Vasomotor Symptoms: More Than Temporary Menopausal Symptoms

Ryu, Ki Jin; Park, Hyuntae; Park, Jin Seol; Lee, Yeon Woo; Kim, Soo Young; Kim, Hayun; Jeong, Youngmi; Kim, Yong Jin; Yi, Kyong Wook; Shin, Jung Ho; Hur, Jun Young; Kim, Tak

doi:10.6118/jmm.20030

Cited by 9 publications

(8 citation statements)

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“…23 In addition to a similar population in which they occur, these conditions seem to be influenced by the same factors, such as growth hormone, vitamin D, and physical exercise. 23 However, several studies have reported that VMS were associated with the risk of osteoporosis in menopausal women, 10 in contrast to the negative relationship between VMS and sarcopenia observed in this study. Such discrepancies imply that complex physiologic mechanisms are involved in the relationships between VMS, and muscle and bone health, which should be determined by a further study.…”

Section: Menopausal Vasomotor Symptoms and Sarcopeniacontrasting

confidence: 88%

“…9 VMS are associated with several chronic disorders, including obesity, insulin resistance, metabolic syndrome, osteoporosis, and cardiovascular diseases. 10 Several epidemiologic studies have reported an association between VMS and obesity assessed using body mass index (BMI) and waist circumference. 11 However, such anthropometric measures are limited because they do not reflect the exact body composition, such as the percentage of adipose tissue versus muscle tissue.…”

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confidence: 99%

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Association between vasomotor symptoms and sarcopenia assessed by L3 skeletal muscle index among Korean menopausal women

et al. 2021

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Objective: To evaluate the association between vasomotor symptoms (VMS), skeletal muscle index (SMI), and sarcopenia in menopausal women.Methods: This cross-sectional study included 295 Korean menopausal women 40 to 65 years old who underwent abdominal computed tomography during routine health checkups between January 2014 and May 2016. The crosssectional areas of adipose and skeletal muscles were measured at the L3 level using computed tomography. The SMI is defined as the sum of the skeletal muscle area (cm 2 )/height 2 (m 2 ). Sarcopenia was identified by an SMI of <34.9 cm 2 /m 2 . VMS were assessed using the Menopause Rating Scale.Results: The mean age of the participants was 54.93 AE 6.20 years. VMS were reported in 160 women (54.2%). Sarcopenia was more prevalent in women without VMS (18.5%) than in those with (6.9%). Multivariate logistic regression showed that the prevalence of sarcopenia was inversely associated with the prevalence of VMS (odds ratio, 0.32; 95% CI, 0.15-0.67). Moreover, the paraspinal muscle index was positively associated with the prevalence of VMS (odds ratio, 1.06; 95% CI, 1.01-1.11) after adjusting for age, body mass index, waist circumference, adipose tissue area, history of hormone therapy, systolic and diastolic blood pressures, total cholesterol, insulin resistance, alcohol intake, and exercise.Conclusions: VMS are less common in women with sarcopenia than in those without and are positively associated with paraspinal muscle mass in Korean menopausal women. Further longitudinal studies are required to investigate the causal relationships and underlying mechanisms.

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Section: Menopausal Vasomotor Symptoms and Sarcopeniacontrasting

confidence: 88%

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confidence: 99%

Association between vasomotor symptoms and sarcopenia assessed by L3 skeletal muscle index among Korean menopausal women

et al. 2021

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“…Hot flashes are characterized by sudden strong fever or sweating on the face, neck and upper chest area, as well as palpitations, anxiety, irritability, and panic. In addition, the peripheral and central body temperatures change (Freedman et al, 1995;Freedman, 2000;Ryu et al, 2020). Hot flashes often occur at night, interfering with sleep, affecting mental health, and lowering quality of life (de Zambotti et al, 2014;Stuenkel, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that up to 85% of women experience hot flashes. Hot flashes are associated with an increased risk of chronic diseases such as 10.3389/fnagi.2022.993955 obesity, metabolic syndrome, insulin resistance, non-alcoholic fatty liver, cardiovascular disease, and osteoporosis (Lee et al, 2012;Kwon et al, 2016;Ryu et al, 2016Ryu et al, , 2018, and they are regarded as an early warning sign of cardiovascular disease (Rathnayake et al, 2019;Ryu et al, 2020). However, the pathophysiology of hot flashes is unknown.…”

Section: Introductionmentioning

confidence: 99%

Glutamatergic and GABAergic neurons in the preoptic area of the hypothalamus play key roles in menopausal hot flashes

Sun

Wang

Lü

et al. 2022

Front. Aging Neurosci.

