Risk of long-term hot flashes after natural menopause

Freeman, Ellen W.; Sammel, Mary D.; Sanders, Richard J.

doi:10.1097/gme.0000000000000196

Cited by 210 publications

(115 citation statements)

References 34 publications

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“…From the results in table 1, the EG showed non-significant improvement in systolic and diastolic blood pressure (SBP/DBP), and resting heart rate by 5.8L%, 3.6L% and 2.6L% respectively. These are in congruence with other studies that reported significant improvement in blood pressure following aerobic exercise (Ammar, In another study, regular aerobic exercise lasting 12 weeks contributed to significant reductions in resting blood pressure of postmenopausal women (Ellen W. Freeman et al, 2015). In a study to determine the effects of daily walking on lowering blood pressure in postmenopausal women that lasted 24 weeks, there were significant reductions in systolic blood pressure (Freeman et al, 2010).…”

Section: Resultssupporting

confidence: 74%

Lipid profile, cardiorespiratory function and quality of life of postmenopausal women improves with aerobic exercise

Akwa¹,

Moses²,

Emikpe³

et al. 2017

jhse

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Objective: Menopause is characterized by physiological changes with increased risk of obesity, dyslipidemia and decreased quality of life (QoL). Despite the plethora of reports on the alleviating effect of exercise on climacteric symptoms, there is little documentation of this lifestyle intervention among Ghanaian menopausal women. This study examined the effect of aerobic exercise on lipid profile, cardiorespiratory function and QoL among menopausal women. Methods: Eighteen sedentary postmenopausal women between 45 to 75 years were randomly assigned to experimental (EG, n=8) and control (CG, n=10) groups. The EG received moderate intensity aerobic exercise training for eight weeks, three times a week while the CG observed normal daily activities. Blood pressure, resting heart rate, BMI, and lipid profile were measured and QoL assessed using the Utian QoL questionnaire at weeks 0 and 9. Results: After 8 weeks, the EG demonstrated significant decrease in cardiovascular risk ratio by 6.5L% and a non-significant decrease in LDL by 11.9L%. The CG showed significant increase in systolic BP by 3.2%L and a non-significant increase in LDL and cardiovascular risk by 14.9L% and 9.4L% respectively. QoL significantly improved in the EG group compared to CG after the 8 weeks. Conclusion: The health and QoL of participants in EG was significantly better than

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Section: Resultssupporting

confidence: 74%

Lipid profile, cardiorespiratory function and quality of life of postmenopausal women improves with aerobic exercise

Akwa¹,

Moses²,

Emikpe³

et al. 2017

jhse

View full text Add to dashboard Cite

show abstract

“…In further studies of placebo effects, a second control group that is not given either active medication or placebo could better address the question of regression to the mean. Although the mean natural duration of menopausal hot flashes is considerable, ranging from about 4 years to more than 10 years (31), and participants were selected for stable ratings of hot flashes in the screen period, it is possible that variations in hot flash frequency could account for placebo improvement. It should also be noted that one protocol required a relatively high frequency of hot flashes in the screen period, suggesting the possibility that subsequent decreases were a return to more usual levels of hot flashes or that hot flashes improved with time for reasons other than the direct effects of study pills.…”

Section: Discussionmentioning

confidence: 99%

Placebo Improvement in Pharmacologic Treatment of Menopausal Hot Flashes

Freeman

Ensrud

Larson

et al. 2015

Psychosomatic Medicine

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Objectives This study characterized the time course, duration of improvement and clinical predictors of placebo response in treatment of menopausal hot flashes. Methods Data were pooled from two trials conducted in the MsFLASH network, providing a combined placebo group (N=247) and a combined active treatment group (N=297). Participants recorded hot flash frequency in diaries twice daily during treatment (week 0-8) and subsequent follow-up (week 9-11). The primary outcome variable was clinically significant improvement, defined as >=50% decrease in hot flash frequency from baseline and calculated for each week in the study. Subgroups were defined a priori using standard clinical definitions for significant improvement and partial improvement. Clinical and demographic characteristics of the participants were evaluated as predictors of improvement. Results Clinically significant improvement with placebo accrued each treatment week, with 33% significantly improved at week 8. Of placebo responders who were improved at both weeks 4 and 8, 77% remained clinically improved at week 11 after treatment ended. Independent predictors of significant placebo improvement in the final multivariable model were African American race (OR 5.61, 95% CI: 2.41-13.07, p<0.001); current smokers (OR 2.30, 95% CI: 1.05-5.06, p=0.038); and hot flash severity in screening (OR 1.45, 95% CI: 1.00-2.10, p=0.047). Conclusions Clinically significant improvement with placebo accrued throughout treatment with a time course similar to improvement with active drug. A meaningful number of participants in the placebo group sustained a clinically significant response after stopping placebo pills. The results suggest that non-specific effects are important components of treatment and warrant further studies to optimize their contributions in clinical care.

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“…1–3 Up to 80% of women experience VMS during the MT, 4,5 and most rate them as moderate to severe. 6 Vasomotor symptoms are one of the chief menopause-related problems for which US women seek medical treatment. 7,8 Results from the Study of Women’s Health Across the Nation (SWAN) suggest that VMS are also independently associated with multiple indicators of elevated cardiovascular risk 9,10 and greater bone loss and higher bone turnover.…”

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confidence: 99%

Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition

et al. 2015

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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.

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Risk of long-term hot flashes after natural menopause

Cited by 210 publications

References 34 publications

Lipid profile, cardiorespiratory function and quality of life of postmenopausal women improves with aerobic exercise

Lipid profile, cardiorespiratory function and quality of life of postmenopausal women improves with aerobic exercise

Placebo Improvement in Pharmacologic Treatment of Menopausal Hot Flashes

Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition

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