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. 2014 Sep;21(9):924-32.
doi: 10.1097/GME.0000000000000196.

Risk of long-term hot flashes after natural menopause: evidence from the Penn Ovarian Aging Study cohort

Ellen W Freeman  1 , Mary D Sammel, Richard J Sanders
Affiliations

Risk of long-term hot flashes after natural menopause: evidence from the Penn Ovarian Aging Study cohort

Ellen W Freeman et al. Menopause. 2014 Sep.

Abstract

Objective: This study aims to estimate the risk of hot flashes relative to natural menopause and to evaluate the associations of hormone levels, behavioral variables, and demographic variables with the risk of hot flashes after menopause.

Methods: We performed annual assessment of 255 women who were premenopausal at baseline and reached natural menopause within 16 years of follow-up.

Results: The prevalence of moderate/severe hot flashes increased in each premenopausal year, reaching a peak of 46% in the first 2 years after the final menstrual period (FMP). Hot flashes decreased slowly after menopause and did not return to premenopausal levels until 9 years after the FMP. The mean (SD) duration of moderate/severe hot flashes after the FMP was 4.6 (2.9) years (for any hot flashes, 4.9 [3.1] y). One third of women at 10 years or more after menopause continued to experience moderate/severe hot flashes. African-American women (obese and nonobese) and obese white women had significantly greater risks of hot flashes compared with nonobese white women (interaction, P = 0.01). In multivariable analysis, increasing follicle-stimulating hormone levels before the FMP (P < 0.001), decreasing estradiol (odds ratio, 0.87; 95% CI, 0.78-0.96; P = 0.008), and increasing anxiety (odds ratio, 1.05; 95% CI, 1.03-1.06; P < 0.001) were significant risk factors for hot flashes, whereas higher education levels were protective (odds ratio, 0.66; 95% CI, 0.47-0.91; P = 0.011).

Conclusions: Moderate/severe hot flashes continue, on average, for nearly 5 years after menopause; more than one third of women observed for 10 years or more after menopause have moderate/severe hot flashes. Continuation of hot flashes for more than 5 years after menopause underscores the importance of determining individual risks/benefits when selecting hormone or nonhormone therapy for menopausal symptoms.

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Conflict of interest statement

Conflict of interest: No conflicts/disclosures were declared by the other authors.

Figures

Figure 1
Figure 1
Proportion of women with hot flashes at each year before and after the final menstrual period (Time 0). Dotted lines indicate time categories used in analysis: Premenopause: each year before FMP up to but not including time 0; early postmenopause: time 0 – 5.9 years; late postmenopause: ≥6 years.
Figure 2
Figure 2
Adjusted means (95% CI) in the years around the final menstrual period (Time 0) for natural logarithm-transformed estradiol (pg/mL) (solid line) and FSH (IU/L) (dotted line), N=255.
Figure 3
Figure 3
Mean prevalence of moderate/severe hot flashes over time for race by BMI (interaction P=0.01), N=255. Data shown in Table 4.
See this image and copyright information in PMC

Comment in

References

    1. National Institutes of Health, State-of-the-Science Panel. National Institutes of Health State-of-the-Science Conference statement: management of menopause-related symptoms. Ann Intern Med. 2005;142:1003–1013. - PubMed
    1. Williams RE, Kalilani L, DiBenedetti DB, et al. Frequency and severity of vasomotor symptoms among peri- and postmenopausal women in the United States. Climacteric. 2008;11:32–43. - PubMed
    1. Manson JE, Chlebowski RT, Stefanick ML, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the women’s health initiative randomized trials. JAMA. 2013;310:1353–1368. - PMC - PubMed
    1. North American Menopause Society. The 2012 hormone therapy position statement of: The North American Menopause Society. Menopause. 2012;19:257–271. - PMC - PubMed
    1. Politi MC, Schleinitz MD, Col NF. Revisiting the duration of vasomotor symptoms of menopause: a meta-analysis. J Gen Intern Med. 2008;23:1507–1513. - PMC - PubMed

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