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Ahmadieh H, Jradi N. Prevalence of menopausal hot flashes in Lebanon: A cross-sectional study. Int J Reprod Biomed 2021; 19:789-800. [PMID: 34723058 PMCID: PMC8548750 DOI: 10.18502/ijrm.v19i9.9711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/12/2020] [Accepted: 12/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background Menopausal hot flashes or vasomotor symptoms are prevalent and could be debilitating in postmenopausal women. There is controversy regarding the risk factors for hot flashes, some of which may vary from one country or culture to another. Objective To shed light on this matter by assessing the prevalence of hot flashes, their effect on quality of life, and their association with certain factors such as physical exercise, caffeine, spicy food consumption, dietary intake, smoking, alcohol, etc. Materials and Methods A large cross-sectional study was conducted among 627 Lebanese women, aged 45-67 yr using a well-developed and comprehensive questionnaire, in order to better assess the prevalence of hot flashes, focusing on their characteristics, association with various factors, severity, and effect on the women's quality of life. Results 62.5% of participants experienced hot flashes. A statistically significant difference was noted between women who experience hot flashes and their counterparts with respect to smoking, body mass index, spicy food consumption, education level, age, menstrual status, and parity. An association was not found with physical activity or other dietary factors. Conclusion As an alternative for hormone therapy, clinicians should consider lifestyle changes to help manage hot flashes, which impose a tremendous physical and social toll on the women experiencing them.
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Affiliation(s)
- Hala Ahmadieh
- Department of Internal Medicine, Beirut Arab University, Beirut, Lebanon
| | - Nadia Jradi
- Department of Internal Medicine, Beirut Arab University, Beirut, Lebanon
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Laudisio D, Barrea L, Pugliese G, Aprano S, Castellucci B, Savastano S, Colao A, Muscogiuri G. A practical nutritional guide for the management of sleep disturbances in menopause. Int J Food Sci Nutr 2021; 72:432-446. [PMID: 33253056 DOI: 10.1080/09637486.2020.1851658] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 02/08/2023]
Abstract
Sleep disturbances (SD) represent one of the main symptoms of menopause and they are caused by several factors. Hormonal changes such as the reduction of oestrogen levels and the consequent vasomotor symptoms (VMS) along with psychiatric disorders such as depression and anxiety could contribute to the onset of SD. Furthermore, obesity per sè or through the obstructive sleep apnoea (OSA) could blunt sleep. Moreover, in menopause is usual a reduction in melatonin, that could contribute to SD. Nutritional strategies are paramount because they could contribute to manage menopause-related SD, in particular tackling obesity and overweight. Furthermore, some foods, such as soy, fish, whole grains, vegetables and fruit could decrease symptoms like depression and VMS, correlated with SD in postmenopausal women. Therefore, the aim of this review is to provide an overview of the current evidence on SD in menopause and to provide nutritional strategies for managing SD in this context.
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Affiliation(s)
- Daniela Laudisio
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Gabriella Pugliese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Sara Aprano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Bianca Castellucci
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
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Mohsenian S, Shabbidar S, Siassi F, Qorbani M, Khosravi S, Abshirini M, Aslani Z, Sotoudeh G. Carbohydrate quality index: Its relationship to menopausal symptoms in postmenopausal women. Maturitas 2021; 150:42-48. [PMID: 34274075 DOI: 10.1016/j.maturitas.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to determine the relationship between carbohydrate quality intake and menopausal symptoms. STUDY DESIGN This is a cross-sectional study of 393 postmenopausal women attending municipality health houses and health centers in the south of Tehran, Iran, from September 2016 to January 2017. MAIN OUTCOME MEASURES The dietary intake and menopausal symptoms of the participants were assessed with a validated food frequency questionnaire and a menopause rating scale (MRS) carbohydrate quality index (CQI) was calculated using three indices: dietary fiber, glycemic index, and the ratio of solid carbohydrates to total carbohydrates. Linear and logistic regressions were used to assess the relationship between CQI and menopausal symptoms. RESULTS After adjustment for age, education, time passed since menopause, body mass index, physical activity and energy intake, an inverse association was found between CQI and total MRS score (TMRSS) (β -0.61; p <0.001), somatic score (SS) (β -0.27; p <0.001) and psychological score (PS) (β -0.37; p <0.001) in multivariable linear regression. In addition, logistic regression analysis revealed that compared with the lowest quartile of CQI, participants in the highest quartile of CQI had a lower TMRSS (odds ratio (OR) 0.36, 95% confidence interval (CI) 0.19-0.68). Moreover, CQI was inversely related to SS (OR 0.34; 95% CI 0.17-0.68) and PS (OR 0.32; 95% CI 0.16-0.61). However, there was no significant association between CQI and urogenital score (US). CONCLUSIONS Higher-quality carbohydrate intake was found to be associated with lower somatic and psychological symptoms of menopause. These findings suggest that CQI may be an important basis for developing an effective dietary modification for reducing menopausal symptoms.
