Beyond frequency: who is most bothered by vasomotor symptoms?
OBJECTIVE
Most menopausal women report vasomotor symptoms (hot flashes, night sweats). However, not all women with vasomotor symptoms, including frequent symptoms, are bothered by them. The primary aim was to identify correlates of vasomotor symptom bother beyond symptom frequency.


METHODS
The Study of Women's Health Across the Nation participants reporting vasomotor symptoms at annual visit 7 comprised the sample (N = 1,042). Assessments included hot flash and night sweats frequency (number per week) and bother (1, not at all- 4, very much). Negative affect (index of depressive symptoms, anxiety, perceived stress, negative mood), symptom sensitivity, sleep problems, and vasomotor symptom duration (number of years) were examined cross-sectionally in relation to bother in ordinal logistic regression models with symptom frequency and covariates. Hot flashes and night sweats were considered separately.


RESULTS
In multivariable models controlling for hot flash frequency, negative affect (odds ratio [OR] = 1.27, 95% CI: 1.08-1.51), symptom sensitivity (OR = 1.18, 95% CI: 1.03-1.37), sleep problems (OR = 1.38, 95% CI: 1.04-1.85), poorer health (OR = 1.24, 95% CI: 1.03-1.48), duration of hot flashes (OR = 1.14, 95% CI: 1.06-1.23), younger age (OR = 0.94, 95% CI: 0.89-0.99), and African American race (vs white, OR = 1.59, 95% CI: 1.12-2.26) were associated with hot flash bother. After controlling for night sweats frequency and covariates, sleep problems (OR = 1.84, 95% CI:1.33-2.55) and night sweats duration (OR = 1.10, 95% CI: 1.02-1.20) were associated with night sweats bother.


CONCLUSIONS
Beyond frequency, factors associated with bothersome hot flashes include mood, symptom sensitivity, symptom duration, sleep problems, age, and race. Correlates of bothersome night sweats include sleep problems and symptom duration. In addition to reducing frequency, interventions for vasomotor symptoms might consider addressing modifiable factors related to symptom bother.
Departments of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. thurstonrc@upmc.edu
Rebecca C
RC
Thurston
Joyce T
JT
Bromberger
Hadine
H
Joffe
Nancy E
NE
Avis
Rachel
R
Hess
Carolyn J
CJ
Crandall
Yuefang
Y
Chang
Robin
R
Green
Karen A
KA
Matthews
D000342:Affective Symptoms / Q000453:epidemiology* / Q000523:psychology; D001007:Anxiety / Q000453:epidemiology; D001294:Attitude to Health; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D006945:Hyperhidrosis / Q000453:epidemiology* / Q000523:psychology; D008019:Life Style; D008593:Menopause; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology; D013546:Sweating; D014481:United States / Q000453:epidemiology; D016387:Women's Health