For many women, vasomotor symptoms, including hot flashes and night sweats, last for more years and persist longer past the final menstrual period than previously thought, a large multiethnic, multiracial observational study has shown.

Of the 3,302 enrollees in the Study of Women’s Health Across the Nation (SWAN), 1,449 reported frequent (6 or more days in the previous 2 weeks) vasomotor symptoms (VMS), reported Nancy E. Avis, Ph.D., and her associates. This group experienced a median 7.4 years of VMS, with a median 4.5 years of symptoms after the final menstrual period (FMP) for the subset of 881 women who identified a definite FMP (JAMA Intern. Med. 2015 Feb. 16 [doi:10.1001/jamainternmed.2014.8063]).

The researchers also identified risk factors for more prolonged duration of VMS and longer persistence after FMP. Ethnicity was a significant factor in VMS variation (P <.001); African American women had the longest duration of VMS at 10.1 years, followed by Hispanic women (8.9 years), non-Hispanic white women (6.5 years), Chinese women (5.4 years), and Japanese women (4.8 years), said Dr. Avis of Wake Forest University, Winston-Salem, N.C., and her associates

African American women in the study also experienced the longest duration of VMS symptoms post-FMP. Depressive symptoms, anxiety, lower educational status, and higher perceived stress were among the other variables significantly associated with longer duration of VMS and longer persistence of symptoms after FMP.

Overall, the strongest single factor predicting both longer duration of VMS and longer symptom persistence after FMP was symptom onset occurring before menopause or during early perimenopause (P <.001).

Dr. Avis and her associates reported several limitations. For example, total VMS duration might have been underestimated. In addition, some women continued to report VMS beyond the 13-year follow-up period, “so longer follow-up is needed to better pinpoint the timing of cessation of VMS,” they noted.

Still, the findings can help clinicians “counsel patients about expectations regarding VMS and assist women in making treatment decisions,” the investigators wrote.

The research was supported by the National Institutes of Health, the Department of Health & Human Services, the National Institute on Aging, the National Institute of Nursing Research, and the Office of Research on Women’s Health. One author reported receiving grant support from Cephalon/Teva, serving as a consultant to Noven, and serving on an advisory board for Merck. None of the other study authors reported financial disclosures.


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