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Affiliation(s)
- Saman Mohsenian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shabbidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | - Shahla Khosravi
- Department of Social Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Abshirini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
| | - Zahra Aslani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Gebretatyos H, Amanuel S, Ghirmai L, Gebreyohannes G, Tesfamariam EH. Effect of Health Education on Healthy Nutrition and Physical Activity among Female Teachers Aged 40-60 Years in Asmara, Eritrea: A Quasiexperimental Study. J Nutr Metab 2020; 2020:5721053. [PMID: 33062325 PMCID: PMC7533026 DOI: 10.1155/2020/5721053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/24/2020] [Accepted: 09/10/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Middle age is a period in women's life where many changes occur in their bodies due to the decline of gonadotropins. As a result, they face various vasomotor, psychological, and somatic symptoms. Moreover, chronic illness such as diabetes, hypertension, heart diseases, and osteoporosis are prevalent at this time. Healthy nutrition and physical activity are effective factors to reduce the problems of menopause faced during middle age. OBJECTIVE This study aimed at assessing the effect of health education on healthy nutrition and physical activity among 40-60-year-old female teachers in elementary, junior, and secondary schools of Asmara. METHOD A quasiexperimental design was used in this study. The data were collected from 99 middle-age female teachers who were selected by stratified random sampling. The intervention was conducted using lecture, brochure, and group discussion for a total of 3 hours. Data on physical activity and healthy nutrition were collecting using HPLP- II subscales physical activity and nutrition. Sociodemographic data were collected using a predesigned questionnaire. The effect of educational training at preintervention and postintervention was evaluated by the paired t-test and factorial mixed ANOVA using SPSS (version 22). RESULTS The mean score of practicing healthy diet and physical activity at preintervention and postintervention was 27/44 (SD = 4.20) and 31/44 (SD = 5.36), respectively. A significant difference in the scores of practicing healthy diet and physical activity was observed after the educational intervention (MD = 4.06, 95% CI 2.95-5.17, p < 0.0001). The effectiveness of health education was seen across the categories of age, educational level, and occupational level where none of them showed significant interaction, displaying similar effect of educational intervention across all categories of the demographic variables. CONCLUSION The structured educational intervention was beneficial for the studied women in changing their practice on healthy nutrition and physical activity.
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Affiliation(s)
- Helen Gebretatyos
- Department of Midwifery, School of Nursing, Asmara College of Health Sciences, Asmara, Eritrea
| | - Soliana Amanuel
- Department of Midwifery, School of Nursing, Asmara College of Health Sciences, Asmara, Eritrea
| | - Lidia Ghirmai
- Department of Midwifery, School of Nursing, Asmara College of Health Sciences, Asmara, Eritrea
| | | | - Eyasu H. Tesfamariam
- Biostatistics and Epidemiology Unit, Department of Statistics, College of Science, Mai Nefhi, Asmara, Eritrea
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Abstract
OBJECTIVE Although menopause is a natural event in a woman's life, some of its symptoms can be severe enough to adversely affect her health. There is some evidence to suggest that diet has an influence on menopausal symptoms, but less attention has been paid to dietary patterns. The purpose of this study is to determine the association of dietary patterns with physical, mental, and genitourinary menopausal symptoms. METHODS A cross-sectional study design was applied using a sample of 400 postmenopausal women who attended health centers in the south of Tehran, Iran. The menopausal symptoms were assessed by a Menopause Rating Scale (MRS) questionnaire; a 147-item, semi-quantitative food-frequency questionnaire was used to collect dietary information, and major dietary patterns were identified by principal component analysis. Linear regression was used to evaluate the relationship between menopausal symptoms and dietary patterns. RESULTS Three major dietary patterns were identified: vegetables and fruits (VF); mayonnaise, liquid oils, sweets, and desserts (MLSD); and solid fats and snacks (SFS). It has been found that the VF dietary pattern is inversely associated with general (β = -1.37; SE = 1.08; P for trend <0.001), physical (β = -1.54; SE = 1.09; P for trend <0.001), and mental (β = -1.58; SE = 1.11; P for trend <0.001) symptoms. A stronger adherence to the MLSD dietary pattern was directly associated with general (β = 1.15; SE = 1.08; P for trend <0.001) and genitourinary symptoms (β = 1.54; SE = 1.1; P for trend <0.001). Moreover, the SFS dietary pattern was directly related to the general (β = 1.23; SE = 1.09; P for trend = 0.01), physical (β = 1.24; SE = 1.09; P for trend = 0.04), and mental (β = 1.29; SE = 1.12; P for trend < 0.001) symptoms. CONCLUSION The present study demonstrated that there is an inverse association between VF dietary pattern and menopausal symptoms. In contrast, the MLSD and SFS dietary patterns were correlated to an increased risk of these symptoms.
