Hot flashes and midlife symptoms in relation to levels of salivary cortisol

Gerber, Linda M.; Sievert, Lynnette Leidy; Schwartz, Joseph E.

doi:10.1016/j.maturitas.2016.11.001

Cited by 15 publications

(10 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For all this trouble, these methods still lack standardization, accuracy and precision ( Ceglarek et al, 2010 ; Rosner et al, 2013 ; Stanczyk & Clarke, 2014 ; Wang et al, 2016 ), so optimal means of studying menopause in autism require further thought and discussion. Some studies have linked menopausal symptoms and distress to cortisol, adrenaline and noradrenaline, associated with the HPA axis and the autonomic nervous system, respectively ( Gerber et al, 2017 ; Reed et al, 2016 ; Woods et al, 2014 ). Cortisol levels are robustly related with mental and physical health outcomes ( Adam et al, 2017 ), so this may also be a worthy physiological index to compare between groups and examine alongside symptom-reporting, given that (a) physical and mental health often decrease with menopause in the non-autistic population ( Hoyt & Falconi, 2015 ), and (b) autistic people are already vulnerable to increased morbidity and mortality ( Croen et al, 2015 ; Hirvikoski et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

‘When my autism broke’: A qualitative study spotlighting autistic voices on menopause

Moseley

Druce

Turner‐Cobb

2020

Autism

View full text Add to dashboard Cite

Autistic women often struggle with the onset of menstruation, a key transition point in the female reproductive lifespan. Presently, there is no research investigating how autistic people navigate the menopausal transition, and whether it poses additional challenges in addition to those already faced by neurotypical women. As a preliminary participatory study in this area, we conducted an online focus group with seven autistic individuals, aged 49–63 years (median = 64.5 years) and assigned female at birth, to explore the state of knowledge about the menopause in autism, difficulties the menopause might bring, support that might be needed, and what questions require scientific investigation. Thematic analysis of the discussion generated three themes: (a) lack of knowledge and understanding; (b) cracking the mask and adaptive functioning; and (c) finding support. Themes suggested a lack of professional knowledge, understanding and communication about menopause for autistic people, and an absence of support. Menopause was discussed as heightening pre-existing and generating new cognitive, social, emotional and sensory difficulties. This study illustrates the need for greater focus of attention towards how autistic people cope with the major life transition of menopause. Lay abstract Autistic girls are known to struggle with the onset of menstruation, reporting that during their period, sensory sensitivities are heightened, it becomes more difficult to think clearly and control their emotions and they struggle more with everyday life and self-care. Yet surprisingly, nothing is known about how autistic women handle the menopausal transition in midlife. In non-autistic women, the menopause brings many physical changes and challenging symptoms from hot flushes to feeling more anxious and depressed. Because autistic women are already vulnerable to suicide, poor physical and mental health, and because they may already struggle with planning, controlling their emotions and coping with change, the menopause may be an especially challenging time. Yet, not one single study exists on the menopause in autism, so we conducted an online discussion (focus group) with seven autistic women. They confirmed that very little is known about menopause in autistic people, very little support is available and that menopause might be especially difficult for autistic people. Autism-related difficulties (including sensory sensitivity, socializing with others and communicating needs) were reported to worsen during the menopause, often so dramatically that some participants suggested they found it impossible to continue to mask their struggles. Participants also reported having extreme meltdowns, experiencing anxiety and depression, and feeling suicidal. This study highlights how important it is that professionals pay attention to menopause in autism, and discusses future research directions.

show abstract

Section: Discussionmentioning

confidence: 99%

‘When my autism broke’: A qualitative study spotlighting autistic voices on menopause

Moseley

Druce

Turner‐Cobb

2020

Autism

View full text Add to dashboard Cite

show abstract

“…Not all studies have shown a consistently positive relationship between hot flashes and cortisol levels. For example, hot flash report has not been associated with the cortisol awakening response or diurnal variation in cortisol levels [26, 28, 29]. One study found greater self-reported hot flash severity associated with a flatter diurnal slope in salivary cortisol [30].…”

