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

Abstract

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.

Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: The role of hysterectomy with ovarian conservation

“…Women who have a hysterectomy with bilateral oophorectomy (both ovaries removed) are consistently reported to have a higher risk of more frequent and/or severe hot flushes and night sweats, which is thought to be related to the abrupt decline in oestrogen levels post-surgery [5]. For women who have a hysterectomy with ovarian conservation (one or both ovaries retained) the reported associations are less consistent [6][7][8]. The proportion of women who retain one or both ovaries at the time of hysterectomy varies by country, ranging from 46% to 82% [4], highlighting the need to increase our understanding of the symptom experiences of these women.…”

Hot flushes still occur in a population of 85-year-old Swedish women

“…In line with these results, Barnabei et al (2002) analysed data from the Heart and Estrogen/Progestin Replacement Study and found that almost 20% of women aged 70-74 years reported very frequent or frequent hot flushes [6] while Rödström et al (2002) reported a lower number, that only 9% of the 72-year old women were troubled by hot flushes [7]. A recent large cohort study [8] on 202638 postmenopausal women showed that menopausal symptoms were still present in 54% 10 years after menopause and that the symptoms and their frequency remained constant from 55 to 65 years of age. The authors concluded that previous studies may have underestimated the duration of menopausal symptoms.…”

Study protocol of a multicentre randomised controlled trial of self-help cognitive behaviour therapy for working women with menopausal symptoms (MENOS@Work)

“…There are over 3.5 million women in employment aged between 50 and 65 in the UK [1] and, as menopause occurs on average between the ages of 50-51 and can last for up to ten years [2] at any one time, a significant proportion of mid-aged and older women workers will be experiencing menopausal symptoms. Hot flushes and night sweats (HFNS) are the main symptoms of the menopause, which for an estimated 20-25% affect quality of life (QOL) largely due to discomfort, embarrassment and the impact of night sweats upon sleep [3,4].…”