Psychometric validity and clinical utility of the GHQ-12 for screening psychological health in isolated, confined and unusual or extreme environments.

Menopause is a natural biological transition characterized by the permanent cessation of menstruation resulting from the loss of ovarian hormone production for at least 12 consecutive months. The menopausal transition typically occurs between 45 and 55 years of age and is frequently accompanied by vasomotor, psychological, and somatic symptoms that may substantially affect quality of life and daily functioning. Although most women experience menopausal symptoms, symptom severity varies widely, and a substantial proportion of women report clinically significant impairment. Socially, menopausal symptoms are increasingly recognized as an important occupational health issue. Midlife women represent a growing proportion of the global workforce, and symptom burden during the menopausal transition has been associated with reduced work performance, increased presenteeism, and higher risk of workforce attrition. Despite experiencing such symptoms, many working women delay seeking medical attention due to work-related demands or other reasons. Epidemiological studies indicate that only a minority of women with moderate-to-severe menopausal symptoms consult health care professionals, highlighting a major gap between symptom burden and access to care. Beyond individual symptom burden, the experience of menopause in the workplace is shaped by physical, psychosocial, and organizational factors. Greater symptom severity has been associated with impaired daily functioning and reduced work performance, and midlife women may therefore experience broader occupational and economic consequences. Economic analyses further highlight substantial productivity losses attributable to menopause-related symptoms. Despite growing recognition of this issue, structured strategies for early identification and preventive intervention remain limited in most occupational settings. As the diagnosis of menopausal disorders relies largely on self-reported symptoms and workplace functioning is influenced by multiple contextual factors, effective support requires timely medical evaluation integrated within a holistic workplace framework. To objectively evaluate menopausal symptom burden in occupational research settings, a reliable and structured assessment tool is essential. The Simplified Menopausal Index (SMI) is a 10-item questionnaire widely used in Japan to assess the severity of menopausal symptoms across vasomotor, psychological, and somatic domains () . Each item is rated on a four-point scale and weighted according to clinical relevance, yielding a total score ranging from 0 to 100. Scores are typically categorized as follows: 0–25 indicates minimal symptoms, 26–50 mild symptoms, and ≥51 moderate to severe symptoms. Individuals with SMI scores ≥51 are generally considered candidates for clinical evaluation and appropriate intervention. However, because the diagnosis of menopausal disorders relies primarily on self-reported symptoms rather than objective biomarkers, early identification in workplace settings may remain challenging until symptom burden becomes clinically significant. Hormone replacement therapy remains the most effective treatment for menopausal symptoms, however, contraindications, safety concerns, and personal preferences limit its use. Cognitive behavioral therapy (CBT) has emerged as an evidence-based nonhormonal treatment for menopausal symptoms, particularly vasomotor symptoms, sleep disturbance, anxiety, and mood changes. The Menopause Society’s 2023 evidence-based position statement now recommends CBT as a first-line nonpharmacologic option, and recent International Menopause Society recommendations also support CBT as an effective nonhormonal therapy for menopausal symptoms.