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Abshirini M, Siassi F, Koohdani F, Qorbani M, Khosravi S, Hedayati M, Aslani Z, Soleymani M, Sotoudeh G. Dietary total antioxidant capacity is inversely related to menopausal symptoms: a cross-sectional study among Iranian postmenopausal women. Nutrition 2018; 55-56:161-167. [PMID: 30086485 DOI: 10.1016/j.nut.2018.04.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/12/2018] [Accepted: 04/21/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to assess the association between dietary total antioxidant capacity (DTAC) and menopausal symptoms (MS) in postmenopausal middle-aged women. METHODS A cross-sectional study was conducted with 400 postmenopausal women who referred to municipality health houses and health centers in south Tehran, Iran. Sociodemographic data and anthropometric measures such as body weight, height, and waist circumference were determined. Dietary intake was assessed using a 147-item validated food frequency questionnaire. Energy-adjusted DTAC was calculated using the US Department of Agriculture database. Individual MS was measured by the Menopause Rating Scale questionnaire. RESULTS Multivariable linear regression analyses indicated that DTAC was negatively associated with total Menopause Rating Scale score, somatic and psychological score, which was independent of confounding variables such as age, education, waist circumference, total physical activity, dietary intake of fiber, tea and coffee intake, total energy intake, and dietary supplement use (P < 0.001). Additionally, in logistic regression, a negative association between MS and DTAC was observed, which was independent of confounding variables (Ptrend = 0.002). Logistic regression for each symptom indicated that higher DTAC was associated with reduction in hot flashes and sweating, sleep problems, anxiety, exhaustion, and difficulty concentrating. However, a significant positive association was observed between DTAC and sexual problems. CONCLUSION DTAC is inversely associated with MS, which could be of particular significance for somatic and psychological symptoms. These findings indicate that DTAC could be an important basis for developing an effective dietary measure for reducing MS.
