Are menopausal and andropausal symptoms associated with presenteeism? A cross-sectional survey of white-collar employees at 14 large corporations in Tokyo, Japan.

Objective: This study aimed to investigate the association of menopausal and andropausal symptom severity with presenteeism among working Japanese adults. Methods: A cross-sectional survey of 3063 employees (1912 men aged ≥30 years and 1151 women aged ≥40 years) from 14 corporations headquartered in Tokyo's Marunouchi District was conducted. Menopausal (women) and andropausal (men) symptoms were assessed using the Simplified Menopausal Index and Aging Male Symptom scale, respectively. Respondents recalled and reported the number of presenteeism days within the past month. Mixed-effects negative binomial regression was used to evaluate the association between menopausal and andropausal symptom severity and the risk of presenteeism, adjusting for sociodemographic, lifestyle and employment-related factors. Results: Among women aged ≥40 years, 28% reported moderate-to-severe menopausal symptoms, while 27.5% of men aged ≥30 years reported moderate-to-severe andropausal symptoms. Women with menopausal symptoms requiring treatment and those with severe symptoms had significantly higher risks of presenteeism than those without symptoms, with adjusted relative risks of 2.47 (95% CI 1.76 to 3.45) and 2.98 (95% CI 1.74 to 5.11), respectively. Men with severe andropausal symptoms had a 3.55-fold higher risk (95% CI 2.65 to 4.74) of experiencing presenteeism than those without symptoms. These associations remained robust among women and men even after excluding participants with psychological distress. Conclusions: Higher menopausal and andropausal symptom severity was significantly associated with an increased risk of presenteeism among working Japanese adults. Inclusive workplace health policies acknowledging these symptoms as critical factors influencing presenteeism, organisational well-being and sex equity are essential.