TRANSFORMING MENOPAUSE RESEARCH: THE POWER OF PERSONAL STORIES IN DRIVING INNOVATION
Shreyer is pioneering research into menopause - the benefits it has, and the variety of symptoms people experience.
Menopause, the chapter of life wherein the ovaries no longer release eggs and menstruation ceases, is a unique phenomenon - occurring in only humans and a few species of whales.1 Despite the fact that roughly half of the human population will experience menopause, there is a lack of scientific literature that documents people’s experiences and characterizes their symptoms. Sofiya Shreyer, a PhD candidate in anthropology working under Dr. Lynnette Sievert, is helping to fill that gap with her research into the experiences of menopause in humans.
Shreyer describes herself as a human biologist that uses anthropological techniques, like community-based research, to study menopause. Shreyer first became interested in menopause research after learning of The Grandmother Hypothesis – the theory that menopause evolved in humans due to the benefits gained by grandmothers helping care for their grandchildren.
As the saying goes, “it takes a village to raise a child.” Shryer explains that humans are a bit of a unique species because we experience menopause. That means people can have long lives after their fertility declines – which is not the case for many other mammalian species… So the question is: “Why was this evolutionarily advantageous?” The Grandmother Hypothesis asserts that it was advantageous for humans to menstruate and live after their “fertile age” because non-fertile (older) family could help care for the next generation and lighten the load for the fertile (younger) generation, ultimately leading to more grandchildren to be born.
Shreyer was fascinated by this idea – if menopause and grand mothering evolved together, she thought we should be able to see some measurable evidence. Following this idea, Shreyer conducted research on the health benefits of grand mothering during her initial master’s program at UMass. Connecting with her own ancestry, Shreyer established a working relationship with a medical research school in Kharkiv, Ukraine. There, Shreyer collected data on the impacts of grandmother caregiving on women’s health and well-being. This work is now published in the American Journal of Human Biology.
In brief, she found that, in Ukraine, the maternal grandmothers often gain health benefits such as lower blood pressure and stronger bone density. However interestingly, these benefits were not observed as frequently with the paternal grandmothers. As Shreyer explained, this result may be because in Ukrainian culture the maternal grandmother tends to be more actively involved in grandparenting. Further research is needed to better understand the “grandmothering effect” and Shreyer had made plans to expand the study into a PhD level thesis; However, due to the on-going war in Ukraine that was not feasible. She hopes to one day return to Ukraine to continue this work.
As the best researchers do, Shreyer found a way to pivot from her grand-mothering work into a PhD project that also studies menopause, but from a different angle. She drew on research that she completed as a research assistant for Dr. Sievert to take a deep look at the physical symptoms of menopause. Shreyer is utilizing data she helped collect from voluntary human participants, which contains a mix of interviews and physiological measurement (ex. heart rate and sweat level). Because there are so few mammals which undergo menopause, lab animals (like mice) are not a useful model. Instead, researchers like Shreyer must “go to the source” by speaking with people and conducting human-based research.
Shreyer conducted hundreds of interviews with cis-gender women who have either experienced menopause or are currently going through those changes. She spoke with them, sometimes for hours, as they shared insights that would otherwise go unheard. As Shreyer explained to me, “Menopause is such a fascinating time in someone's life and it's extremely variable! Some people go through menopause and they don't feel anything. Some people go through menopause and they have really severe impacts, both physically and emotionally… understanding that variation and how people relate to that process, I think, is one of the most fascinating parts and really important to talk about.”
As Shreyer conducted these interviews she began to hear a common refrain, “you should really study the night sweats”. Numerous women recounted their experiences of waking up in the night, completely drenched in sweat, despite their rooms being a normal temperature. They also spoke about the dismissal they felt from medical professionals who claimed they were just experiencing hot flashes during the night.
When Shreyer dove into the existing literature on this phenomenon, she was shocked to find that most scientists did not examine night sweats as a separate symptom. With an anthropological ear Shreyer listened to how women described their symptoms, and she could tell that that explanation of “night hot flashes” didn’t resonate with their lived experience. Shreyer explained that hot flashes were usually described by her interviewees as an internal feeling of heat and not associated with excessive sweating. Night sweats, on the other hand, are described as an external feeling of heat, and are...well…sweaty.
Listening to these women’s concerns has helped to shape the questions Shreyer has studied for her dissertation. Operating on the hypothesis that these women are experiencing two distinctly different symptoms, Shreyer set to work designing an experimental approach to determine if there are measurable differences between hot flashes and night sweats. By applying non-invasive physiological monitors to participants, shown in image 1, Shreyer could collect data on heart rate, core temperature, sweat, and other relevant factors as participants went about their daily life. These monitors provided a large amount of data on different variables for Shreyer to analyze along with the participant interviews. “Speaking to participants…[is] really critical in developing science that is for the people - that serves things that people find important."
In Shreyer’s on-going analysis of the data, she has found that 87% of women who experience both hot flashes and night sweats experience them as completely different symptoms. She shows that hot flashes are characterized by a spike in temperature and sweat for a relatively short duration, whereas night sweats have a more gradual rise that is maintained for a longer duration. She also found that while hot flash symptoms were centralized in the chest and face, night sweats were felt throughout the body, were sweatier, and were more intense for a longer period of time. These physiological changes were also associated with different mental health challenges. Night sweats were less likely to be associated with anxiety but more likely to be associated with depression when compared to hot flashes.
Shreyer stressed the importance of this work stating, “there's so much of Women's Health that dedicated towards reproductive years and so little research is being done on aging and menopause.” Shreyer’s study will be one of the first studies to demonstrate and characterize these two distinct symptoms of menopause. She hopes that her work defining these distinctions will help to validate the experiences of those going through menopause as well as provide a foundation for future research into why these symptoms occur and how they could be mitigated.
Written by Janelle Welton, PhD student in Molecular & Cellular Biology, as part of the Graduate School's Public Writing Fellows Program.