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Affiliation(s)
- Maryam Abshirini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Koohdani
- Department of Cellular, Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Shahla Khosravi
- Department of Social Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Aslani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Soleymani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Risk factors for night sweats and hot flushes in midlife: results from a prospective cohort study. Menopause 2014; 20:953-9. [PMID: 23531688 DOI: 10.1097/gme.0b013e3182844a7c] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aims to identify social, lifestyle, and reproductive history risk factors for night sweats (NS) only, hot flushes (HF) only, and both NS and HF. METHODS Risk factors and symptoms among 10,454 participants of the Australian Longitudinal Study on Women's Health who were aged 45 to 50 years in 1996 were measured at baseline and 3-year intervals (surveys 2-6) for 15 years. Multinomial logistic regression analyses were performed. RESULTS Compared with neither symptom, both symptoms together were reported less often by highly educated women (odds ratio, 0.61; 99.9% CI, 0.50-0.74), but more often by women who were heavier (odds ratio, 1.23; 99.9% CI, 1.08-1.40), were current smokers (odds ratio, 1.31; 99.9% CI, 1.09-1.56), were high-risk drinkers (odds ratio, 1.44; 99.9% CI, 1.10-1.89), were perimenopausal (odds ratio, 6.57; 99.9% CI, 5.52-7.82) or postmenopausal (odds ratio, 4.74; 99.9% CI, 4.00-5.63), had gained weight (odds ratio, 1.15; 99.9% CI, 1.01-1.31), or had premenstrual tension (odds ratio, 1.86; 99.9% CI, 1.48-2.34), than by women without these characteristics. HF only was reported less often by highly educated women (odds ratio, 0.73; 99.9% CI, 0.59-0.90), but more often by perimenopausal (odds ratio, 3.58; 99.9% CI, 2.95-4.35) or postmenopausal (odds ratio, 2.97; 99.9% CI, 2.47-3.57) women and by those with premenstrual tension (odds ratio, 1.60; 99.9% CI, 1.25-2.04). Finally, NS only was reported more often among current smokers (odds ratio, 1.55; 99.9% CI, 1.11-2.19), high-risk drinkers (odds ratio, 1.76; 99.9% CI, 1.04-2.97), perimenopausal women (odds ratio, 1.53; 99.9% CI, 1.14-2.06), those with diabetes (odds ratio, 1.91; 99.9% CI, 1.08-3.35), those with premenstrual tension (odds ratio, 1.67; 99.9% CI, 1.09-2.56), or those of early age at first pregnancy (odds ratio, 1.45; 99.9% CI, 1.05-1.99). CONCLUSIONS The presence of both symptoms is associated with social, behavioral, and menstrual factors. Some differences in risk factors among women who report only one symptom or both symptoms are observed, suggesting a slightly different etiology for each.
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Alexander JL, Burger H, Dennerstein L, Fugate Woods N, Davis SR, Kotz K, Van Winkle J, Richardson G, Ratka A, Kessel B. Treatment of vasomotor symptoms in the menopausal transition and postmenopausally: psychiatric comorbidity. Expert Rev Neurother 2014; 7:S115-37. [DOI: 10.1586/14737175.7.11s.s115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Herber-Gast GCM, Mishra GD. Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study. Am J Clin Nutr 2013; 97:1092-9. [PMID: 23553160 DOI: 10.3945/ajcn.112.049965] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Diet has been suggested to be a potential risk factor for vasomotor menopausal symptoms (VMSs), ie, hot flushes and night sweats. OBJECTIVE We investigated the associations between dietary patterns and risk of VMSs by using data from middle-aged women born between 1946 and 1951 in the Australian Longitudinal Study on Women's Health. DESIGN A prospective cohort study of 6040 women with a natural menopause were followed up at 3-y intervals over 9 y. Dietary intake was assessed at baseline in 2001, and the presence of VMSs was assessed at baseline and follow-up. Factor analysis and generalized estimating equation models for binary repeated measures were performed. RESULTS Six dietary patterns were identified from factor analysis: cooked vegetables, fruit, Mediterranean style, meat and processed meat, dairy, and high fat and sugar. A higher consumption of the fruit or Mediterranean-style diet was inversely associated with VMSs in a comparison of the top with the bottom quintile, with adjusted ORs of 0.81 (95% CI: 0.71, 0.93; P-trend = 0.0009) and 0.80 (95% CI: 0.69, 0.92; P-trend = 0.0004), respectively. The high-fat and -sugar pattern increased the risk of VMSs in a comparison of the top with the bottom quintile, with an adjusted OR of 1.23 (95% CI: 1.05, 1.44; P-trend = 0.02). CONCLUSIONS Consumption of a fruit or Mediterranean-style diet decreased the risk of reporting VMSs, whereas consumption of a high-fat and -sugar diet increased the risk of VMSs. These results may eventually lead to a basis for the development of dietary preventive measures for VMSs.
