The menopausal transition and healthy ageing and wellbeing

Lead Research Organisation: University of Bristol
Department Name: Social Medicine

Abstract

The menopause is a key period in a woman?s life. It marks the end of her reproduction and is often associated with changes in heart disease risk factors, bone density and how much muscle and fat mass she has. This time period is also one when women frequently change their role in the family and may change occupation or employment status. Research has shown that some women feel positive about the menopause, because it marks the end to concerns about contraception and increased freedom to pursue some of their own interests and occupations. Others feel negatively towards the menopause because it marks the loss of youth and the ability to reproduce and because of some of the adverse symptoms associated with it. Few studies have examined in detail how all of these changes interact with each other and how risk factors in earlier life and genetic factors impact on the changes that occur as women go through the menopause. We plan to study biological, medical, social and economic characteristics, as well as body image, sexual health and family relationships as women go through the menopause. We will also study how earlier reproductive health, lifestyles and genetic factors affect these changes. We will undertake this study in a group of 2800 women who will go through the menopausal transition over the next 5 years. We already have a lot of data on these women and this further study will enable us to fully understand how changes that occur as women go through the menopause affect their health and wellbeing. Thus, our research represents good value for money.

Technical Summary

Unlike most physiological systems in humans, which age slowly and continue to function to some extent until death, in women reproductive function is lost abruptly and completely in middle-age. The menopause is a clear marker of the end of reproduction and has important biological, health and social implications for healthy ageing. Our hypotheses are that (i) the menopausal transition (MT) will be importantly related to changes in health, social and economic characteristics; (ii) some of these changes will be temporary and some will be beneficial to long term health and well-being and others detrimental to it; (iii) health related changes will be influenced by lifestyle changes, menopausal hormonal changes and the influence of menopausal hormonal changes on DNA methylation and (iv) that lifestyle, social, economic and health related changes over the MT will influence body image, family relations, employment and income, and vice versa. Because of the complex interplay of lifestyle, molecular genetic, hormonal, health, social and economic outcomes that are likely to influence how the MT influences healthy ageing and wellbeing it is essential that a multidisciplinary and large-scale approach is used to address our hypotheses. Our proposal is unique in that it will be the largest study to date to explore changes over the MT (2800 women will be studied) and will be the only study with a wealth of previously collected (over 20 years) early adulthood data on reproductive health, general health and lifestyle before the menopause, existence of genome wide data and prospectively collected data on offspring and partners. Our research will clarify the relationship between MT changes and healthy ageing and wellbeing in women and how these relate to health and wellbeing in their partners and children.

Publications

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Borges MC (2017) Metabolic Profiling of Adiponectin Levels in Adults: Mendelian Randomization Analysis. in Circulation. Cardiovascular genetics

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Frysz M (2016) Bone Mineral Density Is Positively Related to Carotid Intima-Media Thickness: Findings From a Population-Based Study in Adolescents and Premenopausal Women. in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

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Howe LD (2016) Relationship between mediation analysis and the structured life course approach. in International journal of epidemiology

 
Title Empty Nest: Chap Book 
Description A 'Chap Book' - short book using photographs, quotes, poetry and creative writing to describe how mother's feel when their children leave home. These have used work from the photography and anthropological parts of the UKRC LLHW grant, together with workshops undertaken with women. The books have been distributed to the women involved and through women's groups. 
Type Of Art Creative Writing 
Year Produced 2016 
Impact It is too early to tell - the response from women who have read it is very positive 
 
Description Biomedical Research Centres
Amount £21,000,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 04/2017 
End 03/2022
 
Description Causal pathways from maternal obesity to pregnancy, perinatal & childhood health outcomes
Amount $755,934 (AUD)
Funding ID APP1068320 
Organisation National Health and Medical Research Council 
Sector Public
Country Australia
Start 01/2014 
End 12/2016
 
Description NHMRC
Amount $674,010 (AUD)
Funding ID APP1043178 
Organisation National Health and Medical Research Council 
Sector Public
Country Australia
Start 01/2013 
End 12/2015
 
Description Pregnancy changes and future health of mother and offspring
Amount £64,650 (GBP)
Funding ID WT094529MA 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2012 
End 06/2013
 
Description The relationship of the menopausal transition to healthy ageing and chronic disease risk.
Amount £1,226,786 (GBP)
Funding ID WT092830M 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2011 
End 06/2016
 
Description Wellcome Trust Resources Award
Amount £1,481,389 (GBP)
Funding ID WT101597MA 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 02/2014 
End 01/2018
 
Title Development of Triangulation method for causal inference 
Description Study design and analytical method for improving causal inference Paper published in IJE and work presented at (a) Causal inference workshop in Harvard Boston USA November 2016 and (b) at the London School of Hygiene & Tropical Medicine to MSc, PhD students and staff March 2017 
Type Of Material Model of mechanisms or symptoms - human 
Year Produced 2016 
Provided To Others? Yes  
Impact To date too early to tell 
 
Description UCLEB 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Country United Kingdom 
Sector Academic/University 
PI Contribution One of the key partners Collaboration is concerned with the use of genetics in risk prediction and aetiology (Mendelian randomization) of cardiometabolic disease. Includes the use of metabolomics
Collaborator Contribution As above
Impact Large number of publications - See CV
Start Year 2007
 
Description UCLEB 
Organisation University of Edinburgh
Country United Kingdom 
Sector Academic/University 
PI Contribution One of the key partners Collaboration is concerned with the use of genetics in risk prediction and aetiology (Mendelian randomization) of cardiometabolic disease. Includes the use of metabolomics
Collaborator Contribution As above
Impact Large number of publications - See CV
Start Year 2007
 
Description Bristol City Council Women's Health Public Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Bristol City Council are interested in tacking some of the issues raised in the 2015 Chief Medical Officer's annual report related to menopause and the work place. We were invited to present at this inaugural public event. Isabel de Salis (SRF Medical Anthropologist, funded by this grant) presented our work on 'Time of Our Lives' covering women's views and attitudes. It was very well received.
Year(s) Of Engagement Activity 2017
 
Description Contribution to Radio 4 'Inside Science' 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact I was interviewed for 20 minutes by Adam Rutherford for the radio 4 programme 'Inside Science' programme. The content was reduced to ~ 10 minutes of the 30 minute programme aired on March 3rd 2016. The interview was concerned with birth cohorts and their scientific impact. It was done jointly with Prof Diana Kuh in the week of the 70th anniversary of the longest running Birth cohort which Diana directs - the 1946 birth cohort.
The programme is available currently at
http://www.bbc.co.uk/programmes/b071ld09
Year(s) Of Engagement Activity 2016
URL http://www.bbc.co.uk/programmes/b071ld09
 
Description Our Menopauses: an event for sharing experiences and information about menopause in Bristol 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact An interactive workshop for women to share their experience of the menopausal transition and discuss what is know about its health, societal and occupational impact
Year(s) Of Engagement Activity 2017
 
Description Radio 4 Inside Science 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Participated in Inside Science radio 4 programme - discussing the value of population cohort studies for understanding causes of disease and how to prevent these
Year(s) Of Engagement Activity 2016