Prevalence and impact of vasomotor symptoms due to menopause among women in Canada: A subgroup analysis from an international cross-sectional survey of Women with Vasomotor Symptoms Associated with Menopause (WARM Study)

Abstract

Objective: The aim of the study was to assess the prevalence of postmenopausal vasomotor symptoms (VMS) and the impact of VMS and related treatment patterns among perimenopausal and postmenopausal Canadian women.

Methods: A subgroup analysis of data from a cross-sectional online survey of women aged 40-65 years conducted November 4, 2021, through January 17, 2022, evaluated the prevalence of moderate/severe VMS among postmenopausal Canadian women. The analysis also assessed survey responses from perimenopausal and postmenopausal Canadian women with moderate/severe VMS who completed the Menopause-Specific Quality of Life questionnaire, Work Productivity and Activity Impairment questionnaire, and the Patient-Reported Outcomes Measurement Information System Sleep Disturbances-Short Form 8b and answered questions about treatment patterns and attitudes toward treatments.

Results: Of 2,456 Canadian postmenopausal women, 360 (14.7%; primary analysis) reported moderate/severe VMS in the previous month. Perimenopausal and postmenopausal women with moderate/severe VMS (n = 400; secondary analysis) reported negative impact on overall quality of life (mean total Menopause-Specific Quality of Life questionnaire score: 4.3/8). VMS impaired overall work and daily activities by 30.2% and 35.7%, respectively. Overall mean (SD) Patient-Reported Outcomes Measurement Information System Sleep Disturbance-Short Form 8b score (scale 8-40) was 28.5 (6.9), confirming sleep disturbances in this population. The majority of women (88% of the total cohort) sought advice, but about half were never treated. Most women had positive or neutral attitudes toward menopause.

Conclusions: In a survey conducted in Canada, moderate/severe VMS were reported by 14.7% of postmenopausal women and were associated with impairment in quality of life, work productivity, daily activities, and sleep in perimenopausal and postmenopausal women.

FIG. 1

Menopause symptoms were bothersome across all MENQoL domains. Data are from the 400 women in perimenopause or postmenopause and experiencing moderate to severe VMS. (A) Individual menopause symptoms reported by ≥50% of women,^a as reported on the MENQoL. (B) Impact of VMS on physical, psychosocial, sexual, and vasomotor domains, as indicated by mean MENQoL scores. ^aSexual symptoms are not shown here because no sexual symptoms occurred in ≥50% of women. Physical, psychosocial, and vasomotor symptoms are shown if they occurred in ≥50% of women. ^bScale is from 1 to 8, with higher scores indicating greater impairment. MENQoL, Menopause-Specific Quality of Life questionnaire; SD, standard deviation; VMS vasomotor symptoms.

FIG. 2

WPAI: work productivity and daily activities impaired by VMS. ^aAssessed in all 400 women in perimenopause or postmenopause and experiencing moderate to severe VMS. ^bData are out of 205 women who were employed and responded to work-related questions. ^cWork impairment includes presenteeism and absenteeism. ^dPresenteeism is the percentage of impairment/ineffectiveness at work. ^eAbsenteeism is the percentage of missed work due to VMS. SD, standard deviation; VMS, vasomotor symptoms; WPAI, Work Productivity and Activity Impairment questionnaire.

FIG. 3

Sleep disrupted by VMS in the past 7 days based on the PROMIS Sleep Disturbance-Short Form 8b. Data are from the 400 women in perimenopause or postmenopause and experiencing moderate to severe VMS. ^aScale: 1 = not at all, 2 = a little bit, 3 = somewhat, 4 = quite a bit, 5 = very much. ^bScale: 1 = never, 2 = rarely, 3 = sometimes, 4 = often, 5 = always. ^cScale: 5 = never, 4 = rarely, 3 = sometimes, 2 = often, 1 = always. ^dScale: 5 = very poor, 4 = poor, 3 = fair, 2 = good, 1 = very good. ^eScale: 5 = not at all, 4 = a little bit, 3 = somewhat, 2 = quite a bit, 1 = very much. PROMIS, Patient-Reported Outcomes Measurement Information System; SD, standard deviation; VMS, vasomotor symptoms.

FIG. 4

VMS treatments. Data are from the 400 women in perimenopause or postmenopause and experiencing moderate to severe VMS. ^aCurrently or in the past. ^bExamples include vitamins, calcium, and soy. ^cExamples include estrogen therapy and progestogen therapy. ^dExamples include SSRIs, SNRIs, antidepressants, or gabapentin for hot flashes. ^eExamples include herbs, Kampo, Chinese medicine, acupuncture, acupressure, and aromatherapy. ^fThe term “natural” was included to reflect language exactly as it was presented in the survey. HT, hormone therapy; SNRIs, serotonin and norepinephrine reuptake inhibitors; SSRIs, selective serotonin reuptake inhibitors; VMS, vasomotor symptoms.

FIG. 5

Attitudes toward menopause. Data are from the 400 women in perimenopause or postmenopause and experiencing moderate to severe VMS. ^aScale is from 1 to 7, where 1 = I strongly disagree and 7 = I strongly agree. Scores of 3 to 5 were considered moderate agreement; scores ≥6 were considered strong agreement. The X axis is from 0 to 8 to accommodate SD. SD standard deviation; VMS, vasomotor symptoms.