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During menopause, when estrogen levels are low, abnormalities in the hypothalamic preoptic area (POA) of the thermoregulatory center can cause hot flashes. However, the involved neural population has not been identified. Proteomics showed that under low estrogen, differentially expressed proteins in the hypothalamus were associated with glutamatergic and GABAergic synapses. RNAscope, Western blotting and qRT-PCR indicated that the number of glutamatergic neurons in the POA was decreased, while the number of GABAergic neurons was increased. Chemogenetics showed that the rat body temperature decreased slowly after glutamatergic neurons were activated and increased quickly after glutamatergic neurons were inhibited, while it increased quickly after GABAergic neurons were activated and decreased slowly after GABAergic neurons were inhibited. RNAscope, immunofluorescence, Western blotting and qRT-PCR further showed that glutamate decarboxylase (GAD) 1 expression in the POA was increased, while GAD2 expression in the POA was decreased; that thermosensitive transient receptor potential protein (ThermoTRP) M (TRPM) 2 expression in glutamatergic neurons was decreased, while TRPM8 expression in GABAergic neurons was increased; and that estrogen receptor (ER) α and β expression in the POA was decreased, and ERα and ERβ expressed in both glutamatergic and GABAergic neurons. Estrogen therapy corrected these abnormalities. In addition, CUT&Tag and Western blot after injection of agonists and inhibitors of ERs showed that ERα and ERβ were both transcription factors in glutamatergic and GABAergic synapses. Mechanistically, during menopause, estrogen may regulate the transcription and expression of GADs and ThermoTRPs through ERs, impacting the number and function of glutamatergic and GABAergic neurons, resulting in unbalanced heat dissipation and production in the POA and ultimately triggering hot flashes.

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“…These findings suggest that vasomotor symptoms are biomarkers of impaired cardiometabolic conditions, not just temporary symptoms of menopausal women. 30 Furthermore, the timing of the onset of high blood pressure is usually at the beginning of menopause. Symptoms of female hypertension (such as hot flashes and palpitations) are often mistaken for menopause.…”

Section: Raise Awareness Of Menopausal Transition and Improve Health ...mentioning

confidence: 99%

Menopausal symptoms and risk of heart failure: a retrospective analysis from Taiwan National Health Insurance Database

et al. 2021

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Aims Women with menopausal symptoms show evidence of accelerated epigenetic ageing, vascular aging and low-grade systemic inflammation status. However, data are limited regarding menopausal symptoms and risk of heart failure (HF). We aimed to explore the impact of menopausal symptoms on risk of HF. Methods We included 14 340 symptomatic menopausal women without a history of coronary heart disease (CHD) or HF from the Taiwan National Health Insurance Research Database as the experimental cohort. We included 14 340 asymptomatic women matched for age and comorbidities as controls. We surveyed possible comorbidity-attributable risks of HF and assessed whether menopausal symptoms play a role in risk of HF. Additional analyses were conducted to ascertain the association of CHD and HF in different risk factor burdens categories in both cohorts and CHD was applied as a sensitivity analysis. ResultsThe incidence of HF was not significantly lower in the experimental than in the control cohort (4.87 vs. 5.06 per 1000 person-years, P = 0.336). Participants with a higher comorbidity burden had a proportionally increased risk of HF and CHD in both cohorts. The burden of risk factors had a greater impact on risk of HF in the control than in the experimental cohort (≥five risk factors, adjusted hazard ratio 25.69 vs. 14.75). Participants undergoing hormone therapy had no significant effect on the risk of HF, regardless of the presence or absence of menopausal symptoms. Subgroup analysis revealed that compared with the control cohort, the risk of HF in the experimental cohort did not increase significantly in all subgroups. Conclusions Menopausal symptoms were associated with CHD risk but not with risk of HF. Traditional risk factors rather than menopausal symptoms play important roles in the HF risk among middle-aged women.

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Vasomotor Symptoms: More Than Temporary Menopausal Symptoms

Cited by 9 publications

References 50 publications

Association between vasomotor symptoms and sarcopenia assessed by L3 skeletal muscle index among Korean menopausal women

Association between vasomotor symptoms and sarcopenia assessed by L3 skeletal muscle index among Korean menopausal women

Glutamatergic and GABAergic neurons in the preoptic area of the hypothalamus play key roles in menopausal hot flashes

Menopausal symptoms and risk of heart failure: a retrospective analysis from Taiwan National Health Insurance Database

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