Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: study of women's health across the nation

Abstract

Objectives: We investigated whether vasomotor symptom reporting or patterns of change in symptom reporting over the perimenopausal transition among women enrolled in a national study differed according to race/ethnicity. We also sought to determine whether racial/ethnic differences were explained by sociodemographic, health, or lifestyle factors.

Methods: We followed 3198 women enrolled in the Study of Women's Health Across the Nation during 1996 through 2002. We analyzed frequency of vasomotor symptom reporting using longitudinal multiple logistic regressions.

Results: Rates of vasomotor symptom reporting were highest among African Americans (adjusted odds ratio [OR]=1.63; 95% confidence interval [CI]=1.21, 2.20). The transition to late perimenopause exhibited the strongest association with vasomotor symptoms (adjusted OR = 6.64; 95% CI = 4.80, 9.20). Other risk factors were age (adjusted OR=1.17; 95% CI=1.13, 1.21), having less than a college education (adjusted OR = 1.91; 95% CI = 1.40, 2.61), increasing body mass index (adjusted OR=1.03 per unit of increase; 95% CI=1.01, 1.04), smoking (adjusted OR=1.63; 95% CI=1.25, 2.12), and anxiety symptoms at baseline (adjusted OR=3.10; 95% CI=2.33, 4.12).

Conclusions: Among the risk factors assessed, vasomotor symptoms were most strongly associated with menopausal status. After adjustment for covariates, symptoms were reported most often in all racial/ethnic groups in late perimenopause and nearly as often in postmenopause.

FIGURE 1—

Prevalence of any vasomotor symptoms (a) and vasomotor symptoms reported for 6 or more days (b) in the preceding 2 weeks, by participants’ menopausal transition status and race/ethnicity: Study of Women’s Health Across the Nation, 1996–2002. …Note. VMS = vasomotor symptoms. Prevalence was computed at the first visit at which a change in menopausal status was observed; women could thus contribute only one observation to each menopausal transition status category but could contribute more than one observation by progressing to different categories over the 5-year follow-up. Thus, observations in the 4 menopausal transition status categories were not mutually exclusive.

FIGURE 1—

Prevalence of any vasomotor symptoms (a) and vasomotor symptoms reported for 6 or more days (b) in the preceding 2 weeks, by participants’ menopausal transition status and race/ethnicity: Study of Women’s Health Across the Nation, 1996–2002. …Note. VMS = vasomotor symptoms. Prevalence was computed at the first visit at which a change in menopausal status was observed; women could thus contribute only one observation to each menopausal transition status category but could contribute more than one observation by progressing to different categories over the 5-year follow-up. Thus, observations in the 4 menopausal transition status categories were not mutually exclusive.