title: Longitudinal association of vasomotor symptoms and psychosocial outcomes among postmenopausal women in the United States: a population-based study.
abstract: OBJECTIVE
  Vasomotor and psychosocial symptoms persist as common manifestations of menopause; their explicit association is unclear. We investigated this association among postmenopausal women over a 2-year period.
  
  
  METHODS
  The Menopause Epidemiology Study is a cross-sectional population-based study of women 40 to 65 years old in the United States. We followed participants who were postmenopausal at baseline and at 2-year follow-up (n = 1,506) in the analyses. The vasomotor and psychosocial domains of the Menopause-Specific Quality of Life Questionnaire were used to assess exposure and outcome. Change in symptoms was defined as the difference in the Menopause-Specific Quality of Life Questionnaire domain score from baseline to follow-up 2 years later. Demographic information, behavioral activities, reproductive history, and medication use were evaluated for effect modification and confounding. Covariate-adjusted linear regression was used to assess the relationship between the change in vasomotor symptoms and change in psychosocial symptoms.
  
  
  RESULTS
  One quarter (n = 375) of the women reported an increase in vasomotor symptoms over the 2-year study period. Twenty-two percent of the women reported an increase in both vasomotor and psychosocial symptoms. Current smoking status was found to be an effect modifier: a one-unit increase in the vasomotor domain was associated with a 0.21-unit (95% CI, 0.12-0.29) increase in the psychosocial domain among smokers; this was stronger (0.29, 95% CI, 0.20-0.39) among past or never smokers.
  
  
  CONCLUSIONS
  This study provides further evidence of an association between vasomotor symptoms and psychosocial symptoms using a validated instrument in a population-based study. There is a small increase in psychosocial symptoms with increasing vasomotor symptoms. Clinicians may want to note this association when treating postmenopausal women with either condition.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kristen.vandole@fda.hhs.gov
authors.forename: Kristen B
authors.initials: KB
authors.lastname: Van Dole
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Williams
authors.forename: Rebekkah S
authors.initials: RS
authors.lastname: Brown
authors.forename: Bradley
authors.initials: B
authors.lastname: Gaynes
authors.forename: Robert
authors.initials: R
authors.lastname: Devellis
authors.forename: Michele Jonsson
authors.initials: MJ
authors.lastname: Funk
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D019584:Hot Flashes / Q000523:psychology*; D006801:Humans; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D014481:United States