Hot flash severity in hormone therapy users/nonusers across the menopausal transition.
OBJECTIVE
The purpose of this study was to examine the pattern of and factors that influence hot flash severity across the menopausal transition (MT) and early postmenopause (PM).


METHODS
Women from the Seattle Midlife Women's Health Study (N=302) provided data for these analyses: at least one annual health questionnaire and a menstrual calendar. A subset of women provided a first morning voided urine specimen from 1997 through 2005. Urine samples were assayed for estrone glucuronide and FSH. Linear mixed effects modeling was used to identify change in hot flash severity scores over time, including the relationship to age, MT-related, psychosocial and lifestyle factors.


RESULTS
Increases in hot flash severity were associated with late transition stage, early postmenopause, use of HRT, duration of early transition stage, age of entry into early PM and level of FSH. Age of entry into early transition and estrone levels were associated with decreased hot flash severity. Not associated with hot flash severity were being in early transition stage, age of entry into or duration of late transition stage and all of the psychosocial (anxiety, stress, depressed mood) and lifestyle variables (BMI, activity level, sleep, alcohol use).


CONCLUSIONS
Variables associated with reproductive aging independently predicted changes in hot flash severity; psychosocial and lifestyle variables did not. The effect of age dropped out when factors associated with reproductive aging were considered. Use of HRT ameliorated but did not eliminate severe hot flashes suggesting that there is room for alternative approaches less likely to cause harm.
Smith-DiJulio
Kathleen
K
Department of Family and Child Nursing, University of Washington, Seattle, WA 98195, United States. smithdijulio@comcast.net
Percival
Donald B
DB
Woods
Nancy Fugate
NF
Tao
Eunice Y
EY
Mitchell
Ellen Sullivan
ES
D000328:Adult; D015914:Estrogen Replacement Therapy; D004970:Estrone / Q000652:urine; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000652:urine; D019584:Hot Flashes / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control* / Q000652:urine; D006801:Humans; D008593:Menopause; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014861:Washington / Q000453:epidemiology; D016387:Women's Health
D043373:Follicle Stimulating Hormone, Human; D004970:Estrone