MsFLASH participants’ priorities for alleviating menopausal symptoms

Abstract

Objective To describe self-reported menopausal symptom priorities and their association with demographics and other symptoms among participants in an intervention trial for vasomotor symptoms (VMS). Methods Cross-sectional study embedded in the MsFLASH 02 trial, a three by two factorial design of yoga vs. exercise vs. usual activity and omega-3-fatty acid vs. placebo. At baseline, women (n=354) completed hot flash diaries, a card sort task to prioritize symptoms they would most like to alleviate, and standardized questionnaires. Results The most common symptom priorities were: VMS (n=322), sleep (n=191), concentration (n=140), and fatigue (n=116). In multivariate models, (1) women who chose VMS as their top priority symptom (n=210) reported significantly greater VMS severity (p=0.004) and never smoking (p=0.012) and (2) women who chose sleep as their top priority symptom (n=100), were more educated (p≤0.001) and had worse sleep quality (p<0.001). ROC curves identified sleep scale scores that were highly predictive of ranking sleep as a top priority symptom. Conclusions Among women entering an intervention trial for VMS and with relatively low prevalence of depression and anxiety, VMS was the priority symptom for treatment. A card sort may be a valid tool for quickly assessing symptom priorities in clinical practice and research.

Validity, cut-points, and minimally important differences for two hot flash-related daily interference scales

“…The links between frequent, severe, or bothersome VMS and sleep problems, 44, 45 mood problems, 46–49 and concentration difficulties 50, 51 have all been previously documented and are consistent with two previously published MsFLASH reports: MsFLASH trial participants’ symptom priorities 52 and symptom clusters. 53 In MsFLASH 02, a companion study was added and it required trial participants to complete a card sort task to indicate which three of twelve possible symptoms they would most like to alleviate.…”

“…53 In MsFLASH 02, a companion study was added and it required trial participants to complete a card sort task to indicate which three of twelve possible symptoms they would most like to alleviate. 52 The four most highly rated symptoms were VMS, sleep disruption, concentration impairment, and fatigue. Mood was endorsed much less frequently in this analysis possibly because women with mood disturbances were excluded from the trial.…”

Female Sexual Function Index Short Version: A MsFLASH Item Response Analysis

“…In addition, findings are generalizable to a population of symptomatic peri- and post-menopausal women, but should be interpreted cautiously or replicated in women of different ages and different medical conditions. Our population of peri- and post-menopausal women may have had particular symptoms that affected sexual functioning such as vaginal dryness and subsequent dyspareunia, but the women were not recruited based on sexual function and vaginal dryness, which are only marginally linked to hot flashes (Carpenter et al, 2015). Our findings also reflect a population experiencing hot flashes and may not generalize to the minority 20% of women who do not experience this cardinal menopausal symptom.…”

Non-hormonal treatments for menopausal symptoms

“…Sleep disturbance is common in menopausal women and is a high patient priority for treatment. 69 The addition of the sedative zolpidem (10 mg/night) to an SSRI or SNRI in breast cancer survivors improves sleep and quality of life compared with placebo. 70 However, long term use of zolpidem is not recommended because of concerns about tolerance and daytime somnolence.…”