OBJECTIVE: To estimate the effect of increased menstrual flow on the loss of work. METHODS: Heavy or otherwise abnormal menstrual bleeding is a common problem among women in the reproductive age range. Until now, there has been no evidence of its effect on absences from work. We used data from the National Health Interview Survey 1999, a personal interview household survey using a nationwide representative sample of the civilian noninstitutionalized population of the United States. Participants were 3133 women aged between 18 and 64 years who reported having a natural menstrual period in the last 12 months and in the last 3 months, never having taken medication containing estrogen (except past use of oral contraceptives), and never having been told that they had reproductive cancer. Analysis was performed using data from 2805 women, 373 having self-described heavy flow and 2432 having normal flow. The main outcome measure was work loss associated with the degree of menstrual flow. RESULTS: Using binary logistic regression, age, marital status, education, family size, perception of health, and flow of menstrual periods are associated with work losses (P < .05). The odds ratio of 0.72 (95% confidence interval 0.56, 0.92) indicates that women who have a heavier flow are 72% as likely to be working as are women who have a lighter or normal flow. CONCLUSION: Menstrual bleeding has significant economic implications for women in the workplace: work loss from increased blood flow is estimated to be $1692 annually per woman. © 2002 by The American College of Obstetricians and Gynecologists.
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