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Sievert LL, Whitcomb BW, Verjee MA, Gerber LM. Limited evidence of a threshold effect for increasing adiposity on risk of symptoms at midlife. Menopause 2022; 29:1381-1387. [PMID: 36166728 DOI: 10.1097/gme.0000000000002074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the nature of relationships between increasing body mass index (BMI) and the prevalence of midlife symptoms in a population with high adiposity. METHODS In the cross-sectional Study of Women's Health in Qatar, 841 participants aged 40 to 60 years were recruited from nine primary health centers in Doha. Face-to-face interviews collected demographic, menopause, and symptom information. BMI (kg/m 2 ) was categorized as healthy, overweight, or class I, II, or III obesity. Multivariate logistic regression models were used to examine aches/stiffness in joints, trouble sleeping, shortness of breath, urinary incontinence, and hot flashes with BMI categories. Restricted cubic splines (RCSs) were used to estimate relationships between continuous BMI and each symptom and to conduct formal tests of nonlinearity. RESULTS Mean BMI was 34.3 kg/m 2 (SD, 6.0 kg/m 2 ). Women with class II and III obesity had higher odds of reporting aches/stiffness than women with a healthy BMI, and the odds of reporting urinary incontinence were three times higher among women with class III obesity (odds ratio, 3.08; 95% confidence interval, 1.17-8.14). Using restricted cubic spline models, a significant nonlinear association ( P = 0.002) was observed between aches/stiffness and BMI with an apparent threshold of 38 kg/m 2 . Linear relationships were observed with BMI for urinary incontinence ( P < 0.001 for linear trend) and shortness of breath ( P = 0.005 for linear trend). Trouble sleeping and hot flashes were not associated with BMI. CONCLUSIONS Even at very high levels of BMI, likelihood of urinary incontinence and shortness of breath increases with BMI. In contrast, likelihood of aches/stiffness has a nonlinear relationship with BMI, increasing to a threshold level.
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Affiliation(s)
| | - Brian W Whitcomb
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA
| | | | - Linda M Gerber
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
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Tijerina A, Barrera Y, Solis-Pérez E, Salas R, Jasso JL, López V, Ramírez E, Pastor R, Tur JA, Bouzas C. Nutritional Risk Factors Associated with Vasomotor Symptoms in Women Aged 40-65 Years. Nutrients 2022; 14:2587. [PMID: 35807766 PMCID: PMC9268510 DOI: 10.3390/nu14132587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 12/10/2022] Open
Abstract
Vasomotor symptoms (VMS) are the most common symptoms among menopausal women; these include hot flashes and night sweats, and palpitations often occur along with hot flashes. Some studies in Mexico reported that around 50% of women presented with VMS mainly in the menopausal transition. It has been proven that VMS are not only triggered by an estrogen deficiency, but also by nutritional risk factors. Evidence of an association between nutritional risk factors and VMS is limited in Mexican women. The aim of this study is to identify nutritional risk factors associated with VMS in women aged 40−65 years. This is a comparative cross-sectional study, undertaken in a retrospective way. A sample group (n = 406 women) was divided into four stages according to STRAW+10 (Stages of Reproductive Aging Workshop): late reproductive, menopausal transition, early postmenopause, and late postmenopause. Hot flashes were present mainly in the early postmenopause stage (38.1%, p ≤ 0.001). Two or more VMS were reported in 23.2% of women in the menopausal transition stage and 29.3% in the early postmenopause stage (p < 0.001). The presence of VMS was associated with different nutritional risk factors (weight, fasting glucose levels, cardiorespiratory fitness, and tobacco use) in women living in the northeast of Mexico.
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Affiliation(s)
- Alexandra Tijerina
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Yamile Barrera
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Elizabeth Solis-Pérez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Rogelio Salas
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - José L. Jasso
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Verónica López
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Erik Ramírez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico; (A.T.); (Y.B.); (E.S.-P.); (R.S.); (J.L.J.); (V.L.); (E.R.)
| | - Rosario Pastor
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (R.P.); (C.B.)
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands–IUNICS, 07122 Palma de Mallorca, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands–IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
| | - Cristina Bouzas
- Faculty of Health Sciences, Catholic University of Avila, 05005 Avila, Spain; (R.P.); (C.B.)
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands–IUNICS, 07122 Palma de Mallorca, Spain
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
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Kwon R, Chang Y, Kim Y, Cho Y, Choi HR, Lim GY, Kang J, Kim KH, Kim H, Hong YS, Park J, Zhao D, Rampal S, Cho J, Guallar E, Park HY, Ryu S. Alcohol Consumption Patterns and Risk of Early-Onset Vasomotor Symptoms in Premenopausal Women. Nutrients 2022; 14:nu14112276. [PMID: 35684078 PMCID: PMC9182895 DOI: 10.3390/nu14112276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 01/02/2023] Open
Abstract
The role of alcohol consumption in the risk of vasomotor symptoms (VMS), the most cardinal climacteric symptoms, is not well established. We examined their relationship with early-onset VMS among premenopausal women. Moderately-to-severely bothersome VMS, the primary outcome, was assessed using the Korean version of the Menopause-Specific Quality of Life questionnaire. The alcohol consumption categories included lifetime abstainer, former drinker, or current drinker, categorized as light, moderate, heavy, and very heavy. Compared with the lifetime-abstinence (reference), the multivariable-adjusted odds ratio (95% CIs) for prevalent VMS in alcohol consumption of <10, 10−19, 20−39, and ≥40 g/day were 1.42 (1.02−1.99), 1.99 (1.27−3.12), 2.06 (1.19−3.57), and 3.52 (1.72−7.20), respectively (p trend <0.01). Compared with the lifetime-abstinence, the multivariable-adjusted hazard ratios (95% CIs) for incident bothersome VMS among average alcohol consumption of <10, 10−19, 20−39, and ≥40 g/day were 1.10 (0.85−1.41), 1.03 (0.70−1.51), 1.72 (1.06−2.78), and 2.22 (1.16−4.23), respectively (p trend = 0.02). Increased alcohol consumption positively and consistently showed a relationship with increased risk of both prevalent and incident early-onset VMS. Refraining from alcohol consumption may help prevent bothersome VMS in premenopausal women.
