Many Caregivers Also Experience Increased Menopause Burden
Symptoms of caregiver fatigue and menopause can be similar (and overwhelming)
More than 60% of family caregivers in the United States are midlife women. Given that the average duration of caregiving is five years and the mean age of a caregiver is 50, midlife women will most likely transition through menopause in the same time frame.
A recent study in Mayo Clinic Proceedings, published by Elsevier, finds that being a caregiver is associated with menopausal symptoms.
The study reveals that women who self-identified as caregivers and were caregiving for more than 15 hours a week have significantly increased odds of experiencing moderate or severe menopause symptoms. Researchers have identified a link between the number of caregiving hours per week a woman performs and menopause symptom burden.
The study shines a light on the adverse health outcomes associated with an increased burden of caregiving.
Stephanie S. Faubion, M.D., with Mayo Clinic Women's Health in Jacksonville, Florida, was the lead investigator on the study. She explains, "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."
There are many reasons for the caregiving responsibilities and menopause. While the term "sandwich generation" has been around for many years, it is an issue that is even more prevalent today than when it was originally introduced. Many women are responsible for both the care of the younger and older generations in their family.
With many women choosing to have children later in life, they are still having the day-to-day caregiving of young children when they are experiencing menopause. Other women may find themselves having caregiving responsibilities for older children with physical or mental health issues that require assistance into adulthood. And even primarily independent adult children are in need of support from their parents such as financial assistance or care of their own children.
In addition to caring for their children (and grandchildren) many midlife women are responsible for the care of older adults in their lives, such as aging parents, in-laws, partners or other older relatives. With people living longer, the caregiving burden continues to increase and it falls primarily on middle-aged women.
Multiple Symptoms
According to the study, typical family caregivers (people who provide unpaid support, care or assistance to someone with whom they have a personal relationship) are partnered midlife women who likely care for two or more adults.
The overlap of caregiving and menopause can adversely impact the health of midlife women. Many of the symptoms of caregiver fatigue (such as exhaustion, sleeplessness, weight issues and poor mental health) are also associated with menopause. In addition, menopausal problems such as hot flashes, joint and muscular discomfort and brain fog may be exasperated when combined with the increased physical, mental and emotional responsibilities of caregiving.
Faubion says, "The role of caregiving does seem to primarily fall to women, with society sending signals that this is something that they need to do without complaint."
"The role of caregiving does seem to primarily fall to women, with society sending signals that this is something that they need to do without complaint."
The overlap of caregiving and menopause may impose a disproportionate physical and emotional burden on midlife women. The burden can be overwhelming and lead caregivers to neglect their own health care needs, putting off doctor's appointments and ignoring their own physical or emotional symptoms.
Marvell Adams Jr. is CEO of Caregiver Action Network (CAN) which offers many free services from Facebook Support groups to peer-to-peer counseling. Adams says, "Caregivers often neglect their self-care and put their overall health needs on hold, overwhelmed by their other responsibilities. A caregiving woman will make sure her mom gets her mammogram or stress test but put off scheduling these appointments for herself because she doesn't want to take more time off from work or just doesn't have the energy for herself."
Caregivers may be reluctant to ask for help. "Many caregivers think, 'What is the point about telling someone I have insomnia, occasional incontinence or I am always stressed?'" Adams explains. "They believe this is just what it feels like to be middle-aged and that nothing can be done so why complain or seek help?"
When they do seek medical attention, women are often let down by their providers or reluctant to share what is really going on. Faubion says, "I had a patient who had seen another clinician before me. She was told to lose weight and exercise more to improve her health. After asking her several times about her life and issues, I determined that she was a caregiver with little time to take care of herself. The advice she had received, while appropriate, was impossible to follow given all of the responsibilities she had."
Caregiving Burden
Considering the aging U.S. population means that the caregiving burden will likely increase for midlife women in the years ahead.
The caregiving burden can undermine a caregiver's lifestyle, compromising their ability to live a healthy and productive life. When combined with the symptoms of menopause, it can be a perfect storm, resulting in many women suffering in silence rather than seeking help.
"As it has been said on airplanes for years, it is important for caregivers to put on their oxygen masks first so that they can take care of others."
The study highlights the need for more resources to help midlife women, including more inclusive health care policies and the introduction of more support systems for midlife women in caregiving roles. Faubion says, "As it has been said on airplanes for years, it is important for caregivers to put on their oxygen masks first so that they can take care of others. But of course, this is easier said than done. The first step is to recognize that there is a connection between the menopause symptom burden and caregiving."
From there, it is up to women to continue to advocate for support. The days of menopause symptoms being "all in your head" should be behind us. Menopause symptoms are real and can be debilitating.
Women need to be honest with their medical providers about the symptoms they are experiencing, as treatment options are available. In addition, midlife women should look for support for their caregiving responsibilities and not feel they need to go it alone. From paid help to family support to organizations, there are resources available for caregivers.
"We always lead with the phrase, 'You are not alone,'" Adams says. "A majority of caregivers are middle-aged women. While they may not always be able to discuss their issues with their family, friends or co-workers, they can connect with other caregivers who do understand what they are going through. In fact, in may be easier talking about issues with a stranger who can be objective, offer empathy and advice."
