Association of Various Dimensions of Hot Flashes with Systemic Levels of Gonadal Steroids

Abstract

Hot flashes, the cardinal sign of menopausal vasomotor symptoms, are experienced by millions of women. The experience of hot flashes is characterized by significant inter- and intra-individual variability among women. The goals of this study were to compare concentrations of gonadal hormones between menopausal women with hot flashes (HF) and those with no HF, and to characterize the association between steroid levels and multiple dimensions of hot flashes. Menopausal women, with HF and with no HF, participated in four study sessions, one every 2 months. The Menopausal Vasomotor Symptom (MVS) survey was used to collect subjective data on various dimensions of hot flashes. Concentrations of gonadal hormones were measure at each bi-monthly session. Steroid levels were correlated to duration, frequency, length of each episode, timing, intensity, and bothersomeness of hot flashes. Data from twenty (n = 20) women with HF and fifteen (n = 15) with no HF with similar demographic profiles were analyzed. The results from the present study showed that systemic levels of estrone and progesterone were significantly lower in women experiencing HF than in asymptomatic women. There was a significant association between levels of estradiol, estrone, progesterone, and androstenedione, but not testosterone, with duration, frequency, timing, intensity, and bothersomeness of HF. The findings from this preliminary study suggest that management of symptoms associated with vasomotor HF should be individualized and guided by two factors: (i) thorough assessment of subjectively reported multiple dimensions of hot flashes, and (ii) levels of circulating gonadal steroids representing an average from 2-4 measures. This approach may lead to more targeted, effective, and safe management of vasomotor symptoms in the rapidly growing population of menopausal women.

A randomized controlled study examining the effect of exercise on inflammatory cytokine levels in post-menopausal women

“…26,27 Gonadal hormones are reportedly valuable indirect indicators of vasomotor symptoms. 28 In accordance with others, our results showed significant improvement in biomarkers of vasomotor symptoms, as determined by serum levels of LH and FSH, in post-menopausal women in response to EX. Some have reported increases in LH and FSH result in vasomotor symptoms.…”

“…31 Our findings showed significant decreases in IL-1β, IL-6 and TNF-α, but not CRP in the EX group. Although results are conflicting, 28 others have demonstrated the anti-inflammatory effect of EX training in post-menopausal women and other groups. 15,32 Subjects with high levels of physical activity or following EX interventions show lower serum levels of IL-6, 9 TNF-α and CRP.…”

Prevalence of vasomotor, psychological, psychosomatic and sexual symptoms in perimenopausal and recently postmenopausal Greek women: association with demographic, life-style and hormonal factors

“…Consistently with other studies [21,22], low estrogens predicted independently the intensity of VMS in our study. Estrogens act as potent neuromodulators, affecting important thermoregulatory circuits in the CNS.…”

A Review of Transdermal Nonpatch Estrogen Therapy for the Management of Menopausal Symptoms

“…[6][7][8] As there is no absolute estrogen level below which vasomotor flushes occur, estrogen levels between symptomatic and asymptomatic women can be identical. 6,7,9 Because of this interindividuality, estrogen doses required to achieve consistent symptomatic relief differ for each woman. Current recommendations for hormone therapy from the U.S. Food and Drug Administration (FDA), North American Menopause Society (NAMS), and American College of Obstetricians and Gynecologists (ACOG) suggest the use of the lowest effective dose for the shortest duration of time, consistent with treatment goals, benefits, and risks for the individual woman.…”