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Affiliation(s)
- Ria Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea; (R.K.); (Y.K.); (H.R.C.); (G.-Y.L.); (J.K.); (J.C.)
- Institute of Medical Research, School of Medicine, Sungkyunkwan University, Suwon 16419, Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea; (R.K.); (Y.K.); (H.R.C.); (G.-Y.L.); (J.K.); (J.C.)
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06355, Korea
- Correspondence: (Y.C.); (S.R.); Tel.: +82-2-2001-5139 (Y.C.); +82-2-2001-5137 (S.R.)
| | - Yejin Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea; (R.K.); (Y.K.); (H.R.C.); (G.-Y.L.); (J.K.); (J.C.)
- Institute of Medical Research, School of Medicine, Sungkyunkwan University, Suwon 16419, Korea
| | - Yoosun Cho
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea;
| | - Hye Rin Choi
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea; (R.K.); (Y.K.); (H.R.C.); (G.-Y.L.); (J.K.); (J.C.)
- Institute of Medical Research, School of Medicine, Sungkyunkwan University, Suwon 16419, Korea
| | - Ga-Young Lim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea; (R.K.); (Y.K.); (H.R.C.); (G.-Y.L.); (J.K.); (J.C.)
- Institute of Medical Research, School of Medicine, Sungkyunkwan University, Suwon 16419, Korea
| | - Jeonggyu Kang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea; (R.K.); (Y.K.); (H.R.C.); (G.-Y.L.); (J.K.); (J.C.)
| | - Kye-Hyun Kim
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Yun Soo Hong
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.S.H.); (J.P.); (D.Z.); (E.G.)
| | - Jihwan Park
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.S.H.); (J.P.); (D.Z.); (E.G.)
| | - Di Zhao
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.S.H.); (J.P.); (D.Z.); (E.G.)
| | - Sanjay Rampal
- Department of Social and Preventive Medicine, Centre for Epidemiology and Evidence Based Practice, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Juhee Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea; (R.K.); (Y.K.); (H.R.C.); (G.-Y.L.); (J.K.); (J.C.)
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06355, Korea
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.S.H.); (J.P.); (D.Z.); (E.G.)
| | - Eliseo Guallar
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.S.H.); (J.P.); (D.Z.); (E.G.)
| | - Hyun-Young Park
- Department of Precision Medicine, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju 28159, Korea;
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea; (R.K.); (Y.K.); (H.R.C.); (G.-Y.L.); (J.K.); (J.C.)
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06355, Korea
- Correspondence: (Y.C.); (S.R.); Tel.: +82-2-2001-5139 (Y.C.); +82-2-2001-5137 (S.R.)
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Kanadys W, Barańska A, Błaszczuk A, Polz-Dacewicz M, Drop B, Kanecki K, Malm M. Evaluation of Clinical Meaningfulness of Red Clover ( Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2021; 13:nu13041258. [PMID: 33920485 PMCID: PMC8069620 DOI: 10.3390/nu13041258] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/03/2021] [Accepted: 04/09/2021] [Indexed: 12/18/2022] Open
Abstract
The meta-analysis presented in this article covered the efficacy of red clover isoflavones in relieving hot flushes and menopausal symptoms in perimenopausal and postmenopausal women. Studies were identified by MEDLINE (PubMed), Embase, and the Cochrane Library searches. The quality of the studies was evaluated according to Cochrane criteria. A meta-analysis of eight trials (ten comparisons) demonstrated a statistically significant reduction in the daily incidence of hot flushes in women receiving red clover compared to those receiving placebo: weighted mean difference (WMD—weighted mean difference) −1.73 hot flushes per day, 95% CI (confidence interval) −3.28 to −0.18; p = 0.0292. Due to 87.34% homogeneity, the performed analysis showed substantive difference in comparisons of postmenopausal women with ≥5 hot flushes per day, when the follow-up period was 12 weeks, with an isoflavone dose of ≥80 mg/day, and when the formulations contained a higher proportion of biochanin A. The meta-analysis of included studies assessing the effect of red clover isoflavone extract on menopausal symptoms showed a statistically moderate relationship with the reduction in the daily frequency of hot flushes. However, further well-designed studies are required to confirm the present findings and to finally determine the effects of red clover on the relief of flushing episodes.
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Affiliation(s)
- Wiesław Kanadys
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
| | - Agnieszka Barańska
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
- Correspondence:
| | - Agata Błaszczuk
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Małgorzata Polz-Dacewicz
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Bartłomiej Drop
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
| | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Warsaw Medical University, 02-007 Warsaw, Poland;
| | - Maria Malm
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
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5
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Chung HF, Zhu D, Dobson AJ, Kuh D, Gold EB, Crawford SL, Avis NE, Mitchell ES, Woods NF, Anderson DJ, Mishra GD. Age at menarche and risk of vasomotor menopausal symptoms: a pooled analysis of six studies. BJOG 2021; 128:603-613. [PMID: 33135854 PMCID: PMC7855657 DOI: 10.1111/1471-0528.16393] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine the association between age at menarche and risk of vasomotor menopausal symptoms (VMS) and whether midlife body mass index (BMI) modified the association. DESIGN A pooled analysis of six cohort studies. SETTING The International collaboration on the Life course Approach to reproductive health and Chronic disease Events (InterLACE). POPULATION 18 555 women from the UK, USA and Australia. METHODS VMS frequency data (never, rarely, sometimes and often) were harmonised from two studies (n = 13 602); severity data (never, mild, moderate and severe) from the other four studies (n = 4953). Multinominal logistic regression models were used to estimate relative risk ratios (RRRs) and 95% CIs adjusted for confounders and incorporated study as random effects. MAIN OUTCOME MEASURES Hot flushes and night sweats. RESULTS Frequency data showed that early menarche ≤11 years was associated with an increased risk of 'often' hot flushes (RRR 1.48, 95% CI 1.24-1.76) and night sweats (RRR 1.59, 95% CI 1.49-1.70) compared with menarche at ≥14 years. Severity data showed similar results, but appeared less conclusive, with RRRs of 1.16 (95% CI 0.94-1.42) and 1.27 (95% CI 1.01-1.58) for 'severe' hot flushes and night sweats, respectively. BMI significantly modified the association as the risk associated with early menarche and 'often' VMS was stronger among women who were overweight or obese than those of normal weight, while this gradient across BMI categories was not as strong with the risk of 'severe' VMS. CONCLUSIONS Early age at menarche is a risk factor for VMS, particularly for frequent VMS, but midlife BMI may play an important role in modifying this risk. TWEETABLE ABSTRACT Overweight and obesity exacerbate the risk of vasomotor symptoms associated with early menarche.
