title: Duration of menopausal hot flushes and associated risk factors.
abstract: OBJECTIVE
  To estimate the duration of moderate-to-severe menopausal hot flushes and identify potential risk factors for hot flush duration.
  
  
  METHODS
  The Penn Ovarian Aging Study cohort was monitored for 13 years. Hot flushes were evaluated at 9-month to 12-month intervals through in-person interviews. The primary outcome was the duration of moderate-to-severe hot flushes estimated by survival analysis (n=259). Potential risk factors included menopausal stage, age, race, reproductive hormone levels, body mass index (BMI), and current smoking. A secondary analysis included women who reported any hot flushes (n=349).
  
  
  RESULTS
  The median duration of moderate-to-severe hot flushes was 10.2 years and was strongly associated with menopausal stage at onset. Hot flushes that started near entry into the menopause transition had a median duration greater than 11.57 years; onset in the early transition stage had a median duration of 7.35 years (95% confidence interval [CI] 4.94-8.89; P<.001); and onset in the late transition to postmenopausal stages had a median duration of 3.84 years (95% CI 1.77-5.52; P<.001). The most common ages at onset of moderate-to-severe hot flushes were 45-49 years (median duration, 8.1 years; 95% CI 5.12-9.28). African American women had a longer duration of hot flushes than white women in adjusted analysis.
  
  
  CONCLUSIONS
  The median duration of hot flushes considerably exceeded the timeframe that is generally accepted in clinical practice. The identified risk factors, particularly menopausal stage, race, and BMI, are important to consider in individualizing treatment and evaluating the risk-to-benefit ratio of hormones and other therapies.
authors.affiliation: From the Department of Obstetrics/Gynecology, the Center for Clinical Epidemiology and Biostatistics, and the Center for Research in Reproduction and Women's Health, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and the Division of Biostatistics, Department of Medicine, Indiana University, Indianapolis, Indiana.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Hui
authors.initials: H
authors.lastname: Lin
authors.forename: Ziyue
authors.initials: Z
authors.lastname: Liu
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
mesh_terms: D000328:Adult; D001741:Black or African American; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D019584:Hot Flashes / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D057566:Self Report; D013997:Time Factors; D014481:United States; D044465:White People