Section: Introductionmentioning

confidence: 99%

Stress and the menopausal transition in Campeche, Mexico

Sievert

Gómez

Cahuich‐Campos

et al. 2018

womens midlife health

View full text Add to dashboard Cite

BackgroundStress has been implicated as a factor in the presence and severity of symptoms during the menopausal transition. Our primary aim was to test the hypothesis that stress-sensitive biological measures and self-reported stress would be positively associated with a greater likelihood and intensity of hot flashes. Our secondary aim was to examine measures of stress in relation to the most often reported symptoms in Campeche, Mexico. We also hypothesized ethnic differences (Maya versus non-Maya) in relation to measures of stress and symptom reports.MethodsParticipants aged 40–60 (n = 305) were drawn from multiple sites across the city of San Francisco de Campeche to achieve a generally representative sample. Measures included C-reactive protein (CRP), an indicator of inflammation; Epstein-Barr virus antibodies (EBV-Ab), an indicator of immune function; the Perceived Stress Scale (PSS); a symptom checklist; anthropometric measures; and a questionnaire that elicited symptoms, ethnicity (based on language, birthplace, and last names of the woman, her parents, and her grandparents) and ten dimensions of socioeconomic status (SES). The relationships between symptoms and stress-sensitive biological and self-reported measures were examined in bivariate analyses, and with logistic and linear regressions.ResultsThe twelve most common symptoms reported, in descending order of frequency, were tiredness, muscle and joint pain, nervous tension, problems concentrating, feeling depressed, difficulty sleeping, headaches, feeling of ants crawling on the skin, loss of interest in sex, urinary stress incontinence, hot flashes, and night sweats. PSS scores were significantly associated with the likelihood of seven symptoms (yes/no), and with the intensity of ten symptoms after controlling for ethnicity, SES, education, cohabitation status, parity, smoking, body mass index, and menopausal status. The stress-sensitive biological measures of immune function (EBV-Ab and CRP) were not significantly associated with midlife symptoms. The PSS was associated with more symptoms among the Maya (e.g., feeling nervous/tense and having difficulty concentrating) than non-Maya.ConclusionPSS scores were associated with the intensity, but not the likelihood, of hot flashes. Other symptoms were also associated with self-reported stress but not with physiological measures. Maya/non-Maya differences may indicate that either symptoms or stress were experienced and/or reported in culture-specific ways.

show abstract

“…The Neighborhood Study of Blood Pressure and Sleep, conducted from September 1999 through July 2003, was a cross-sectional investigation of race/ethnicity, socioeconomic status, and diurnal blood pressure (BP) patterns [18, 51]. Data for this study were drawn from this parent study.…”

Section: Methodsmentioning

confidence: 99%

Neighborhood disorder, exposure to violence, and perceived discrimination in relation to symptoms in midlife women

Gerber

Sievert

2018

womens midlife health

View full text Add to dashboard Cite

BackgroundSome symptoms at midlife are associated with stress, such as hot flashes, trouble sleeping, headaches, or depressed mood. Hot flashes have been studied in relation to laboratory stressors, physiological biomarkers, and self-reported stress, but less is known about hot flashes in relation to the larger context of women’s lives. This study examined the risk of symptoms in relation to neighborhood disorder, exposure to neighborhood violence, social cohesion and perceived discrimination. We hypothesized that women exposed to more negative neighborhood characteristics and discrimination would be more likely to report hot flashes and other midlife symptoms.MethodsParticipants were black and white women, aged 40 to 60, drawn from a cross-sectional investigation of race/ethnicity, socioeconomic status, and blood pressure in New York City (n = 139). Demographic information, medical history, menopausal status, and symptoms were measured by questionnaire. Likert scales were used to measure neighborhood characteristics, specifically, the Neighborhood Disorder Scale, the Exposure to Violence Scale, the Perceived Violence Subscale, the Neighborhood Social Cohesion and Trust Scale, and the Everyday Discrimination Scale. Ten symptoms were included in analyses: lack of energy, feeling blue/depressed, backaches, headaches, aches/stiffness in joints, shortness of breath, hot flashes, trouble sleeping, nervous tension, and pins/needles in hands/feet. Each scale with each symptom outcome was examined using logistic regression analyses adjusting for significant covariates.ResultsBlack women reported higher scores on all negative neighborhood characteristics and discrimination, and a lower score on the positive Neighborhood Social Cohesion and Trust. Neighborhood Disorder was associated with feeling blue/depressed, aches/stiffness in joints, and hot flashes, and Perceived Violence was associated with aches/stiffness in joints, after controlling for model-specific covariates. There was a lower risk of backaches with increasing Neighborhood Social Cohesion and Trust score. The Everyday Discrimination Scale was associated with lack of energy. Lack of energy, feeling blue/depressed, aches/stiffness in joints, and hot flashes appeared to be most vulnerable to negative neighborhood context and discrimination.ConclusionsThis study adds to the literature linking neighborhood environments to health outcomes. The associations between negative neighborhood contexts and discrimination with diverse symptoms, and the association between social cohesion and back pain, point to the need to expand analyses of stress to multiple physiological systems.

show abstract

Hot flashes and midlife symptoms in relation to levels of salivary cortisol

Cited by 15 publications

References 52 publications

‘When my autism broke’: A qualitative study spotlighting autistic voices on menopause

‘When my autism broke’: A qualitative study spotlighting autistic voices on menopause

Stress and the menopausal transition in Campeche, Mexico

Neighborhood disorder, exposure to violence, and perceived discrimination in relation to symptoms in midlife women

Contact Info

Product

Resources

About