly 50% of Japanese women report impaired work performance due to menstrual symptoms. A survey of Japanese working women found that 44.6% of patients who did not seek treatment did so as they chose to endure the symptoms. We analyzed dysmenorrhea's impact on work productivity and its association with treatments using Japanese survey and claims data. Methods Using an anonymized database consisting of linked Japanese health insurance claims and Work Productivity and Activity Impairment Questionnaire - General Health (WPAI-GH) responses for women aged between 18 and 50 years, we conducted descriptive analyses of dysmenorrhea patients’ WPAI-GH survey responses, and compared dysmenorrhea’s impact with other chronic diseases and across dysmenorrhea patients grouped by treatment. We also analyzed patient-reported coping methods for menstrual pain. Results Among 9,235 individuals in the database, 956 (10.4%) had dysmenorrhea. The WPAI-GH scores for dysmenorrhea patients showed absenteeism at 2.5 ± 0.3% (mean ± standard error) and presenteeism at 26.8 ± 0.9%, comparable to mental disorders, headaches, or low back pain. Within dysmenorrhea patients, the highest rate of absenteeism was observed in patients who received the Kampo medicine (Chinese traditional herbal medicine adopted to and evolved in Japan) alone, followed by analgesic agents alone, and progestin alone. The highest rate of presenteeism was observed in patients with intrauterine devices, followed by analgesic agents alone and progestin alone. Patients who were treated with the most frequently used treatment, LEP (low-dose estrogen–progestin; also known as combined oral contraceptives), experienced second to the lowest absenteeism and presenteeism within treatment groups right above levonorgestrel intrauterine systems and Kampo medicine alone, respectively. Among 5,471 respondents who responded on coping methods for menstrual pain, 2,250 (41.1%) used over-the-counter medications, while only 329 (6.0%) sought medical care. Conclusion Dysmenorrhea’s impact was found to be significant and comparable to other major chronic conditions with high patient burden. We further found correlations between dysmenorrhea’s disease impact and treatment; suggesting the importance of treatment selection and joint decision making between patients and clinicians in promoting evidence-based dysmenorrhea treatment that takes productivity impact into account. Trial registration Not applicable