More data analysis concerning hot flashes from the Study of Women’s Healthiness Across the Nation (SWAN) has actually been published today in Menopause, the diary of The North American Menopause Society (NAMS). A study by Ping G. Tepper, PhD, and colleagues shows that the improvement of vasomotor symptoms (VMS) across the menopause transition appears to be greatly and independently associated along with a lot of sociodemographic, reproductive hormone, and psychosocial factors.
Vasomotor symptoms (hot flashes and night sweats) are the classic menopause symptoms. Prevalence of VMS is higher throughout and after the menopause transition, and specific women have actually substantial variations in the timing of onset and path of VMS. Hormonal, psychosocial, lifestyle, health, and biological factors have actually all of been previously associated along with VMS.
SWAN was a multisite longitudinal community-based study of 3,302 women (aged 42-52 years at enrollment) transitioning through menopause from February 1996 through April 2013. The women belonged to among 5 racial/ethnic groups: white, black, Japanese, Chinese, and Hispanic. This study sample included 1,455 women along with nonsurgical menopause: nearly half of the women (47.3%) were non-Hispanic white; 25.8% were black; 11.5% were Japanese; 9.8% were Chinese; and 5.6% were Hispanic. Median follow-up was 15.4 years; median age of menopause was 52.2 years.
“SWAN is among the largest and longest racially and ethnically diverse studies of the menopause transition,” says Dr. JoAnn Pinkerton, Executive Director of The North American Menopause Society. “This study looked to characterize the trajectories of VMS occurrence in a diverse cohort and identify specific factors related to variations.”
At the baseline visit and at 13 follow-up visits, participants completed a protocol that included questionnaires, bodily measures, and provision of blood samples. Women self-reported their VMS in two questions asking concerning the presence and frequency of hot flashes and night sweats over the prior 2 weeks. Women offered fasting blood samples to test estradiol and follicle-stimulating hormone (FSH) levels.
Time was evaluated 12 years prior to to 15 years after the date of the last menstrual period. Temporal patterns of VMS and associations along with reproductive hormones, race/ethnicity, physique mass index (BMI), and demographic and psychosocial factors were examined utilizing group-based trajectory models. The study sample had 17,814 observations, an standard 12.2 observations per woman.
The researchers identified four distinct VMS trajectory patterns: onset early (11 years prior to the last menstrual period), along with decline after menopause (early onset group); onset near the last menstrual period along with later decline (late onset group); onset early along with persistently higher frequency (higher group), and persistently reduced frequency (reduced group).
Women along with early onset VMS were Much more most likely to have actually raised baseline depressive symptoms and anxiety, poorer health, and older age at menopause. Reduced BMI, black race/ethnicity, and current smoking distinguished women in the late-onset VMS group, that were likewise much less most likely to be obese.
Women in the persistently higher VMS group were characterized by much less education attainment, better alcohol use, poorer health, better depressive and anxiety symptoms, and better symptom sensitivity and were Much more most likely to be black, much less most likely to be Chinese, and prove to a trend toward reduced levels of estradiol prior to the last menstrual period, along with a slow-moving decline in hot flashes over the menopause transition. Black women were overrepresented in the persistently higher and the late-onset VMS teams (the two P < 0.05) relative to white women, and Chinese women in the reduced VMS group. Women that were over weight were underrepresented in the late-onset subgroup (odds ratio, 0.56; 95% self-confidence interval, 0.36-0.87; P < 0.05). There were relatively equal proportions of women in each VMS group.
The pattern of estradiol levels over the menopause transition was greatly associated along with VMS patterns. reduced levels of estradiol were crucial for VMS occurrence, especially in the early and persistently higher VMS groups. As soon as FSH levels were substituted for estradiol levels in the analysis, comparable associations in between participant characteristics and VMS group were found. FSH levels did not distinguish the VMS groups, except that women in the higher VMS group were Much more most likely to have actually higher FSH levels relative to the reduced group.
These outcomes appear to prove to that hormones, race/ethnicity, BMI, education, smoking, drinking alcohol, overall Healthiness status, anxiety, and depression have actually a durable relation to the timing and persistence of VMS in a diverse population of midlife women.
“This short article offers assistance in to the various patterns of highly prevalent and regularly bothersome menopause symptoms,” says Dr. Pinkerton. “Interventions to manage VMS might be tailored to handle individual factors, including ethnicity and patterns of hot flashes that contribute to VMS, allowing us to target women that are a lot of damaged and aiding clinicians to advice women and women’s ability to make informed decisions concerning treatment options.”
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