The present study investigated the effect of menstruation/menopause symptoms on the association between post-traumatic stress disorder (PTSD) symptoms related the COVID-19 pandemic and loneliness in Japanese female workers. A web survey of 530 female workers (303 pre-menopausal and 217 post-menopausal women) was conducted in February 2023, in Japan. The Japanese version of the Impact of Event Scale-Revised was used to evaluate PTSD symptoms. Symptoms of premenstrual syndrome (PMS) were investigated in 263 pre-menopausal women (mean age=37.0years, SD=8.9) and 203 post-menopausal women (mean age=57.1years, SD=9 0.6) were asked about menopausal symptoms. The Japanese version of the three-item loneliness scale. The pre-menopausal women scored higher in loneliness than the post-menopausal women. However, after adjusting for age, this significant difference was attenuated. Results of multiple regression analyses showed that PMS symptoms were positively associated with loneliness in the pre-menopausal women. In comparison, both PTSD symptoms and menopause symptoms were positively associated with loneliness in post-menopausal women. There was no interaction between PMS/menopausal symptoms and PTSD symptoms in loneliness scores. The indirect effect of PMS symptoms, particularly the psychological symptoms, was associated with PTSD symptoms and loneliness in pre-menopausal women. In addition, there was a significant indirect effect of menopausal symptoms in the post-menopausal women. When female workers were subjected to COVID-19 pandemic-related psychological stress, their menstrual and menopausal symptoms would lead to intensified loneliness, especially in pre-menopausal women.
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