Frequent vasomotor symptoms (VMS) associated with menopause persist longer than had been thought, and the sooner they start, the longer they last. The longest duration of VMS occurred among black women.
Up to 80% of women experience VMS, and many seek relief. The duration of VMS affects healthcare decisions, such as when to begin and how long to undergo hormone replacement therapy. Many sources of information for patients state that hot flashes and night sweats last 3 to 5 years. Clinical guidelines maintain that most women experience VMS for 6 months to 2 years, but anecdotal reports as well as epidemiologic studies place the duration at up to 13 years.
The researchers established two primary outcomes: “Total VMS duration” indicated the years elapsed between the first and last report of frequent VMS, and “Post-FMP persistence” indicated the number of years that frequent VMS persisted after the final menstrual period (FMP). The researchers defined cessation of VMS as two consecutive visits without hormone replacement therapy or experiencing VMS.
Black women experienced the longest total VMS duration (median, 10.1 years). Japanese and Chinese women reported the shortest VMS duration (median, 4.8 years and 5.4 years, respectively). The median total VMS durations were 6.5 years for non-Hispanic white women and 8.9 years for Hispanic women.
Longer VMS duration was associated with younger age, lower educational level, history of smoking, greater perceived stress, greater sensitivity to symptoms, and depression and anxiety at the time of the first report of VMS. Shorter VMS duration was noted among women with partners, higher educational level, less financial pressure, and greater social support.
In addition, the median total VMS duration of 7.4 years highlights the limitations of guidance recommending short-term [hormone therapy] use and emphasizes the need to identify safe long-term therapies for the treatment of VMS.
They point out that women at the beginning of menopause may in fact still be fertile, and if they experience frequent VMS, low-dose combined oral contraceptives may protect them from pregnancy while tempering the hot flashes and drenching night sweats.
The longer timeframe for menopause may also encourage some women to seek nonhormonal treatments for managing VMS symptoms, such as antidepressants (certain selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors) clonidine, and complementary and alternative methods.