Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition

Abstract

IMPORTANCEThe expected duration of menopausal vasomotor symptoms (VMS) is important to women making decisions about possible treatments.OBJECTIVES To determine total duration of frequent VMS (Ն6 days in the previous 2 weeks) (hereafter total VMS duration) during the menopausal transition, to quantify how long frequent VMS persist after the final menstrual period (FMP) (hereafter post-FMP persistence), and to identify risk factors for longer total VMS duration and longer post-FMP persistence. DESIGN, SETTING, AND PARTICIPANTSThe Study of Women's Health Across the Nation (SWAN) is a multiracial/multiethnic observational study of the menopausal transition among 3302 women enrolled at 7 US sites. From February 1996 through April 2013, women completed a median of 13 visits. Analyses included 1449 women with frequent VMS. MAIN OUTCOMES AND MEASURESTotal VMS duration (in years) (hot flashes or night sweats) and post-FMP persistence (in years) into postmenopause. RESULTSThe median total VMS duration was 7.4 years. Among 881 women who experienced an observable FMP, the median post-FMP persistence was 4.5 years. Women who were premenopausal or early perimenopausal when they first reported frequent VMS had the longest total VMS duration (median, >11.8 years) and post-FMP persistence (median, 9.4 years). Women who were postmenopausal at the onset of VMS had the shortest total VMS duration (median, 3.4 years). Compared with women of other racial/ethnic groups, African American women reported the longest total VMS duration (median, 10.1 years). Additional factors related to longer duration of VMS (total VMS duration or post-FMP persistence) were younger age, lower educational level, greater perceived stress and symptom sensitivity, and higher depressive symptoms and anxiety at first report of VMS.CONCLUSIONS AND RELEVANCE Frequent VMS lasted more than 7 years during the menopausal transition for more than half of the women and persisted for 4.5 years after the FMP. Individual characteristics (eg, being premenopausal and having greater negative affective factors when first experiencing VMS) were related to longer-lasting VMS. Health care professionals should counsel women to expect that frequent VMS could last more than 7 years, and they may last longer for African American women.

Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: The role of hysterectomy with ovarian conservation

“…One of the strongest predictors of longer vasomotor symptom duration in studies of women who experienced natural menopause was if the symptoms began early in the menopause transition (premenopausal or perimenopausal) [27,28] . All of the women in our hysterectomy group had their surgery before they were 50 years old and likely to be in these early menopausal stages.…”

Evolution of menopausal hormone therapy: from standard to ultra-low doses

“…Далее звучат новые ноты: «Однако вазомоторные симптомы продолжаются в среднем в течение 7,4 и более лет… Средние/тяжелые приливы могут сохраняться у 42% женщин в возрасте от 60 до 65 лет». Приводя эти цифры, эксперты NAMS ссылаются на опубликованные в 2015 г. результаты двух важных исследований: The Study of Women's Health Across the Nation (SWAN) [8] и исследова-ние австралийских ученых [5].…”

“…В исследовании The Study of Women's Health Across the Nation (SWAN), продолжавшемся с февраля 1996 г. по апрель 2013 г., приняли участие 1 449 женщин с частыми приливами, наблюдавшиеся в период перехода от пре-к пери-и далее к постменопаузе [8]. Результаты исследова-ния показали, что средняя продолжительность приливов составила 7,4 года.…”

“…Тем не менее за прошедший с 2002 г. период времени получено много новых данных и проведен неоднократ- [11][12][13]. Абсолютные риски для разнообразных событий, свя-занных с ГТ, были существенно ниже для женщин в воз-расте 50-59 лет, чем для пожилых женщин, и ни эстроген-прогестероновая, ни эстрогеновая терапии не повлияли на показатели смертности [8].…”

“…Ультранизкая доза для трансдермальных препаратов, например для пластыря, составляет 14 мкг [22]. Исследования, проводившиеся с целью определения оптимальной дозы, показали, что пероральные препара-ты, включающие <0,5 мг эстрадиола, не купируют вазо-моторные симптомы, поэтому именно она признана минимальной эффективной дозой [8].…”