Menopause symptoms worsen with caregiver burden

Key takeaways:

• Half of midlife women who spent 15 hours or more per week caregiving reported moderate to severe menopausal symptoms.
• Heavy caregivers were 57% more likely to report worse menopause symptoms vs. non-caregivers.

PHILADELPHIA — Midlife women who identified as a family caregiver reported worse menopause-related symptoms as hours of caregiving rose, according to a presenter at the Annual Meeting of The Menopause Society.

More than half of those who spent at least 15 hours per week caregiving reported moderate to severe menopausal symptoms, Mariam Saadedine, MD, a postdoctoral fellow at Mayo Clinic Women’s Health Center in Rochester, Minnesota, said during her presentation.

“Caring for loved ones dealing with illness, disability, aging or other limitations can be exceptionally demanding, especially when you’re a middle-aged woman juggling the responsibilities of both your children and your parents,” Saadedine told Healio. “Caregiving can add to the challenges of going through menopause. Since caregiving and menopause often coincide in a woman’s life, it’s crucial to ensure that female caregivers receive the appropriate support and care during this challenging period.”

Saadedine and colleagues analyzed data from questionnaire responses from 4,295 women aged 45 to 60 years (mean age, 54.6 years; 96.6% white; 77.9% partnered; 93.5% with some college) in primary care at Mayo Clinic locations from March to June 2021. The data were collected as part of the Hormones and Experiences of Aging (HERA) study.

Among the participants, 19.7% reported currently caring for or making health care decisions for someone with a health condition or disability, and caregivers were evenly divided among groups providing care fewer than 5 hour per week (minimal), 5 to 14 hours per week (moderate) and at least 15 hours per week (heavy).

Among the minimal caregiving group, 34.1% reported moderate to severe symptoms in at least one domain on the Menopause Rating Scale (MRS) — somatic, psychological or urogenital — as did 42.6% of the moderate and 50.4% of the heavy caregiving groups (P < .001). Compared with no caregiving, providing at least 15 hours of care per week increased the likelihood of reporting moderate to severe symptoms in at least one MRS domain (OR = 1.77; 95% CI, 1.39-2.26; P < .001). After adjusting for caregiver relationship, employment status, current HT use and daily stress level, heavy caregivers were 57% more likely to report worse menopause symptom burden compared with non-caregivers (OR = 1.57; 95% CI, 1.22-2.02; P < .001).

“The relationship between the duration of caregiving and the likelihood of experiencing more intense menopause symptoms wasn’t solely attributable to daily stress levels or mental health. While these factors certainly play a role, they didn’t fully account for this connection,” Saadedine said. “This discovery is surprising because it suggests that there may be specific qualities or characteristics in midlife women who are caregivers that increase their likelihood of having more bothersome menopause symptoms. In simpler terms, it appears that caregiving itself has a distinct influence on menopause symptoms, beyond what we typically associate with stress and mental well-being.”

Saadedine said health care providers should ask about caregiving responsibilities to help identify women who may be at higher risk for worse menopause symptoms.

“With the expected increase in the demand for caregiving among midlife women as the U.S. population ages, there is a critical need for efforts to enhance menopause care and support during this transition,” Saadedine said.