title: Hot flushes during the menopause transition: a longitudinal study in Australian-born women.
abstract: OBJECTIVE
  To investigate factors associated with the presence, severity, and frequency of hot flushes.
  
  
  METHODS
  A 9-year prospective study of 438 Australian-born women, aged 45 to 55 years and menstruating at baseline. Annual fasting blood collection, physical measurements, and interviews including questions about bothersome hot flushes in previous 2 weeks were performed. A "hot flush index" score was calculated from the product of the severity and frequency data. Data were analyzed using random-effects time-series regression models.
  
  
  RESULTS
  A total of 381 women supplied complete data over the follow-up years. A total of 350 women experienced the menopause transition, of whom 60 (17%) never reported bothersome hot flushes. At baseline, women who reported hot flushes were significantly more likely to have higher negative moods, not be in full- or part-time paid work, smoke, and not report exercising every day. Over the 9-year period of the study, variables significantly associated with reporting bothersome hot flushes were relatively young age (P < 0.001), low exercise levels (P < 0.05), low estradiol levels (P < 0.001), high follicle-stimulating hormone (FSH) levels (P < 0.001), smoking (P < 0.01), being in the late menopause transition (P < 0.001), or being postmenopausal (P < 0.001). In women reporting hot flushes, the hot flush index score increased as their FSH levels increased (P < 0.01), as they entered the late stage of the menopause transition (P < 0.001), and as they became postmenopausal (P < 0.05), and decreased with as their age (P < 0.001) and exercise level (P < 0.05) increased. Between-women analyses found that the hot flush index score was greater in women with higher average FSH levels over time (P < 0.05).
  
  
  CONCLUSIONS
  Menopause status, FSH and estradiol levels, age, exercise level, and smoking status all contributed to the experience of bothersome hot flushes.
authors.affiliation: Office for Gender and Health, Department of Psychiatry, The University of Melbourne, Victoria, Australia. janetrg@unimelb.edu.au
authors.forename: Janet R
authors.initials: JR
authors.lastname: Guthrie
authors.forename: Lorraine
authors.initials: L
authors.lastname: Dennerstein
authors.forename: John R
authors.initials: JR
authors.lastname: Taffe
authors.forename: Philippe
authors.initials: P
authors.lastname: Lehert
authors.forename: Henry G
authors.initials: HG
authors.lastname: Burger
mesh_terms: D000339:Affect; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D004651:Employment; D004958:Estradiol / Q000097:blood; D015444:Exercise; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D015438:Health Behavior; D019584:Hot Flashes / Q000453:epidemiology*; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D008593:Menopause; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects
chemical_list: D004958:Estradiol; D005640:Follicle Stimulating Hormone