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Affiliation(s)
- Hsin-Fang Chung
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Dongshan Zhu
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Annette J. Dobson
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Ellen B. Gold
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Sybil L. Crawford
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nancy E. Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ellen S. Mitchell
- Family and Child Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - Nancy F. Woods
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA, USA
| | - Debra J. Anderson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Gita D. Mishra
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Zhu D, Chung HF, Dobson AJ, Pandeya N, Anderson DJ, Kuh D, Hardy R, Brunner EJ, Avis NE, Gold EB, El Khoudary SR, Crawford SL, Mishra GD. Vasomotor menopausal symptoms and risk of cardiovascular disease: a pooled analysis of six prospective studies. Am J Obstet Gynecol 2020; 223:898.e1-898.e16. [PMID: 32585222 DOI: 10.1016/j.ajog.2020.06.039] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/18/2020] [Accepted: 06/18/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Menopausal vasomotor symptoms (ie, hot flashes and night sweats) have been associated with unfavorable risk factors and surrogate markers of cardiovascular disease, but their association with clinical cardiovascular disease events is unclear. OBJECTIVE To examine the associations between different components of vasomotor symptoms, timing of vasomotor symptoms, and risk of cardiovascular disease. STUDY DESIGN We harmonized and pooled individual-level data from 23,365 women in 6 prospective studies that contributed to the International Collaboration for a Life Course Approach to Women's Reproductive Health and Chronic Disease Events consortium. Women who experienced cardiovascular disease events before baseline were excluded. The associations between frequency (never, rarely, sometimes, and often), severity (never, mild, moderate, and severe), and timing (before or after age of menopause; ie, early or late onset) of vasomotor symptoms and incident cardiovascular disease were analyzed. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. RESULTS In the adjusted model, no evidence of association was found between the frequency of hot flashes and incident cardiovascular disease, whereas women who reported night sweats "sometimes" (hazard ratio, 1.22; 95% confidence interval, 1.02-1.45) or "often" (hazard ratio, 1.29; 95% confidence interval, 1.05-1.58) had higher risk for cardiovascular disease. Increased severity of either hot flashes or night sweats was associated with higher risk of cardiovascular disease. The hazards ratios of cardiovascular disease in women with severe hot flashes, night sweats, and any vasomotor symptoms were 1.83 (95% confidence interval, 1.22-2.73), 1.59 (95% confidence interval, 1.07-2.37), and 2.11 (95% confidence interval, 1.62-2.76), respectively. Women who reported severity of both hot flashes and night sweats had a higher risk for cardiovascular disease (hazard ratio, 1.55; 95% confidence interval, 1.24-1.94) than those with hot flashes alone (hazard ratio, 1.33; 95% confidence interval, 0.94-1.88) and night sweats alone (hazard ratio, 1.32; 95% confidence interval, 0.84-2.07). Women with either early-onset (hazard ratio, 1.38; 95% confidence interval, 1.10-1.75) or late-onset (hazard ratio, 1.69; 95% confidence interval, 1.32-2.16) vasomotor symptoms had an increased risk for incident cardiovascular disease compared with women who did not experience vasomotor symptoms. CONCLUSION Severity rather than frequency of vasomotor symptoms (hot flashes and night sweats) was associated with increased risk of cardiovascular disease. Vasomotor symptoms with onset before or after menopause were also associated with increased risk of cardiovascular disease.
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Huang Z, Shi J, Liu W, Wei S, Zhang Z. The influence of educational level in peri-menopause syndrome and quality of life among Chinese women. Gynecol Endocrinol 2020; 36:991-996. [PMID: 32573286 DOI: 10.1080/09513590.2020.1781081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective: To investigate the influence of education level in the peri-menopausal symptoms and quality of life (QoL) among Chinese women.Methods: We carried out a cross-sectional study of 1632 peri-menopausal women (age 40-60 y) who visited Hangzhou Women's Hospital from November 2018 to November 2019. The menopausal symptoms were evaluated by modified Kupperman index (KI). World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to evaluate the QoL.Result: In total, 1501 women were included in the analysis. The mean age of natural menopause was 49.63 years in China. The five most frequent symptoms in menopausal women were Hot flash (75.53%), sexual problems (72.62%), insomnia (67.29%), fatigue (65.56%), and irritability (61.89%). Natural menopausal age, parity, BMI, bone mineral density, depression, skin formication, total score of KI, and the score of WHOQOL-BREF questionnaire were different in different educational background women (p < .05).Conclusions: The results of the study suggest that education level is associated with the age of natural menopause and menopausal symptoms. A high educational level is correlated with a better score of WHOQOL-BREF in peri-menopause women.
