Mediating effects of menstruation/menopause on the association between the COVID-19 pandemic related post-traumatic stress disorder symptoms and loneliness in Japanese female workers: A cross-sectional study

Abstract

Objective

The present study investigated the effect of menstruation/menopause symptoms on the association between post-traumatic stress disorder (PTSD) symptoms related the COVID-19 pandemic and loneliness in Japanese female workers.

Study design

A web survey of 530 female workers (303 pre-menopausal and 217 post-menopausal women) was conducted in February 2023, in Japan. The Japanese version of the Impact of Event Scale–Revised was used to evaluate PTSD symptoms. Symptoms of premenstrual syndrome (PMS) were investigated in 263 pre-menopausal women (mean age = 37.0 years, SD = 8.9) and 203 post-menopausal women (mean age = 57.1 years, SD = 9 0.6) were asked about menopausal symptoms.

Main outcome measure

The Japanese version of the three-item loneliness scale.

Results

The pre-menopausal women scored higher in loneliness than the post-menopausal women. However, after adjusting for age, this significant difference was attenuated. Results of multiple regression analyses showed that PMS symptoms were positively associated with loneliness in the pre-menopausal women. In comparison, both PTSD symptoms and menopause symptoms were positively associated with loneliness in post-menopausal women. There was no interaction between PMS/menopausal symptoms and PTSD symptoms in loneliness scores. The indirect effect of PMS symptoms, particularly the psychological symptoms, was associated with PTSD symptoms and loneliness in pre-menopausal women. In addition, there was a significant indirect effect of menopausal symptoms in the post-menopausal women.

Conclusions

When female workers were subjected to COVID-19 pandemic-related psychological stress, their menstrual and menopausal symptoms would lead to intensified loneliness, especially in pre-menopausal women.