title: Vasomotor symptoms are associated with a lower bone mineral density.
abstract: OBJECTIVE
  The severity of vasomotor symptoms has been hypothesized to be linked to a lower bone mineral density (BMD). We examined whether women with vasomotor symptoms are different from women without symptoms with regard to BMD.
  
  
  METHODS
  We used data from a population-based sample of 5,600 women, aged 46 to 57 years and free from bone diseases, who participated in the first cross-sectional part of the Eindhoven Perimenopausal Osteoporosis Study between 1994 and 1995. Questionnaires at baseline were used to collect data on vasomotor symptoms and potential confounders. At baseline, BMD of the lumbar spine was measured using dual energy x-ray absorptiometry. Linear regression analysis was used to analyze the data.
  
  
  RESULTS
  Flushing was reported by 39% of all women, and night sweats, by 38% of all women. The average BMD was 1.01 +/- 0.14 g/cm and decreased with increasing frequency of flushing (P for trend < 0.0001) and night sweats (P for trend = 0.03). After multivariate adjustments for age, body mass index, menopause status, smoking, education, exercise, and hormone use, women with the highest frequency of symptoms had a 0.022 g/cm (95% CI, -0.03 to -0.01) lower BMD compared with asymptomatic women. Women who reported having the highest frequency of night sweats had a 0.011 g/cm (95% CI, -0.02 to -0.001) lower BMD compared with women with no symptoms of night sweats.
  
  
  CONCLUSIONS
  Our findings show that vasomotor symptoms are associated with reduced bone density. It could be hypothesized that women with vasomotor symptoms might be more susceptible to the beneficial effects of estrogens, possibly by neutralizing the effect of estrogen fluctuations. Further research is needed to extend these findings to other estrogen-sensitive end organs.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. G.C.M.Gast@umcutrecht.nl
authors.forename: Gerrie-Cor M
authors.initials: GC
authors.lastname: Gast
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Victor J M
authors.initials: VJ
authors.lastname: Pop
authors.forename: Jules J
authors.initials: JJ
authors.lastname: Keyzer
authors.forename: Colette J M
authors.initials: CJ
authors.lastname: Wijnands-van Gent
authors.forename: Göran N
authors.initials: GN
authors.lastname: Samsioe
authors.forename: Peter M
authors.initials: PM
authors.lastname: Nilsson
authors.forename: Yvonne T
authors.initials: YT
authors.lastname: van der Schouw
mesh_terms: D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D019584:Hot Flashes / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D013546:Sweating; D014666:Vasomotor System / Q000503:physiopathology*