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Prevalence, frequency and problem rating of hot flushes persist in older postmenopausal women: impact of age, body mass index, hysterectomy, hormone therapy use, lifestyle and mood in a cross-sectional cohort study of 10 418 British women aged 54-65 Objective Hot flushes and night sweats (HFs/NSs) are the main menopausal symptoms, but few studies have been adequately powered to examine the dimensions or predictors of experiencing HFs/NSs. We report on these variables in a large UK cohort of postmenopausal women.Design Cross-sectional cohort study.Setting UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) cohort. Methods Women completed a follow-up questionnaire, and those aged 54-65 years were mailed a survey in July 2008.Main outcome measures Hot flush prevalence and hot flush rating scale.Results Of the 15 000 women mailed, 10 418 returned completed questionnaires; 90% had previously had HFs/NSs. Despite being on average 10 years postmenopausal, 54% experienced HFs/NSs (frequency of 33 per week with mean problem rating 4/10) that persisted across the age range. Past hysterectomy (OR 1.50, 95% CI 1.19-1.86), ever having smoked (OR 1.27, 95% CI 1.11-1.46) and alcohol consumption (current units) (OR 1.05, 95% CI 1.01-1.09) predicted ever having had HFs/NSs. Anxiety (OR 3.09, 95% CI 2.57-3.72), hysterectomy (OR 2.74, 95% CI 2.32-3.25), depressed mood (OR 1.57, 95% CI 1.24-1.99), years since last menstrual period (OR 0.95, 95% CI 0.94-0.96) and education (above and below 18 years) (OR 0.98, 95% CI 0.97-0.99) predicted the current prevalence of HFs/NSs. Few predictors of frequency were identified, but problem rating was associated with depressed mood, hysterectomy, skirt size increase and frequency of HFs/NSs. Past hormone therapy users who had discontinued treatment were more likely to have HFs/NSs that were more frequent and problematic.Conclusions To date, this is the largest UK study of the experience of HFs/NSs amongst older postmenopausal women. HFs/NSs are more prevalent in this age band than has previously been assumed. These findings and the associations of smoking, hysterectomy, anxiety, depressed mood and hormone therapy use with the experience of HFs/NSs have implications for prevention and symptom management.

Earlier studies have shown that primary infections of winter wheat crops by septoria tritici blotch are initiated in autumn by air‐borne ascospores of the teleomorph stage, Mycosphaerella graminicola, which originate from sources outside the crop. Subsequent disease development within the crop, and damage to the upper leaves in summer, were commonly ascribed to the anamorph stage, Septoria tritici, which first arises from primary, ascosporic lesions and develops to give rise to splash‐borne pycnidiospores produced in pycnidia. Trapping studies, using a Burkard volumetric trap sited adjacent to field trials of winter wheat, showed that ascospores are released from pseudothecia throughout the year; peak release is not restricted to the autumn and early winter when the primary infections occur. As M. graminicola ascospores can be confused with those of other species, their authenticity was established by incubating ascospores on trap tapes for 24–48 h before counting. Examination of wheat plants cv. Riband, removed from unsprayed crops just prior to harvest and exposed to external weather conditions over the winter in 1995 and 1996, showed that pseudothecia mature on residues of the upper leaf layers between August and March. However, peak development occurred in December/January, when there was a corresponding decline in pycnidial formation. On regenerated wheat in set‐aside (left uncultivated) fields, sources of pseudothecia of M. graminicola were exhausted by February of the following year. Natural development of the teleomorph stage was monitored in an unsprayed crop of winter wheat cv. Riband during the 1996–97 season, and was present on leaf 8 at growth stage 32 (24 April) and on leaf 3 at growth stage 85 (8 July), then a week later, on both leaf 2 and the flag leaf. The temporal development of M. graminicola asexual and sexual phases was also studied in inoculation experiments under external weather conditions on pot‐grown seedlings of winter wheat cv. Longbow, using inoculum from two single‐ascospore cultures.

Objective To investigate the effectiveness of exercise as treatment for vasomotor menopausal symptoms.Design Three-group randomised controlled trial, two exercise interventions and a control group.Setting Primary Care, West Midlands UK.Population Perimenopausal and postmenopausal women experiencing at least five hot flushes/night sweats per day and not taken MHT in previous 3 months were recruited from 23 general practices.Methods Participants in both exercise interventions groups were offered two face-to-face consultations with a physical activity facilitator to support engagement in regular exercise. In addition, one exercise group received a menopause-specific information DVD and written materials to encourage regular exercise and the other exercise group was offered the opportunity to attend exercise social support groups in their communities. Interventions lasted 6 months.Main outcome measure The primary outcome was frequency of hot flushes/night sweats at 6-month up.Results Two hundred and sixty-one women were randomised (n = 87 per group). Neither of the exercise intervention groups reported significantly less frequent hot flushes/night sweats per week than controls (exercise-DVD versus control: À8.9, 95% CI À20.0 to 2.2; exercise-social support versus control: À5.2, 95% CI À16.7 to 6.3).Conclusions This trial indicates that exercise is not an effective treatment for hot flushes/night sweats. Contrary to current clinical guidance, women should not be advised that exercise will relieve their vasomotor menopausal symptoms.