WOMEN'S HEALTH
Caregiving hours increase menopause burden, researchers find
Study in Mayo Clinic Proceedings highlights a critical need for greater advocacy for more inclusive healthcare policies and support systems for midlife women in caregiving roles
Elsevier
Researchers have identified a link between the number of caregiving hours per week a woman performs and menopause symptom burden. A novel study in Mayo Clinic Proceedings, published by Elsevier, found that women caregiving for more than 15 hours a week have significantly increased odds of experiencing moderate or severe menopause symptoms. It sheds light on the adverse health outcomes associated with an increased burden of caregiving.
The majority of caregivers in the United States are women with an average age of 50 years. The duration of caregiving in the United States is about five years, further raising the likelihood that women who are caregivers are likely to experience the menopause transition in the course of caregiving. They are generally having children later in life such that they may have, in midlife, the dual and concurrent commitment to care for their own children as well as an aged adult, known as the “sandwich generation.”
Caregiving can undermine a caregiver’s lifestyle, compromise their ability to focus on their own health, and contribute to higher levels of anxiety, depression, and burnout, with these effects being more pronounced in women than in men. The overlap of caregiving and menopause may impose a disproportionate physical and emotional burden on midlife women. The current study was conducted to assess the association between caregiving status, hours spent caregiving, and menopause symptom severity.
Lead Investigator Stephanie S. Faubion, MD, MBA, Division of General Internal Medicine, Mayo Clinic Women’s Health, Mayo Clinic, Jacksonville, FL, says, "This study demonstrates an association between time spent caregiving and menopause symptom burden in midlife women. Women have many different roles, and during midlife, they may be navigating challenging careers, dealing with menopause, and at the same time may have significant caregiving responsibilities for an aging parent, a partner, or even a child with special needs. It is critical to better understand these links so that we can better support women during this universal life transition."
In a cross-sectional analysis conducted among 4,295 women aged 45-60 years who received primary care at one of four Mayo Clinic locations between March 1 and June 30, 2021, 19.7% self-identified as caregivers and 37.6% reported moderate to very severe menopause symptoms as assessed by the Menopause Rating Scale. The burden of menopause symptoms across all symptom domains increased as the weekly number of caregiving hours increased, and this association persisted when relevant indices of daily stress levels and mental health were taken into consideration: 34.1% in the less than 5 hours/week group, 42.6% in the 5-14 hours/week group, and 50.4% in the 15 hours or more/week group. Further analysis showed that caregiving for 15 hours or more/week significantly increased the odds of having moderate or worse menopause symptoms in at least one symptom domain compared to no caregiving.
Co-investigator Ekta Kapoor, MBBS, Mayo Clinic Women’s Health and Women’s Health Research Center, Mayo Clinic, Rochester, MN, notes, "Menopause and caregiving are two life experiences that commonly intersect, yet their reciprocal influences had not been explored prior to this study. We have major gaps in understanding the menopause experience and how it differs in diverse populations or under different circumstances. This is the first study to examine an association between menopause symptoms and caregiving in midlife women, helping to provide more clarity on the full lived experiences of women in midlife."
Co-investigator Chrisandra L. Shufelt, MD, MS, Division of General Internal Medicine, Mayo Clinic Women’s Health, and Women’s Health Research Center, Mayo Clinic, Jacksonville, FL, adds, "This study is crucial because women in midlife or approaching menopause often juggle caregiving responsibilities for both children and aging parents, finding themselves in the ‘sandwich generation.’ Given the aging US population and likely resultant increases in caregiving burden that can exacerbate menopausal symptoms, women should be aware of effective treatment options available through a menopause provider. Our study highlights the need for greater advocacy for more inclusive healthcare policies and support systems for midlife women in caregiving roles."
The investigators offer the compelling suggestion that caregiver status should be included under the rubric social determinants of health (SDOH); be assessed and documented in the medical record; and be considered for its potential exacerbatory effects on menopause symptoms and its other risks.
Karl A. Nath, MBChB, Mayo Clinic Division of Nephrology and Hypertension, and Editor-in-Chief of Mayo Clinic Proceedings, comments, “Caregiving is essentially altruistic in origin, but it should not be a zero sum game, wherein the beneficent and unfettered provision of care and support then impose a stressful and inordinate burden on the caregiver. In this regard, this study provides needed advocacy for health care policies and support systems that can aid and ease the burdens of the caregiver including those that worsen menopause symptoms.”
Information on menopause-certified clinicians can be found on the Menopause Society website at menopause.org.
Journal
Mayo Clinic Proceedings
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Mayo Clinic Proceedings
Study shows potential of resveratrol to aid fertility
Research suggests natural compound can improve quantity and quality of egg cells
Anglia Ruskin University
New research indicates that a natural compound found in the skin of grapes, blueberries and raspberries has the potential to improve female fertility.
The systematic review into resveratrol, which is a polyphenolic compound known for its antiaging, anti-inflammatory and antioxidant properties, is published in the International Journal of Molecular Sciences.
Researchers from Anglia Ruskin University (ARU) in Cambridge, England, alongside colleagues from Italy, South Korea and the Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust, examined all previously published research on resveratrol and female reproductive health.
By collating and reviewing results from 24 in vitro and in vivo studies, involving a total of 9,563 human participants, they found evidence to suggest resveratrol can improve the quantity and quality of egg cells, called oocytes.
Four studies specifically investigated resveratrol in connection with the quantity of matured oocytes. Two of these reported an increase, while two found no significant differences. Additionally, two studies assessed the quality of matured oocytes and both reported an improvement amongst women who took resveratrol.
A possible explanation is that resveratrol reduces oxidative stress, helping to protect mitochondrial DNA from damage and enhance telomerase activity, to reduce cellular aging. Resveratrol also activates the molecule sirtuin 1 (SIRT1), which is typically reduced in aged oocytes, therefore potentially slowing cell aging and extending ovarian lifespan.
The review also found evidence that resveratrol could potentially treat infertility associated with endometriosis, and have positive effects on polycystic ovary syndrome and obesity-related infertility, by inhibiting pathways involved in androgen production and reducing inflammation and oxidative stress.
Crucially, the review found mixed results regarding miscarriage and pregnancy data. Five studies reported on pregnancy rates, with two indicating an increase, two found no difference, and one reporting a decrease amongst those taking resveratrol. The same study that noted a decrease in pregnancy rates also reported an increase in miscarriage rates, while a second study found no difference.
Resveratrol is generally considered safe when consumed in moderate amounts through diet and through supplements, in doses up to five grams a day for a month, although the safety of high-dose supplementation, particularly over long periods, remains unclear.
Lee Smith, Professor of Public Health at Anglia Ruskin University (ARU) and senior author of the paper, said: “Our systematic review on resveratrol and female fertility is a comprehensive overview of all current research, and it highlights the compound’s potential to improve reproductive outcomes and possibly pave the way for new, less invasive treatments, using natural substances.
“However, our findings are based on a number of limitations, including the limited number of human studies, the different parameters of each study and the lack of robust data on dosage and side effects, particularly related to birth defects or foetal abnormalities.
“Therefore, there is a need for further clinical trials, involving human participants, in order to translate these promising results into practical recommendations for women looking to improve their fertility, including guidance on the safe and effective dosage of resveratrol.”
Journal
International Journal of Molecular Sciences
Method of Research
Systematic review
Article Title
Resveratrol and Female Fertility: A Systematic Review
COI Statement
Authors Damiano Pizzol and Susanna Caminada were employed by Eni SpA, but the paper is not reflecting any company involvement.