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Affiliation(s)
- Zheren Huang
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Junyu Shi
- Department of Obstetrics and Gynecology, The First People's Hospital of Changzhou, Changzhou, China
| | - Wenhua Liu
- Department of Obstetrics and Gynecology, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
| | - Shuangshuang Wei
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Zhifen Zhang
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
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8
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Woods R, Hess R, Biddington C, Federico M. Association of lean body mass to menopausal symptoms: The Study of Women's Health Across the Nation. Womens Midlife Health 2020; 6:10. [PMID: 32944260 PMCID: PMC7490966 DOI: 10.1186/s40695-020-00058-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022] Open
Abstract
Background The purpose of this study was to examine the association of lean body mass (LBM) to the development of vasomotor symptoms (VMS) as women transition through menopause. Methods This study is a secondary use of data available for public use from follow up visits six through 10 for participants in the Study of Women’s Health Across the Nation. The study examined 2533 women, between the ages 42–52 years, each year over a10-year period. Data was modeled for associations of lean body mass and VMS. Changes in LBM since prior visit and since baseline were also modeled along with differences in means using binary logistic regression, adjusting for covariates. Results LBM was significantly associated to concurrent VMS (p = .036), percent change in LBM since prior visit (p = .003), percent change since baseline (p < .001), and overall means associations (p = .023). LBM was not significant for VMS at individual visit measures. In mixed regression modeling, time was significant (p < .0001) at all visits. The estimated probability of developing VMS decreases significantly as LBM increases. Conclusions Lean body mass is negatively associated with incident VMS. Our data suggests that maintaining higher levels of LBM during the menopausal transition may be protective against the development of VMS. Every woman will experience menopause in her life and the ability to potentially prevent the onset of specific symptoms through basic interventions, such as resistance training to increase lean body mass, may positively impact this large population.
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Affiliation(s)
- Rosanne Woods
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Rebecca Hess
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Carol Biddington
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Marc Federico
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
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Costanian C, Zangiabadi S, Bahous SA, Deonandan R, Tamim H. Reviewing the evidence on vasomotor symptoms: the role of traditional and non-traditional factors. Climacteric 2020; 23:213-223. [DOI: 10.1080/13697137.2019.1711051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- C. Costanian
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - S. Zangiabadi
- School of Kinesiology & Health Science, York University, Toronto, ON, Canada
| | - S. A. Bahous
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - R. Deonandan
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - H. Tamim
- School of Kinesiology & Health Science, York University, Toronto, ON, Canada
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No Author. Chapitre 9 : Médecine complémentaire et parallèle. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41 Suppl 1:S122-S129. [DOI: 10.1016/j.jogc.2019.02.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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11
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Boghrati MR, Shakiba M, Oloumi-Yazdi E, Tabatabaee FS, Tabatabaee ES. An analysis of the efficacy of reducing daily spices and simple carbohydrates intake on treating night sweats in toddlers. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2019. [DOI: 10.1016/j.jnim.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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12
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Avis NE, Crawford SL, Green R. Vasomotor Symptoms Across the Menopause Transition: Differences Among Women. Obstet Gynecol Clin North Am 2018; 45:629-640. [PMID: 30401547 DOI: 10.1016/j.ogc.2018.07.005] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Vasomotor symptoms (VMS) are the primary menopausal symptoms, occurring in up 80% of women and peaking around the final menstrual period. The average duration is 10 years, longer in women with an earlier onset. Compared with non-Hispanic white women, black and Hispanic women are more likely and Asian women are less likely to report VMS. Risk factors include greater body composition (in the early stage of menopausal transition), smoking, anxiety, depression, sensitivity to symptoms, premenstrual syndrome, lower education, and medical treatments, such as hysterectomy, oophorectomy, and breast cancer-related therapies. VMS patterns over time and within higher-risk subgroups are heterogeneous across women.
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Affiliation(s)
- Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
| | - Sybil L Crawford
- Graduate School of Nursing, University of Massachusetts Medical School, 55 Lake Avenue, S1-853, Worcester, MA 01655, USA
| | - Robin Green
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, 1300 Morris Park Avenue Block, Room 316, Bronx, NY 10461, USA
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Fooladi E, Bell RJ, Masoumi M, Azizi M, Atarod Z, Davis SR. Bothersome menopausal symptoms amongst postmenopausal Iranian women. Climacteric 2018; 21:586-593. [PMID: 30145921 DOI: 10.1080/13697137.2018.1493452] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study was undertaken to determine the impact of menopause on middle-eastern women. METHODS This was a cross-sectional study of 1520 women, aged 40-64 years, living in Sari, Northern Iran, recruited by multistage cluster sampling between October 2016 and April 2017. All women completed the Menopause Quality of Life Questionnaire (MENQOL) and Beck Depression Inventory-II (BDI-II). RESULTS Of all the women, 54.5% were perimenopausal or postmenopausal. The prevalences of any vasomotor symptom (VMS) and moderate-severely bothersome VMS were greatest for postmenopausal women aged <55 years (66.4%, 95% confidence interval (CI) 59.9-72.3% and 13.5%, 95% CI 9.6-18.6%, respectively). Having moderate-severe VMS was associated with moderate-severe depressive symptoms (adjusted odds ratio (AOR) 2.9; 95% CI 1.6-5.2; p < 0.001). Symptoms of vulvovaginal atrophy (VVA) were reported by 41.1% (95% CI 37.4-45.0%) of perimenopausal and postmenopausal women, with 22.9% (95% CI 19.8-26.3%) reporting their symptoms as moderate-severely bothersome. In women with moderate-severe VMS, the proportion with both moderate-severe depressive symptoms and moderate-severe VVA symptoms (12.1%) was four times that in women with no or mild VMS (3.3%) (p < 0.001). CONCLUSION One in seven perimenopausal and postmenopausal women has moderate-severely bothersome VMS and few women receive appropriate therapy. The reporting of moderate-severe VMS should alert clinicians to the likelihood of significant concurrent VVA and depressive symptoms.
