Caregiving Hours Increase Menopause Burden, Researchers Find

Researchers have identified a link between the number of caregiving hours per week a woman performs and menopause symptom burden. A novel studyopens in new tab/window in Mayo Clinic Proceedingsopens in new tab/window, 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.orgopens in new tab/window.

Notes for editors

The article is “Association of Informal Caregiving and Menopause Symptoms in Midlife Women: A Cross-Sectional Study,”by Mariam Saadedine, MD; Nancy Safwan, MD; Ekta Kapoor, MBBS; Chrisandra L. Shufelt, MD, MS; Juliana M. Kling, MD, MPH; Mary S. Hedges, MD; Rajeev Chaudhry, MBBS, MPH; Kristin Cole, MS; Stacey J. Winham, PhD; Joan M. Griffin, PhD; and Stephanie S. Faubion, MD, MBA (https://doi-org.ucc.idm.oclc.org/10.1016/j.mayocp.2024.07.009opens in new tab/window). It appears online in volume 100, issue 1 (January 2025) of Mayo Clinic Proceedings, published by Elsevier.

The article is openly available for 60 days at https://www.mayoclinicproceedings.org/article/S0025-6196(24)00353-7/fulltextopens in new tab/window.

Full text of the article is also available to credentialed journalists upon request. Contact Brittney Binns at +1 215 297 3278 or [email protected]opens in new tab/window to obtain copies. Journalists wishing to interview the study authors should contact Stephanie S. Faubion, MD, MBA, at [email protected]opens in new tab/window, or Farah Hyett at [email protected]opens in new tab/window.

An accompanying video is available at https://youtu.be/aiUHRfGNn50opens in new tab/window.

About Mayo Clinic Proceedings

Celebrating 100 years of continuous publication in 2025, Mayo Clinic Proceedingsopens in new tab/window remains one of the premier online only peer-reviewed clinical journals in general and internal medicine. Content includes Nobel-prize-winning research, and the journal is among the most widely read and highly cited scientific publications for physicians. While the Proceedings is sponsored by Mayo Clinic, it welcomes submissions from authors worldwide, publishing articles that focus on clinical medicine and support the professional and educational needs of its readers. https://www.mayoclinicproceedings.orgopens in new tab/window

About Mayo Clinic

Mayo Clinic is a nonprofit worldwide leader in medical care, research, and education for people from all walks of life. For more information visit www.mayoclinic.org/aboutopens in new tab/window and https://newsnetwork.mayoclinic.org/opens in new tab/window.

엘스비어 소개

엘스비어는 첨단 정보와 의사결정 지원 분야의 글로벌 선도 기업으로 100년 넘게 과학과 헬스케어의 발전을 지원하며 인류 진보에 기여해 왔습니다. 우리는 170개국 이상에서 학술 및 기업 연구 커뮤니티, 의사, 간호사, 미래의 의료 전문가와 교육자들을 지원합니다. 근거에 기반한 신뢰할 수 있는 과학·의학 콘텐츠와 최첨단 AI 기술을 결합해 중요한 통찰과 혁신적인 솔루션을 제공해, 의미있는 성과를 이루도록 돕고 있습니다. 또한 다양성과 지속 가능성을 제품과 기업 문화 전반에 내재화하며, 우리가 속한 커뮤니티와 협력합니다. 엘스비어 재단opens in new tab/window은 전 세계에서 연구와 보건 파트너십을 지원합니다.

엘스비어는 전문가 및 기업 고객에게 정보 기반의 분석과 의사결정 도구를 제공하는 글로벌 기업 RELXopens in new tab/window의 일원입니다. 자세한 내용은 www.elsevier.com에서 확인할 수 있으며, 소셜미디어 @elsevierconnect를 통해 최신 소식을 받아보실 수 있습니다.