Menopausal symptoms, work ability, and quality of life: a cross-sectional study among employed women in southern India.

Introduction: Menopausal symptoms impair midlife women's quality of life and work ability, especially in physically demanding low-resource jobs, yet occupational variations remain underexplored in India. This study examines symptom prevalence, severity, and impacts on work ability and quality of life among southern Indian working women. Methods: A community-based analytical cross-sectional study was conducted among 280 employed menopausal women aged 45-65 years, representing diverse occupational groups. Data were collected through face-to-face interviews using standardized tools. Correlation analyses and heat-map visualizations examined relationships between symptom severity, quality of life, occupation, and work ability. Bootstrap-adjusted logistic regression with false discovery rate correction identified predictors of poor work ability (WAI ≤27). Results: Overall, 73.2% of participants reported moderate-to-severe menopausal symptoms, with the highest burden observed among unskilled workers. Symptoms significantly affected physical, psychological, and vasomotor quality-of-life domains, particularly in physically demanding occupations. Women reporting reduced capacity to perform usual activities had nearly twice the odds of poor work ability. Sleep problems and fatigue were also independently associated with poor work ability. Symptom severity showed a strong positive correlation with poorer quality of life and a negative association with work ability; most pronounced among unskilled women. Conclusion: Menopausal symptoms are highly prevalent and adversely affect work ability and quality of life among employed women, especially those in low-autonomy or physically demanding jobs. These findings underscore the need for occupation-sensitive workplace policies, targeted health education, and supportive interventions to promote well-being, productivity, and workforce retention.