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Affiliation(s)
- E Fooladi
- a Women's Health Research Program , School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia.,b Reproductive and Sexual Health Research Centre, School of Nursing and Midwifery , Mazandaran University of Medical Sciences , Sari , Mazandaran , Iran
| | - R J Bell
- a Women's Health Research Program , School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
| | - M Masoumi
- b Reproductive and Sexual Health Research Centre, School of Nursing and Midwifery , Mazandaran University of Medical Sciences , Sari , Mazandaran , Iran
| | - M Azizi
- b Reproductive and Sexual Health Research Centre, School of Nursing and Midwifery , Mazandaran University of Medical Sciences , Sari , Mazandaran , Iran
| | - Z Atarod
- c Department of Obstetrics and Gynecology, School of Medicine , Mazandaran University of Medical Sciences , Sari , Mazandaran , Iran
| | - S R Davis
- a Women's Health Research Program , School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
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14
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Climacteric-related symptoms in menopause transition and beyond: a prospective 19-year follow-up study on previously hysterectomized women. Menopause 2018; 25:890-896. [DOI: 10.1097/gme.0000000000001091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Beezhold B, Radnitz C, McGrath RE, Feldman A. Vegans report less bothersome vasomotor and physical menopausal symptoms than omnivores. Maturitas 2018; 112:12-17. [DOI: 10.1016/j.maturitas.2018.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/24/2018] [Accepted: 03/12/2018] [Indexed: 12/11/2022]
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16
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Longitudinal analysis of changes in weight and waist circumference in relation to incident vasomotor symptoms: the Study of Women's Health Across the Nation (SWAN). Menopause 2018; 24:9-26. [PMID: 27749738 DOI: 10.1097/gme.0000000000000723] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Greater body mass index (BMI) and body fat are associated with vasomotor symptoms (VMS). Thus, weight loss may prevent VMS. We analyzed whether concurrent BMI or waist circumference and/or changes in weight or waist circumference predicted incident VMS and whether these relations differed by menopause stage or race/ethnicity. METHODS Data from 10 follow-up visits for 1,546 participants in the Study of Women's Health Across the Nation who reported no VMS at baseline were modeled for time to first symptomatic visit in relation to concurrent BMI and waist circumference and change in weight and waist circumference during early and late menopause using discrete survival analyses, adjusting for covariates. RESULTS Greater concurrent BMI and waist circumference were significantly related to greater any and frequent (≥6 d in the last 2 wk) incident VMS in early menopause and lower VMS risk in late menopause. Percentage weight change since baseline and since the prior visit was unrelated to incident any VMS in either menopause stage. Percentage weight change since baseline had a significant shallow U-shaped association with incident frequent VMS in early menopause (P = 0.02), a shallow inverse U-shape in late menopause (P = 0.02), and a significant interaction with menopause stage (P = 0.004) but not with race/ethnicity. Recent weight change was unassociated with incident VMS in either menopause stage. Results were similar for waist change. CONCLUSIONS Concurrent BMI and waist circumference were positively related to incident VMS in early menopause and negatively related in late menopause. Maintaining healthy weight in early menopause may help prevent VMS.
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Schnelle C, Minford EJ, McHardy V, Keep J. A Group of 500 Women Whose Health May Depart Notably From the Norm: Protocol for a Cross-Sectional Survey. JMIR Res Protoc 2017; 6:e234. [PMID: 29170148 PMCID: PMC6173249 DOI: 10.2196/resprot.7993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 09/17/2017] [Accepted: 10/11/2017] [Indexed: 11/13/2022] Open
Abstract
Background Longitudinal studies of women’s health often seek to identify predictors of good health. Research has shown that following simple guidelines can halve women’s mortality. The ongoing Australian Longitudinal Study of Women’s Health (ALSWH) shows that Australian women are getting better at reducing their smoking and alcohol use, and are generally diligent about attending recommended health screenings, but are becoming less successful at dealing with obesity. There are communities of women who live unusually healthy lives (Rosetans, Seventh-Day Adventists, traditional Japanese women), but their lifestyles are unlikely to be adopted widely. Universal Medicine (UM) is a complementary-to-medicine approach that emphasizes personal empowerment and the importance of menstrual health symptoms. Objective This survey investigates whether the approximately 500 women associated with UM exhibit health status significantly above the norm. As part of this investigation, questions for a newly developed menstrual attitudes questionnaire will also be evaluated. Methods A quantitative cross-sectional survey of women in a UM cohort was designed with the help of three focus groups of women at three life stages: in menses, peri-menopausal, and menopausal. The menstrual attitudes portion of the survey incorporates the insights of these women regarding female health issues. The survey also includes 41 questions taken from the ALSWH. Focus groups generated additional questions about symptoms experienced and attitudes toward female health issues. ALSWH questions, including a range of health scales like the Short Form 36 (SF-36), Center for Epidemiologic Studies Depression Scale, Perceived Control Scale, Kessler Psychological Distress Scale, and the Multi-Item Summed Score for Perceived Stress, along with questions about experienced major health events, were investigated and incorporated if considered suitable. At the time of publication of this protocol, data collection has been completed. Results The validity of the menstrual attitudes questionnaire will be evaluated with Cohen’s kappa. ALSWH respondents and UM participants will be compared, using unweighted regression or regression weighted or normalized by age, education, and interest in alternative treatments (to increase comparability), as appropriate. Analyses will determine whether UM-related variables (being a UM participant, length of UM participation, number of UM events attended) are associated with: differences in the number of major health events and health symptoms experienced; SF-36 physical and mental health scores; body mass index; and consumption of alcohol, tobacco, sugar, salt, caffeine, and dairy. Conclusions If women in the UM cohort are truly in substantially better health than the norm, further investigations may be worthwhile to see whether UM plays a causal role, and whether the women’s practices are generalizable. International Registered Report Identifier (IRRID) DERR1-10.2196/7993
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Affiliation(s)
- Christoph Schnelle
- School of Public Health, Faculty of Medicine, University of Queensland, Goonellabah, Australia
| | - Eunice J Minford
- Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Antrim, Ireland
| | | | - Jane Keep
- Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, United Kingdom
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Ee CC, Thuraisingam S, Pirotta MV, French SD, Xue CC, Teede HJ. Expectancy after the first treatment and response to acupuncture for menopausal hot flashes. PLoS One 2017; 12:e0186966. [PMID: 29077767 PMCID: PMC5659680 DOI: 10.1371/journal.pone.0186966] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 10/11/2017] [Indexed: 12/02/2022] Open
Abstract
Background Evidence on the impact of expectancy on acupuncture treatment response is conflicting. Objectives This secondary analysis of a randomized sham-controlled trial on acupuncture for menopausal hot flashes investigated whether treatment expectancy score was associated with hot flash score at end-of-treatment. Secondary analyses investigated whether there were associations between other pre-specified factors and hot flash score. Study design Women experiencing moderately-severe hot flashes were randomized to receive 10 sessions of real or sham acupuncture over eight weeks. Hot flash score was collected using a seven-day hot flash diary, and expectancy using the modified Credibility and Expectancy Questionnaire immediately after the first treatment. Linear mixed-effects models with random intercepts were used to identify associations between expectancy score and hot flash score at end-of-treatment. Regression was also used to identify associations between pre-specified factors of interest and hot flash score. Because there was no difference between real and sham acupuncture for the primary outcome of hot flash score, both arms were combined in the analysis. Results 285 women returned the Credibility and Expectancy Questionnaire, and 283 women completed both expectancy measures. We found no evidence for an association between expectancy and hot flash score at end-of-treatment for individual cases in either acupuncture or sham group. Hot flash scores at end-of-treatment were 8.1 (95%CI, 3.0 to 13.2; P = 0.002) points lower in regular smokers compared to those who had never smoked, equivalent to four fewer moderate hot flashes a day. Conclusion In our study of acupuncture for menopausal hot flashes, higher expectancy after the first treatment did not predict better treatment outcomes. Future research may focus on other determinants of outcomes in acupuncture such as therapist attention. The relationship between smoking and hot flashes is poorly understood and needs further exploration.
