Working through the transition? Or is the transition working you?
I ran across an interesting study examining how work affects menopause and visa versa. Initiated two years ago by Professor Amanda Griffiths of the Institute of Work, Health & Organizations at the University of Nottingham in the UK, the study aims to identify challenges that women face while working through their transition and also help raise employer awareness.
I contacted Professor Griffiths to learn more . Although she is still compiling her final data (culled from 900 women, ages 40+), she did share some interim nuggets that are pretty interesting.
The fact that menopause, or more specifically menopausal symptoms might affect life quality and work is not a novel idea. Numerous studies have shown that hot flashes in particular can significantly impact daily activities, especially when they are severe. In turn, hot flashes, night sweats and hormonal swings can significantly affect sleep and coping mechanisms. Hence it’s not surprising that among an initial group of 941 female police officers surveyed*, most agreed that the primary factors affecting their ability to function in their job were fatigue and insomnia. Nevertheless, about 2/3rds said that they wouldn’t or didn’t disclose the fact that they were going through menopause to their managers, either because their managers were men, were younger (and therefore unlikely to understand or have much empathy) or because they felt embarrassed. This point of view only changed if the symptoms were so obvious that they felt they had to explain, if they felt that their ability to cope with their symptoms was less than stellar, if their performance was somehow being affected by their symptoms or if they felt the need to justify a change in their behavior at work. However, I was heartened to read that many of the women felt comfortable sharing their experience with other colleagues who were similarly in the midst of menopause or had already gone through it.
Griffiths reports that a clear majority of women surveyed that expectations of their physical capacities did not change as they aged. Yet, less than half believed that their contributions were valued as much as their younger peers.
When asked what changes they’d like to see in their jobs to ease their way through the transition and challenges of growing older, most pointed out greater flexibility in working hours (e.g. flex time, no night shifts or since this was a police force, shifting from the front line to a desk job), access to workplace-focused health promotion, such as regular check ups and fitness program), improved awareness among managers of health-related changes in midlife and improvements in the physical working environment.
Griffiths says that more recently, she and her colleagues have surveyed women from all walks of career life, including education, administration and journalism and the final write-up of the study** will include these opinions as well. However, based on our correspondence, it appears that the difficulties that women face in the workplace during the transition are fairly universal. She explains that menopause is ‘taboo’ yet happens to 50% of workforce (I imagine that this number will only continue to grow as the population ages and we are forced due to economic constraints, to work well into retirement years.) “Evidence suggests that some women do experience a lot of difficulty – largely tiredness – much of which can be resolved with sensible line management and flexible work,” says Griffiths. However, “as with any other long-term health condition, employees should feel empowered to discuss health conditions with their line manager/supervisor, otherwise the latter are not in a position to help.”
Isn’t it time for change? Rather than let the transition work us, shouldn’t we be looking for empowering ways to work through it? In the early days of this blog, I wrote that science has confirmed what women have known all along: social support networks are one of the strongest weapons we have against the aging process. Griffiths’ research confirms that by engaging female peers who are going through similar experiences, we have a stronger experience overall. Yet, she also points out very clearly that men need to be brought into the equation as well. The only way to foster understanding is to share and educate, right?
The research shows that women want their managers to be more aware the menopause doesn’t simply affect their personal lives but also their occupational health. Although sharing may be risky, we really need to ask ourselves how much we are risking by allowing the transition to work us. Time for change, don’t you think?
*The initial research was funded by the British Association of Women in Policing. **Dr. Griffiths’ larger study is funded by the British Occupational Health Foundation.
Read MoreWednesday Bubble: rhubarb rules the day
Today’s Bubble is straight from the research files and it’s not burstable. In fact, I’m pretty excited about this.
Researchers say that a phytoestrogen extract from Siberian rhubarb (rhapontic rhubarb), better known in studies as “ERr 731,’ is an effective alternative to HRT for alleviating menopausal symptoms.
Evidently Siberian rhubarb has been used for decades to treat menopausal symptoms, both in Germany, where it is readily and commercially available, and in Chinese medicine. Clinical studies suggest that ERr works very similar to estrogen in the body and in fact, has been shown to have properties that are equivalent to SERMS – selective estrogen receptor modulators – which are synthetic compounds that mimic the action of estrogen in the body without necessarily causing some of its harmful effects.
When I delved further into ERr 731, I found numerous, well-designed studies that demonstrate its benefits in perimenopausal women including:
- A significant decline in the number and severity of hot flashes over the short-term (i.e. 3 months) by as much as 50%, with further improvements through the long-term (i.e. 6 months).
- Improvements in other menopausal symptoms such as sleep disruption, mood and vaginal dryness.
- Improvements in self-reported quality of life.
- Minimal if any side effects and no changes in uterine or vaginal tissues among women taking the extract, suggesting that it may be safe in terms of breast or uterine cancer.
In the U.S., ERr 731 is marketed as a supplement called Estrovera. Although it appears to be safe, like any drug, you should speak to your practitioner before trying it.
I’m heartened to see that an herb that been in use for decades in both Western and Eastern cultures in finally available to US women. I’ll continue to monitor for additional studies but in the interim, I’d love to hear from you if you are taking Estrovera.
Read MoreWednesday Bubble: the soy controversy
Do they or don’t they?
Soy isoflavones have been touted as beneficial in everything from improving body composition and lowering breast and colorectal cancer, to addressing menopausal hot flashes and moods. You can read about some of these findings on Flashfree. This week, Reuters Health reported that eating foods rich in soy protein (i.e. 25 grams of soy protein and 60 mg isoflavones) daily did not provide favorable responses from blood fats, implying that soy has little benefit in terms of lowering cholesterol levels and in turn, promoting heart health.
