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

Abstract

flushes and night sweats symptom profiles over a 17-year period in mid-aged women: the role of hysterectomy with ovarian conservation.Maturitas http://dx.doi.org/10. 1016/j.maturitas.2016.05.011 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights There has been limited longitudinal analysis of hysterectomy and vasomotor symptoms.  The present study found that hysterectomy with ovarian conservation is associated with persistent hot flushes and night sweats.  Obesity, smoking and a lower level of education/occupation are also associated with persistent symptoms.Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: the role of hysterectomy with ovarian conservation. ABSTRACT OBJECTIVES:There is limited research on hot flushes and night sweats in women with a hysterectomy with ovarian conservation. We aimed to describe the patterns of these symptoms in a cohort of Australian women and to investigate the relationship between distinct symptom patterns and hysterectomy status. STUDY DESIGN AND OUTCOME MEASURES:Repeated-measures latent class analysis (LCA) was used to identify hot flushes and night sweats symptom patterns across seven surveys (over 17 years) in the mid-cohort of the Australian Longitudinal Study on Women"s Health. Multinomial logistic regression was used to assess the associations of the symptom patterns in women with a hysterectomy with ovarian conservation (n=1,129) versus women without a hysterectomy (n=4,977). RESULTS:A higher proportion of women with a hysterectomy than of those without experienced a constant pattern of hot flushes (15% versus 30%) and night sweats (9% versus 19%). Women with a hysterectomy had higher odds of constant hot flushes versus minimal hot flushes (OR = 1.97, 95% CI: 1.64, 2.35) and constant versus minimal night sweats (OR = 2.09, 95% CI: 1.70, 2.55). Smoking, a "lower level of education to non-professional occupation" pathway and body mass index (BMI) patterns of "always obese" and "increasingly obese" were also associated with a higher risk of constant symptoms. CONCLUSIONS:Women who have a hysterectomy (with ovarian conservation) have a higher risk of hot flushes and night sweats that persist over an extended period.

Global consensus recommendations on menopause in the workplace: A European Menopause and Andropause Society (EMAS) position statement

“…Other menopausal symptoms may include chronically disturbed sleep, which, in turn, can lead to insomnia, fatigue, irritability and difficulties with short-term memory and concentration as well as muscle and joint discomfort [27,28]. Although vasomotor symptoms usually are present for less than five years, some women will continue to flush beyond the age of 60 years [29,30,31,32]. Urogenital symptoms may be lifelong [33].…”

“…Surgically induced menopause often leads to the immediate onset of vasomotor symptoms. Current smoking and obesity may also predispose a woman to more severe or frequent hot flushes [32,35].…”

Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations

“…VMS and sleep disturbance are especially common and can be severe after surgical menopause. 54,55 An evaluation of the co-occurrence of depressive symptoms and menopausal symptoms was performed via cluster analysis in a sample of 797 women with no history of MDD who were participating in the MSFlash trials. 56 At baseline, there were two symptom clusters that included women with elevated depressive symptoms.…”

Vasomotor Symptoms Across the Menopause Transition

“…Two groups of women deserve special attention: those who undergo a hysterectomy or oophorectomy and those who experience VMS as a result of breast cancer treatment. VMS are more likely in women with a hysterectomy--even with ovarian conservation--than in women with a natural menopause 25,63,64 , possibly due to disruption of blood flow to the ovaries (which in turn affects hormone levels) from abdominal surgery. Bilateral salpingo ovariectomy (BSO) without concurrent exogenous hormone therapy (HT) is also linked to more frequent and severe VMS compared with a natural menopause.…”