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Affiliation(s)
- Carolyn C. Ee
- National Institute of Complementary Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
| | - Sharmala Thuraisingam
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Marie V. Pirotta
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Simon D. French
- School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, New South Wales, Australia
| | - Charlie C. Xue
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation: a partnership between Monash Health and the School of Public Health, Monash University, Melbourne, Victoria, Australia
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Ziv-Gal A, Smith RL, Gallicchio L, Miller SR, Zacur HA, Flaws JA. The Midlife Women’s Health Study – a study protocol of a longitudinal prospective study on predictors of menopausal hot flashes. Womens Midlife Health 2017; 3:4. [PMID: 30766705 PMCID: PMC6300019 DOI: 10.1186/s40695-017-0024-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/28/2017] [Indexed: 11/10/2022] Open
Abstract
Background The Midlife Women’s Health Study (MWHS) was developed to address some of the gaps in knowledge regarding risk factors for hot flashes among generally healthy midlife women during their menopausal transition. This manuscript describes the methods from the study and the main findings that were published to date, with a focus on predictors of hot flashes. This study was initially funded to test the hypothesis that obesity is associated with an increased risk of hot flashes through mechanisms that involve ovarian failure, altered sex steroid hormone levels, and selected genetic polymorphisms. Methods/Design The MWHS was conducted between 2006 and 2015 as a prospective longitudinal population-based study of generally healthy midlife women (ages 45 to 54 years) during their natural menopausal transition. Women were eligible if they had intact uteri and both ovaries and reported having at least 3 menstrual periods in the last 12 months. Exclusion criteria included pregnancy, cancer, and use of hormonal/hormone-like supplements. Overall, 780 women were recruited into the study. The majority of study participants were followed for 4 to 7 years. At annual visits, women donated blood and urine samples, completed questionnaires, had a vaginal ultrasound, and had their anthropometric measurements taken. Discussion Several risk factors for menopausal hot flashes were identified or confirmed, including older age, perimenopausal status, current and former cigarette smoking, lower estradiol levels, lower progesterone levels, black race, and depressive symptoms. Factors that were associated with decreased odds of hot flashes included moderate alcohol consumption and more than 5 years of cessation of cigarette smoking. Body mass index was not associated with hot flashes. The MWHS has provided important information regarding hot flashes. The study methods are rigorous and can be easily adopted by research groups investigating naturally occurring menopausal hot flashes.
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Abstract
Clinicians should periodically assess their menopausal patients' alcohol use. Specific health hazards from excessive alcohol consumption, as well as potential benefits of low-level consumption (for cardiovascular disease, bone health, and type 2 diabetes), should be discussed with their patients who drink. The information in this Practice Pearl can help clinicians provide evidence-based guidance about alcohol consumption and its relationship to common health concerns.
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Abstract
Many women know about the risks of lung cancer and cardiovascular disease that stem from tobacco use, but many don't realize there are several other potential health consequences of smoking. Nurses should utilize every opportunity to educate women about the various health risks of smoking. Promotion of smoking cessation now may help women prevent numeroushealth problems later.
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Risk factors for hot flashes among women undergoing the menopausal transition: baseline results from the Midlife Women's Health Study. Menopause 2016; 22:1098-107. [PMID: 25783472 DOI: 10.1097/gme.0000000000000434] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to examine the associations of demographic characteristics, health behaviors, and hormone concentrations with the experience of any, current, more severe, and more frequent midlife hot flashes. METHODS Baseline data from 732 women aged 45 to 54 years who were enrolled in the Midlife Women's Health Study were analyzed. A clinic visit was conducted to collect blood samples for hormone assays and to measure ovarian volume using transvaginal ultrasound. A self-administered questionnaire ascertained information on demographic factors, health habits, and hot flash history. Multivariable logistic regression was conducted to examine associations between potential risk factors and hot flash outcomes. RESULTS Approximately 45% of participants reported experiencing midlife hot flashes. In covariate-adjusted models, older age, perimenopause status, current and past cigarette smoking, and depressive symptoms were significantly associated with increased odds of all of the hot flash outcomes. In addition, history of oral contraceptive use was associated with increased odds of any hot flashes. In contrast, higher current alcohol intake was significantly associated with decreased odds of any, current, and more severe hot flashes. Higher estradiol and progesterone concentrations were significantly associated with decreased odds of all hot flash outcomes. CONCLUSIONS Although the temporality of such associations is not known because of the cross-sectional nature of the data, these observed relationships can help to identify women at risk for hot flashes.
