Years of caregiving make menopause harder, and the more hours a woman spends caring for others each week, the more symptoms she tends to report. If you have spent decades being the one everyone counts on, and now your sleep is off, your energy is gone, and your body is changing in ways you can't explain, it has little to do with how hard you are trying.
When a woman who has been a caregiver for years comes to my office, she usually feels guilty at that first meeting for needing help or spending money on herself, and she is frustrated too. Most of the time she has started to notice symptoms that affect how she shows up for other people, and that is what finally brings her in for herself.
What does years of caregiving look like in my office?
Sleep is usually the first thing. Most of the time it has been off for a long time. Often that lack of sleep and energy has affected her weight or her libido, and that has started to affect her relationships, which is the reason many women finally book.
Her stress is usually something she downplays. Unless something traumatic has happened recently, women tend to decide their stress isn't big enough, that it doesn't count. Her eating has often become restrictive, because years of stress, poor sleep, and overwork led to weight gain, and her body image has taken a hit along the way. Some women use alcohol or food to cope, since both can numb you out, and the relief lasts only a short while.
What are caregivers missing about their own health?
Most of them don't connect the years of serving others to how they feel now. Serving has been a positive in their lives, a way of fulfilling their roles, so it doesn't register as something that costs them. They tend to blame hormones or age instead. We don't just suddenly start feeling bad in our 40s and 50s, and what I see is a cumulative process over time. I wrote more about how many systems perimenopause touches in Your Body Isn't Broken.
Many women also downplay what they have done. Showing up for everybody all the time feels like part of being a wife, a mom, a woman, and anything done without extra support or many thank yous is above and beyond. When you are not the first person on anyone's list, it wears on you, and it wears on how you show up for yourself and how much you want to show up for others.
What does the research say about caregiving and menopause?
A study in Mayo Clinic Proceedings in January 2025 looked at 4,295 women ages 45 to 60 who received primary care at Mayo Clinic locations. Of those, 19.7 percent were caregivers. The more hours a woman spent caregiving each week, the more likely she was to report moderate to very severe menopause symptoms. The rate was 34.1 percent for women caregiving under 5 hours, 42.6 percent at 5 to 14 hours, and 50.4 percent at 15 hours or more. The link held after the researchers accounted for daily stress and mental health.
The study captured one point in time, so it shows an association and cannot prove that caregiving causes symptoms. It fits what I see in my office. The Menopause Society also notes that poor sleep and high stress are closely linked to weight gain at midlife, and sleep and stress are the first two things most caregivers bring me.
Why does menopause feel harder when your caregiving role changes?
Caregiving roles change, often around this stage of life. Some women feel lost when their children need less of them. The sports schedules and school demands are gone, and they wonder what their purpose is now. For others the role shifts toward caring for their parents, where you are expected to enjoy it or be grateful for the time. Women still feel guilty, because the reality is that it is a burden. Caring for a parent is a very different relationship from caring for a child, and it brings its own set of challenges.
One woman who did everything right
One client was gaining weight. She was doing all the workouts she thought were right and following every food restriction she thought she needed, and she was still showing up for everybody, an amazing volunteer and friend. We ran cortisol testing, and hers came back very low. It was hard for her to hear that this was not going to be solved quickly. It became a process of learning to say no to some things and taking care of herself, and that takes time. Real change happened.
How do I work with a caregiver differently?
Doctors are great at certain things, and our healthcare system asks too much of them and doesn't allow enough time with each patient. I get to take that time. I take a full history, so we look at what could have shaped her health over a lifetime and not only what is bothering her now. I ask what is bothering her most and why changing it matters to her. Then we work on things that make sense physiologically and emotionally and that matter to the woman sitting in front of me, because she knows her body best.
We talk through all the body systems so she can see the whole picture. For many women it is the first time in a long time that someone has seen them as a whole person, mental, emotional, physical, and the way life feels to them. I think about these women outside of the office too, and I consider it a privilege that they let me in.
What helps a caregiver most?
Boundaries. Learning to stop and say no is one of the most helpful things I have seen. It also helps to realize that your role will keep shifting. Many women have lived on a schedule for so long, often one they built themselves, and building self-care into that schedule keeps life organized while new habits take hold. Be patient with yourself. We didn't learn to take care of everybody overnight, so we won't unlearn it overnight.
What this means for you
Now is the best time to take care of yourself. There is no use regretting the past or deciding this is as good as it gets. Prioritize your health the way you would your children's or your parents', and know that you deserve a practitioner who cares about you and listens.
If you'd like to talk it through, the first step is a free discovery call. I see women online in nearly every state and in person in New Braunfels, Texas. Book your free discovery call.
References
- Saadedine, M., et al. (2025). Caregiving hours and menopause symptom burden. Mayo Clinic Proceedings, 100(1). Press release
- The Menopause Society. (2025). MenoNote: Weight Gain
This post is for educational purposes only and does not constitute medical advice.
