Variability of bothersome menopausal symptoms over time – a longitudinal analysis using the Estonian postmenopausal hormone therapy trial (EPHT)

Abstract

BackgroundVery little data are available on the natural course or level of disturbance of vasomotor symptoms among middle-aged women. Using readily collected trial data we studied the persistence of vasomotor symptoms among untreated women.MethodsIn a trial comparing combined hormone therapy to placebo or no treatment (control groups), a cohort of women aged 50–59 at recruitment were followed annually by questionnaires. Women in the control groups (n = 486) were grouped by the number of years followed, with the prevalence and severity of symptoms calculated both cross-sectionally and longitudinally.ResultsAbout two thirds of the women (67%) reported vasomotor symptoms and half (46%) bothersome symptoms at recruitment. In the cross-sectional analysis, their prevalence declined between recruitment and 1-year follow-up (32% bothersome symptoms) and 2-year follow-up (27%). Thereafter it remained about the same level. In the longitudinal analysis, there was a notable variation in the prevalence of disturbing vasomotor symptoms over time, time entering the study and the compliance to the surveys. In the two groups having most follow-up times, the proportion of women with bothersome symptoms first increased and then decreased.ConclusionsThere was a notable variability in the development of disturbing vasomotor symptoms over time in a selected group of women aged 50–59. Population-based follow-up studies of untreated women would be useful to estimate the symptom burden.

The 2020 Menopausal Hormone Therapy Guidelines

“…Most severe VMS appear within 1-2 years from the last day of menstruation and usually continue for about 4-5 years. However, there are cases in which the symptoms last for more than 12 years, which is reported to be 10% of the total cases; therefore, the symptom duration greatly varies [13,15].…”

Patient considerations in the management of menopausal symptoms: role of conjugated estrogens with bazedoxifene

“…Rates of HT use have declined dramatically since the WHI trials, such that HT is now used by <10% of postmenopausal women in most developed countries in Europe ( Figure 1A ) and the USA ( Figure 1B ). 26 , 27 Given the high prevalence of bothersome symptoms, 1 , 6 low rates of HT use suggest under-treatment of menopausal symptoms. Indeed, a survey of postmenopausal women in the USA, conducted by the Endocrine Society, revealed that nearly three-fourths of women with menopausal symptoms had not been treated for them.…”

“…Vasomotor symptoms (VMSs) of menopause occur in ~55%–90% of women, 1 – 5 and ~70% of women with these hot flushes and night sweats find them bothersome. 6 In addition, ~40%–70% of postmenopausal women experience vaginal/sexual symptoms (eg, discomfort, dryness, soreness, itching, burning, or pain on contact, dyspareunia, diminished libido, and avoidance of intimacy); 3 , 5 three-fourths of these women say vaginal symptoms have a negative impact on their lives. 3 Life expectancy is increasing, 7 and data suggest, for some women, menopausal symptoms may last many more years than previously suspected.…”

Empfehlungen zur Phytotherapie in der S3-Leitlinie „Peri- und Postmenopause – Diagnostik und Interventionen“

“…Wechseljahresbeschwerden gelten grundsätzlich nicht als Erkrankung. Aber etwa 30 % der betroffenen Frauen leiden sehr stark unter ihnen, weitere 30 % berichten mittelschwere Symptome und nur 40 % haben eigentlich keine nennenswerten Probleme [11], [12]. Eine Reihe von Faktoren beeinflusst die Beschwerden zusätzlich: die Ethnie, der Sozialstatus, kulturelle Einflüsse oder das Umfeld [13], [14].…”