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Abdulnour J, Stacey D, Dionne IJ, Brochu M, Doucet É, Prud’homme D. Vasomotor symptoms and cardiometabolic risk factors in menopausal women: a MONET Group study. Climacteric 2016; 19:381-6. [DOI: 10.1080/13697137.2016.1191459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- J. Abdulnour
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institut de recherche de l’Hôpital Montfort, Ottawa, ON, Canada
- Behavioral and Metabolic Research Unit, University of Ottawa, Ottawa, ON, Canada
| | - D. Stacey
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, ON, Canada
| | - I. J. Dionne
- Faculté des sciences de l’activité physique, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, QC, Canada
| | - M. Brochu
- Faculté des sciences de l’activité physique, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, QC, Canada
| | - É. Doucet
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Behavioral and Metabolic Research Unit, University of Ottawa, Ottawa, ON, Canada
| | - D. Prud’homme
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institut de recherche de l’Hôpital Montfort, Ottawa, ON, Canada
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The effect of conjugated estrogens/bazedoxifene therapy on body weight of postmenopausal women. Menopause 2016; 23:376-82. [DOI: 10.1097/gme.0000000000000541] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vasomotor symptoms and the homeostatic model assessment of insulin-resistance in Korean postmenopausal women. Obstet Gynecol Sci 2016; 59:45-9. [PMID: 26866035 PMCID: PMC4742475 DOI: 10.5468/ogs.2016.59.1.45] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 07/29/2015] [Accepted: 08/13/2015] [Indexed: 11/24/2022] Open
Abstract
The aim of this cross-sectional study was to evaluate the association between vasomotor symptoms (VMS) and insulin resistance, which can be postulated by the homeostatic model assessment (HOMA) index. This study involved 1,547 Korean postmenopausal women (age, 45 to 65 years) attending a routine health check-up at a single institution in Korea from January 2010 to December 2012. A menopause rating scale questionnaire was used to assess the severity of VMS. The mean age of participants was 55.22±4.8 years and 885 (57.2%) reported VMS in some degree. The mean HOMA index was 1.79±0.96, and the HOMA index increased with an increase in severity of VMS (none, mild, moderate and severe) in logistic regression analysis (β=0.068, t=2.665, P =0.008). Insulin resistance needs to be considered to understand the linkage between VMS and cardiometabolic disorders.
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Katainen RE, Engblom JR, Siirtola TJ, Erkkola RU, Polo-Kantola P. Climacteric symptoms in middle-aged women with chronic somatic diseases. Maturitas 2016; 86:17-24. [PMID: 26921923 DOI: 10.1016/j.maturitas.2016.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Chronic diseases may aggravate or simulate climacteric symptoms. Although acknowledged in clinical practice, there is a lack of research systematically analysing the association between chronic diseases and climacteric symptoms. STUDY DESIGN AND MAIN OUTCOME MEASURES Our study was a cross-sectional population-based study, which included 3421 women, aged 41-54 years. Climacteric symptoms were evaluated using the Women's Health Questionnaire (WHQ), of which we included seven symptom domains (vasomotor, sleep, depressive, anxiety/fears, cognitive, sexual, and menstrual) and a question concerning whether the women were worried about growing old. The occurrence of various diseases (cardiovascular, neurological, sensory organ, bronchopulmonary, musculoskeletal, gastrointestinal, urological, dermatological, and thyroid disease, diabetes, and cancer) was recorded. The associations between the diseases and symptoms were defined with multivariable analyses, adjusting for various confounding factors. RESULTS The women with the diseases had more symptoms. Vasomotor symptoms and sleep problems were associated only with gastrointestinal diseases, and lower sexual functioning only with diabetes. The remaining symptoms were associated with several diseases, except being worried about growing old, which was not associated with any. CONCLUSIONS Many symptoms connected to the climacteric may manifest also due to chronic diseases. Thus, health-care professionals should consider the origin of the symptoms when treating middle-aged women with chronic diseases.
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Affiliation(s)
- Riina E Katainen
- Department of Obstetrics and Gynaecology, Turku University Hospital and University of Turku, Turku, Finland.
| | - Janne R Engblom
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Tiina J Siirtola
- Department of Obstetrics and Gynaecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Risto U Erkkola
- Department of Obstetrics and Gynaecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Päivi Polo-Kantola
- Department of Obstetrics and Gynaecology, Turku University Hospital and University of Turku, Turku, Finland
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Jenabi E, Poorolajal J. The association between hot flushes and smoking in midlife women: a meta-analysis. Climacteric 2015; 18:797-801. [PMID: 26488934 DOI: 10.3109/13697137.2015.1080236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Several epidemiological studies have investigated the association between hot flushes and smoking, but the results are inconsistent. This meta-analysis was performed to estimate an overall effect of former smoking and current smoking on the risk of hot flushes in midlife women. METHODS We searched PubMed, Web of Science, and Scopus for observational studies addressing the association between hot flushes and smoking until March 2015. Data were independently extracted and analyzed using odds ratio with 95% confidence intervals (CI) based on the random-effects model. RESULTS We identified 621 references and included eight studies with 27 054 participants. The odds ratio of an association between hot flushes and former smoking was estimated as 1.31 (95% CI 1.22-1.41) and that of current smoking was estimated as 1.97 (95% CI 1.81-2.14). No evidence of heterogeneity and publication bias was observed. CONCLUSION The findings from this meta-analysis indicated that former and current smoking are associated with an increased risk of hot flushes. However, more evidence based on large, prospective cohort studies is required to provide stronger evidence whether former and current smoking may be associated with an increased risk of hot flushes.
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Affiliation(s)
- E Jenabi
- a Department of Midwifery , Toyserkan Branch, Islamic Azad University , Toyserkan
| | - J Poorolajal
- b Modeling of Noncommunicable Diseases Research Center, Department of Epidemiology , School of Public Health, Hamadan University of Medical Sciences , Hamadan , Iran
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Obesity Education Strategies for Cancer Prevention in Women's Health. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2015; 4:249-258. [PMID: 26877893 DOI: 10.1007/s13669-015-0129-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Obesity is the cause of up to one-third of all cancers affecting women today, most notably endometrial, colon and breast cancer. Women's health providers are poised to advise women on obesity's link to cancer development, but often lack resources or training to provide appropriate counseling. Here, we review obesity's role in increasing the risk of several common reproductive system conditions faced by women, including polycystic ovarian syndrome, infertility, gynecologic surgical complications, and pregnancy complications. These events can be used as teachable moments to help frame the discussion of weight management and promote cancer prevention. We also review national guidelines and existing tangible weight-loss strategies that can be employed within the outpatient women's health setting to help women achieve weight loss goals and affect cancer prevention.
