The impact of workplace psychosocial factors on menstrual disorders and infertility: a protocol for a systematic review and meta-analysis

Natsu Sasaki, Kotaro Imamura, Kazuhiro Watanabe, Yui Hidaka, Emiko Ando, Hisashi Eguchi, Akiomi Inoue, Kanami Tsuno, Yu Komase, Mako Iida, Yasumasa Otsuka, Asuka Sakuraya, Yumi Asai, Mai Iwanaga, Yuka Kobayashi, Reiko Inoue, Akihito Shimazu, Akizumi Tsutsumi, Norito Kawakami

Research output: Contribution to journalArticlepeer-review


Introduction: Workplace environment, especially psychosocial factors at work such as job strain, workplace social support, and shift work, may affect the menstrual abnormalities and fertility of female workers. However, the association between psychosocial factors at work and menstrual abnormalities or fertility is not well understood. To address this relationship, we will conduct a systematic review and a meta-analysis of the literature that has utilized a longitudinal or prospective cohort design. Methods and analysis: The inclusion criteria for this systematic review and meta-analysis are defined as follows: (P) adult female workers (over 18 years old), (E) the presence of adverse psychosocial factors at work, (C) the absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility. The MEDLINE, Embase, PsycINFO, PsycArticles, and Japan Medical Abstracts Society electronic databases will be used to search for published studies. The statistical synthesis of the studies included in the meta-analysis will be conducted to estimate pooled coefficients and 95% CIs. For the main analysis, we will synthesize measures of association between psychosocial factors at work and menstrual-related disorders/symptoms. At least three eligible studies will have to be gathered to conduct a meta-analysis; otherwise (i.e., if only one or two studies will be eligible and included), the results will be presented in a narrative table. We will use the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) to determine the quality of selected studies. To assess meta-bias, Egger’s test, along with a funnel plot, will be used to check for publication bias. Lastly, we will examine heterogeneity using the χ2 test with Cochran’s Q statistic and I2. Ethics and dissemination: The results and findings will be submitted and published in a scientific peer-reviewed journal and will be disseminated broadly to researchers and policymakers interested in the translatability of scientific evidence into good practices. Systematic review registration: The study protocol was registered at the UMIN registry (registration number: UMIN000039488). The registration date is on 14 Feb 2020. URL:

Original languageEnglish
Article number195
JournalSystematic Reviews
Issue number1
Publication statusPublished - 2022 Dec


  • Biopsychosocial medicine
  • Endocrine
  • Gynecology
  • Occupational health
  • Reproductive health

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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