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Fisher WI, Johnson AK, Elkins GR, Otte JL, Burns DS, Yu M, Carpenter JS. Risk factors, pathophysiology, and treatment of hot flashes in cancer. CA Cancer J Clin 2013; 63:167-92. [PMID: 23355109 PMCID: PMC3640615 DOI: 10.3322/caac.21171] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Hot flashes are prevalent and severe symptoms that can interfere with mood, sleep, and quality of life for women and men with cancer. The purpose of this article is to review existing literature on the risk factors, pathophysiology, and treatment of hot flashes in individuals with cancer. Electronic searches were conducted to identify relevant English-language literature published through June 15, 2012. Results indicated that risk factors for hot flashes in cancer include patient-related factors (eg, age, race/ethnicity, educational level, smoking history, cardiovascular risk including body mass index, and genetics) and disease-related factors (eg, cancer diagnosis and dose/type of treatment). In addition, although the pathophysiology of hot flashes has remained elusive, these symptoms are likely attributable to disruptions in thermoregulation and neurochemicals. Therapies that have been offered or tested fall into 4 broad categories: pharmacological, nutraceutical, surgical, and complementary/behavioral strategies. The evidence base for this broad range of therapies varies, with some treatments not yet having been fully tested or showing equivocal results. The evidence base surrounding all therapies is evaluated to enhance hot flash treatment decision-making by clinicians and patients.
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Affiliation(s)
- William I Fisher
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
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Huang AJ, Subak LL, Wing R, West DS, Hernandez AL, Macer J, Grady D. An intensive behavioral weight loss intervention and hot flushes in women. ACTA ACUST UNITED AC 2010; 170:1161-7. [PMID: 20625026 DOI: 10.1001/archinternmed.2010.162] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Higher body mass index is associated with worse hot flushes during menopause but the effect of weight loss on flushing is unclear. METHODS Self-administered questionnaires were used to assess bothersome hot flushes in a 6-month randomized controlled trial of an intensive behavioral weight loss program (intervention) vs a structured health education program (control) in 338 women who were overweight or obese and had urinary incontinence. Weight, body mass index, abdominal circumference, physical activity, calorie intake, blood pressure, and physical and mental functioning were assessed at baseline and at 6 months. Repeated-measures proportional odds models examined intervention effects on bothersome hot flushes and potential mediating factors. RESULTS Approximately half of participants (n = 154) were at least slightly bothered by hot flushes at baseline. Among these women, the intervention was associated with greater improvement in bothersome flushes vs control (odds ratio [OR] for improvement by 1 Likert category, 2.25; 95% confidence interval [CI], 1.20-4.21). Reductions in weight (OR, 1.32; 95% CI, 1.08-1.61; per 5-kg decrease), body mass index (1.17; 1.05-1.30; per 1-point decrease), and abdominal circumference (1.32; 1.07-1.64; per 5-cm decrease) were each associated with improvement in flushing, but changes in physical activity, calorie intake, blood pressure, and physical and mental functioning were not related. The effect of the intervention on flushing was modestly diminished after adjustment for multiple potential mediators (OR, 1.92; 95% CI, 0.95-3.89). CONCLUSION Among women who were overweight or obese and had bothersome hot flushes, an intensive behavioral weight loss intervention resulted in improvement in flushing relative to control. Trial Registration clinicaltrials.gov Identifier: NCT00091988.
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Affiliation(s)
- Alison J Huang
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94115, USA.
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Abstract
PURPOSE The purpose of this article is to detail a novel hypothesis regarding the role of changes in brain glucose delivery in menopausal hot flashes. ORGANIZING FRAMEWORK The impaired glucose delivery hypothesis of menopausal hot flashes is presented as a potential model of hot flash physiology. As foundational to the hypothesis, brain glucose physiology, specifically neurobarrier coupling, is presented in detail. With brain activation, glucose needs immediate increase; additional glucose is supplied through increased production of glucose transporter 1 (GLUT1) at the blood-brain barrier (BBB) and through vasodilation. Estrogen is important to this system in stimulating production of GLUT1. As estrogen declines at menopause, upregulation of GLUT1 is less efficient. As a consequence, neurobarrier coupling overcompensates with an excess neurovascular response, or a hot flash. Research supporting this hypothesis is briefly reviewed and new questions raised are reviewed. CONCLUSIONS The impaired glucose hypothesis of menopausal hot flashes proposes an inadequate neurobarrier response to neurometabolic stimulation as estrogen declines, resulting in additional neurometabolic stimulation with consequent neurovascular stimulation. In this model, the menopausal woman has diminished ability to respond to fluctuations in blood glucose over the course of the day, which results in hot flashes as a counter-regulatory response. This perspective accounts for observed physiological changes that have not been previously detailed. New research directions are identified.
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Affiliation(s)
- Sharon L Dormire
- University of Texas at Austin, School of Nursing, Austin, Texas 78701-1499, USA.
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