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Liu P, Yuan Y, Liu M, Wang Y, Li X, Yang M, Xi S, Ding Y, Liu JE, Xu G, Guo X, Ren Z, Bai W, Yao C. Factors associated with menopausal symptoms among middle-aged registered nurses in Beijing. Gynecol Endocrinol 2015; 31:119-24. [PMID: 25310028 DOI: 10.3109/09513590.2014.971237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine factors related to menopause symptoms among middle-aged registered nurses in Beijing. METHODS Self-administered questionnaires that included closed-ended questions on many factors possibly related to menopausal symptoms were distributed to 2100 registered nurses aged 40-55 at 20 hospitals in Beijing, China. RESULTS Menopausal status was most associated with menopausal symptoms (p < 0.01), including hot flashes and sweating, paresthesiae, insomnia, arthralgia/myalgia, palpitations, skin formication and an unsatisfactory sexual life. The odds ratios (ORs) were highest for hot flashes and sweating. Upsetting events in the past year and being pessimistic were significantly inversely correlated with almost all the symptoms analyzed. Hot flashes and sweating (p < 0.01), paresthesiae (p < 0.01), unsatisfactory sexual life (p < 0.01), irritability (p < 0.05), depression or suspicion (p < 0.05) and dizziness (p < 0.05) were negatively correlated with the frequency of sexual activity. CONCLUSION Many factors may influence symptoms of the menopause. We found that menopausal status was most strongly associated with most menopausal symptoms, especially hot flashes and sweating. Psychosocial factors also played an important role. A higher frequency of sexual activity negatively correlated with most menopausal symptoms.
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Affiliation(s)
- Peihao Liu
- Peking University First Hospital , Beijing , China
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Is an unfavourable cardiovascular risk profile a risk factor for vasomotor menopausal symptoms? Results of a population-based cohort study. BJOG 2014; 122:1252-8. [DOI: 10.1111/1471-0528.13260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2014] [Indexed: 12/01/2022]
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Herber-Gast G, Brown WJ, Mishra GD. Hot flushes and night sweats are associated with coronary heart disease risk in midlife: a longitudinal study. BJOG 2014; 122:1560-7. [PMID: 25377022 DOI: 10.1111/1471-0528.13163] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate associations between vasomotor menopausal symptoms (VMS), i.e. hot flushes and night sweats, and the incidence of coronary heart disease (CHD). DESIGN A prospective cohort study. SETTING AND POPULATION 11 725 women, aged 45-50 years at baseline in 1996, were followed up at 3-year intervals for 14 years. METHODS Self-reported VMS and incident CHD were measured at each survey. MAIN OUTCOME MEASURE We determined the association between VMS and CHD at the subsequent survey, using generalised estimating equation analysis, adjusting for time-varying covariates. RESULTS At baseline, 14% reported rarely, 17% reported sometimes, and 7% reported often having night sweats. During follow-up, 187 CHD events occurred. In the age-adjusted analysis, women who reported their frequency of experiencing hot flushes and night sweats as 'often' had a greater than two-fold increased odds of CHD (OR hot flushes 2.18, 95% CI 1.49-3.18; OR night sweats 2.38, 95% CI 1.62-3.50) compared with women with no symptoms (P trend < 0.001 for frequency of symptoms). Adjustment for menopausal status, lifestyle factors, body mass index, diabetes, and hypertension attenuated the associations (OR hot flushes 1.70, 95% CI 1.16-2.51, P trend = 0.01; OR night sweats 1.84, 95% CI 1.24-2.73), P trend = 0.004). CONCLUSIONS Women who report having hot flushes or night sweats 'often' have an increased risk of developing CHD over a period of 14 years, even after taking the effects of age, menopause status, lifestyle, and other chronic disease risk factors into account.
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Affiliation(s)
- Gcm Herber-Gast
- Centre for Longitudinal and Life Course Research, School of Population Health, University of Queensland, Brisbane, Qld, Australia
| | - W J Brown
- School of Human Movement Studies, University of Queensland, Brisbane, Qld, Australia
| | - G D Mishra
- Centre for Longitudinal and Life Course Research, School of Population Health, University of Queensland, Brisbane, Qld, Australia
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Managing Menopause Chapter 9 Complementary and Alternative Medicine (CAM). JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2014. [DOI: 10.1016/s1701-2163(15)30465-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vasomotor menopausal symptoms are not associated with incidence of breast cancer in a population-based cohort of mid-aged women. Eur J Cancer 2013; 50:824-30. [PMID: 24361228 DOI: 10.1016/j.ejca.2013.11.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 11/25/2013] [Accepted: 11/26/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Recently, two case-control studies showed that vasomotor menopausal symptoms (VMS), i.e. hot flushes (HF) and night sweats (NS), are associated with a decreased risk of breast cancer. Until now, however, no prior studies have prospectively examined the association between VMS and breast cancer incidence. We investigated this in a population-based cohort of mid-aged women in Australia. METHODS We included 11,297 women without a history of breast cancer aged 47-52 years from the Australian Longitudinal Study on Women's Health, surveyed every 3 years from 1998 to 2010. Information regarding first invasive breast cancer events and date of diagnosis was obtained from cancer registries. We determined the association between HF and NS and breast cancer occurrence before the subsequent survey, using time-dependent cox regression analysis, adjusting for time-varying lifestyle factors. RESULTS At baseline 33.1% of the women reported experiencing HF and 24.6% reported NS. During a mean follow-up of 13.7 years, 348 cases of breast cancer occurred. VMS were not associated with breast cancer; adjusted hazard ratios were 1.09; 95% confidence interval (CI) 0.87-1.35 for HF and 1.06; 95% CI 0.84-1.33 for NS. No significant interactions were found between each of body mass index, alcohol use, current hormone therapy use, menopausal status and VMS and breast cancer (p-values>0.05). CONCLUSIONS We did not find an association between VMS and breast cancer incidence. Research in this area is scarce and additional large prospective population-based studies are required to confirm or refute these findings.
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