Are you confused yet?
Increasingly, women are turning to soy and other compounds as alternatives to estrogen and hormone replacement therapy, which mounting evidence shows can be associated with a broad range of risks including increased breast, lung and ovarian cancer to heart disease. And yet, findings from clinical trials examining soy are often contradictory, making it difficult to come to any firm conclusion about its benefits.
What’s the problem? Well, researchers say that part of the problem is poorly designed studies, small number of study participants, wide range of ages and years from menopause, studies that don’t examine the pros and cons of an agent or strategy for a long enough period of time (i.e. longer than a year). In other cases (as I’ve argued previously), the study design does not account for certain factors that are critical to a therapeutic strategy, for example, the opportunity to clearly focus an intervention so that individual factors are accounted for (this was borne out by findings from a trial that examined and provided evidence for the role of acupuncture in easing hot flashes).
There’s good news though! Researchers finally appear to be getting their act together on the soy fron. They’ve announced that they are conducting a well-designed, large trial of soy phytoestrogens. Called SPARE (Soy Phytoestrogens as Replacement Estrogen), this new study will be looking at the effects of 200 mg soy versus sugar tablet daily — namely on bone health and symptoms — in 248 menopausal women over a two- year period. They will also be taking daily calcium carbonate plus vitamin D (in ranges of 500 mg to 1000 mg calcium and 200 to 400 IU vitamin D, depending on previous intake).
The study is specifically geared towards looking at spine bone density, but will also be looking at hip density, thyroid levels, menopausal symptoms, mood changes, depression, and quality of life, as well as any changes in blood fats. Study participants are between the ages of 45 and 60 and are within five years from menopause. What’s more, the researchers have also included a large percentage of hispanic women, which allows them to focus on how soy affects this minority group (Notably, the large multiethnic population of women in this study includes Asians, Blacks and Caucasians.)
The researchers say that they hope that the results of SPARE will provide a range of information that is especially relevant to Boomers reaching menopause. They also note that the dose of soy isoflavones being studied is much larger than what’s been studied in previously and are roughly twice that typically consumed in the Asian diet.
I realize that this post is pretty scientific. But what makes it most relevant is that it appears that researchers are finally starting to design studies that might actually show benefit of some of the alternative strategies we have available to us on the market. For those of you who insist on calling these alternatives “snake oil,” all I can say is ‘stay tuned.’
This bubble might finally be shattered; perhaps all that is needed is a better understanding of what it needs to test these substances appropriately.
Read MoreGot ‘tude?
[Used with permission. Thanks to egopicks.com and their seriously fine guitar picks! Rock n Roll!]
Your ‘tude may be affecting how you experience menopause as well as how frequently those flashes occur. What’s more, your environment may also play a role.
In a detailed review of 13 studies examining women’s attitudes before and during menopause, researchers discovered a few choice tidbits:
- Ya gotta live it to understand it. Apparently, younger women who are premenopausal have more negative attitudes towards menopause than women who are menopausal. In fact, data show that one’s mood state prior to starting menopause may actually affect one’s menopausal atttitudes and experiences.
- I’ve got all my sisters (and teachers) with me. Research shows that education and social support contribute greatly to having positive attitudes and experiences during the transition.
- Which came first? The chicken or the egg? Depression is apparently associated with having more negative attitudes about menopause although researchers haven’t quite figured out the causality, i.e. depression before symptoms or symptoms before depression. Regardless, it might bet helpful to tackle those blues and try to chase them away.
- It takes a village. The reviewed studies included women from North America, Europe, Asia and the middle east. They showed that cultural attitudes can significantly impact attitudes towards menopause. One of the most discouraging (and telling) findings was that the medicalization of menopause affected Caucasian women in particular, leading to a tendency towards negative attitudes. Say no more!
Overall, the key take-away point is that negative social attitudes + individual negative attitudes = worsening symptoms and poorer experiences. I believe that we can change this equation for the positive by supporting one another, working on changing our beliefs about menopause and what it is (and isn’t), taking steps to boost mood, whether they be exercise, herbs, antidepressants, or mind-body practices, and by unifying to stop the medicalization of menopause.
What do you say? You in? Got ‘tude?
Read MoreMore joys of soy
More news on soy. Researchers have discovered yet another component of soy isoflavones that may prove useful in improving symptoms of menopause: soy aglycons of isoflavones (SAI). Soy aglycons are a group of chemicals found in fermented soybeans and comprise a great portion of diets for Chinese and Japanese individuals. Of note, high cholesterol, coronary heart disease, and menopausal symptoms are often seen in a smaller percentage of these women than their European and American counterparts.
Among the various chemical molecules of soy, SAI are absorbed faster and more efficiently than other components.
In this particular study, which was just published in Nutrition & Metabolism, researchers fed rats whose ovaries had been removed either high or low doses of SAI-supplemented diets. These animals were then compared to rats with intact ovaries who were fed a regular diet.
The researchers found that rats fed supplemental SAI had significantly lower cholesterol and low-density lipoprotein (LDL) values , higher high-density lipoprotein (HDL) levels and faster liver metabolism. The lining of the uterus was also enhanced by dietary SAI supplementation.
They said that these results suggest that SAI may help protect against or lessen symptoms during menopause that are associated with the natural decline of estrogen. SAI might also be an effective and safe alternative to HRT, which has been linked to breast and uterine cancers. In general, SAI may protect against menopausal heart disease.
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