Lifestyle and Demographic Factors in Relation to Vasomotor Symptoms: Baseline Results from the Study of Women's Health Across the Nation

Abstract

Results of recent trials highlight the risks of hormone therapy, increasing the importance of identifying preventive lifestyle factors related to menopausal symptoms. The authors examined the relation of such factors to vasomotor symptoms in the multiethnic sample of 3,302 women, aged 42-52 years at baseline (1995-1997), in the Study of Women's Health Across the Nation (SWAN). All lifestyle factors and symptoms were self-reported. Serum hormone and gonadotropin concentrations were measured once in days 2-7 of the menstrual cycle. After adjustment for covariates using multiple logistic regression, significantly more African-American and Hispanic and fewer Chinese and Japanese than Caucasian women reported vasomotor symptoms. Fewer women with postgraduate education reported vasomotor symptoms. Passive exposure to smoke, but not active smoking, higher body mass index, premenstrual symptoms, perceived stress, and age were also significantly associated with vasomotor symptoms, although a dose-response relation with hours of smoke exposure was not observed. No dietary nutrients were significantly associated with vasomotor symptoms. These cross-sectional findings require further longitudinal exploration to identify lifestyle changes for women that may help prevent vasomotor symptoms.

Longitudinal Analysis of the Association Between Vasomotor Symptoms and Race/Ethnicity Across the Menopausal Transition: Study of Women’s Health Across the Nation

“…61 Thus, ethnic differences in perceptions and tolerance of thermal discomfort may extend to perceptions and reporting of vasomotor symptoms. In contrast to the expectation that higher BMIs will have a protective effect owing to higher estrone production, [14][15][16] the positive relation of BMI to vasomotor symptoms observed in our previous cross-sectional baseline examination 4 was found again in this study and has been reported by others. 6,18,19,63 We observed a statistically significant positive association between BMI and vasomotor Finally, our results indicate no effects of physical activity or caffeine or alcohol intake on reports of vasomotor symptoms, suggesting that changes in these behaviors are not likely to significantly influence vasomotor symptom reporting.…”

“…Psychosocial variables included symptom sensitivity at the first follow-up visit (1997-1998) (summed score of degree of awareness of loud noise, hot or cold, hunger, pain, and things happening in one's body; sensitivity ratings ranged from not at all true [1] to extremely true [5]), 43 social support (summed scale assessing how often 4 types of needed emotional and instrumental support were available; responses ranged from none of the time [0] to all of the time [4]), 44 perceived stress (summed scale assessing how often over the preceding 2 weeks 4 aspects of stress were experienced; responses ranged from never [1] to very often [5]), 45 depressive symptoms (score of 16 or above on a 20-item scale assessing the extent to which each item had been experienced in the previous week), 46 anxiety (summed score of numbers of days in the past 2 weeks in which 4 symptoms [irritability or grouchiness, feeling tense or nervous, pounding or racing heart, fearful for no reason] were experienced; responses ranged from no days [0] to every day [4]), and preferred language for reading and speaking (as a measure of acculturation). 47 BMI was measured as weight in kilograms divided by height in meters squared.…”

“…Two studies have shown higher symptom rates among African American women, [3][4][5][6] whereas another has not. 7 Several studies have reported reduced frequencies of symptoms among Asian women.…”

“…[14][15][16] Thus, differences in other factors are likely to account for ethnic differences in vasomotor symptoms. In addition to differences in body size, hypotheses regarding racial/ethnic differences in reports of vasomotor symptoms include differences in hormone levels, 17,18 socioeconomic status, 3,7,[19][20][21][22][23][24] active or passive exposure to tobacco smoke, 4,7,19,21,[24][25][26][27] diet, [28][29][30][31][32][33][34][35][36][37][38] physical activity, 3,39 and psychosocial factors. 4,5 Determining whether race/ ethnicity-specific differences in rates of vasomotor symptoms are independent of these factors will help clarify the physiology of such symptoms and provide valuable information for women and clinicians about high-risk groups and potential behavioral interventions.…”

Predicting menopausal health in a diverse population group through a theoretical linear model——Theoretical model to predict menopausal health

“…But escalating cost and recent controversies surrounding hormone therapy appeared to have raised some concerns on the issue of quality of life of women entering menopause-climacteric. Thus, a complete review of issues and factors such as demographic, nutritional, life style linked to menopause and its management is currently underway in the developed world [22,23]. In India where it was poorly studied, acquiring & generating population based specific information on menopause is of vital interest to the policy makers.…”