![]() ![]() Very little attention has been given to the substantial minority of women who continue to have hot flushes 5 or more years after menopause, even though it is these women who appear to be at greatest risk of suffering adverse effects from using estrogen to treat their symptoms. In most women, hot flushes resolve within a few years of menopause, but some women report symptoms for many years after they cease to menstruate. 3 - 5 With several randomized controlled trials pointing to the negative long-term effects of systemic estrogen therapy in postmenopausal women, 6, 7 there is growing interest in identifying modifiable risk factors for hot flushes and developing alternate therapies for these symptoms. 1, 2 These common symptoms have been shown to negatively affect quality of life by disturbing sleep, interfering with work and leisure activities, and exacerbating anxiety and depression. Hot flushes are among the most frequent complaints of women during the menopausal transition, affecting up to 80% of women within the first year of cessation of menses. Identification of risk factors for hot flushes may help guide evaluation and treatment in this population. Fewer years since menopause (OR, 1.15 95% CI, 1.01-1.32 per 5-year decrease) and trouble sleeping (OR, 1.97 95% CI, 1.19-3.26) were associated with symptom persistence.Ĭonclusions For a substantial minority of women, hot flushes are a persistent source of discomfort into the late postmenopausal years. Of the 375 women with baseline symptoms, 278 contributed 3-year data, and 157 (56.5%) of these women reported persistent symptoms after 3 years. Hot flushes were also associated with higher body mass index (OR, 1.22 95% CI, 1.08-1.38 per 1 SD), higher follicle-stimulating hormone levels (OR, 1.34 95% CI, 1.20-1.51 per 1 SD), lower high-density lipoprotein levels (OR, 1.17 95% CI, 1.03-1.34 per 1 SD decrease), vaginal dryness (OR, 1.52 95% CI, 1.19-1.93), and trouble sleeping (OR, 2.48 95% CI, 1.94-3.16), but not estradiol levels. Women were more likely to have baseline symptoms if they were less educated (odds ratio, 1.28 95% confidence interval, 1.06-1.53 per 4-year decrease), more recently menopausal (OR, 1.44 95% CI, 1.34-1.56 per 5-year decrease), had previously used estrogen (OR, 1.57 95% CI, 1.23-2.00), or had undergone hysterectomy (OR, 1.51 95% CI, 1.14-1.99). Results At baseline, 375 women (11.8%) reported bothersome hot flushes. Logistic regression was used to identify characteristics associated with symptoms at baseline and after 3 years of follow-up. Methods Prevalence, severity, and 3-year change in severity of hot flushes were assessed by questionnaire in 3167 older postmenopausal women with osteoporosis. Objective To examine the prevalence, natural history, and predictors of hot flushes in older postmenopausal women. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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