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| Sybil Crawford, PhD |
A JAMA Internal Medicine study co-authored by Sybil Crawford, PhD, found that hot flashes can last years longer than previously expected, and the earlier they start the longer they last. The finding has major implications for treating and managing menopausal vasomotor symptoms long-term.
“We are realizing that these symptoms do go on, often beginning long before, and lasting long past, a woman’s final menstrual period,” said Dr. Crawford, professor of medicine in the Division of Preventive and Behavioral Medicine.
The large-scale, 17-year study of women transitioning to menopause found that for the nearly 80 percent of American women who suffer from the troublesome symptoms, they can last years longer than previously thought, and the earlier they start, the longer they are likely to continue.
“We need different treatments and we need to start thinking about what happens long term,” noted Crawford.
Published online Feb. 16 by JAMA Internal Medicine, “Duration of menopausal vasomotor symptoms over the menopause transition” reports a median 7.4 years duration of symptoms among 1,449 women with frequent symptoms (defined as occurring at least six days in the previous two weeks). Among women whose symptoms began before menopause, median symptom duration was more than 11.8 years, with a median of 9.4 years after the final menstrual period. Data collected by the multiracial/multiethnic Study of Women’s Health Across the Nation from 1996 to 2013 also showed that African American women reported the longest total symptom duration (median 10.1 years) and Japanese American women the shortest (median 4.8 years).
These durations underscore the need for better options than hormone therapy for long-term management of menopausal vasomotor symptoms.
The Division of Preventive and Behavioral Medicine at UMass Medical School ran an arm of the pivotal National Women’s Health Initiative. In 2003, the initiative concluded that in postmenopausal women, particularly those starting hormone therapy well after the final menstrual period, the risks may outweigh the benefits. This led to the guideline that women who take hormones do so for the shortest time possible—advice that offers limited relief for women with long-lasting symptoms.
“We’re looking for alternatives to standard hormone therapy,” said Crawford.
Crawford and colleagues have received funding to continue following study participants for five more years, and say their findings also underscore the need for more long-term research into the mechanisms, effects and outcomes of the menopausal transition that can span decades of a woman’s life.
“We don’t have decades of observations yet,” Crawford pointed out. “Lack of long-term data may be why the duration of vasomotor symptoms has been understated.”
Related links on UMassMedNow:
More soy more often better for hot flashes: Increased dose and frequency brings relief in UMMS study
Times quotes Julia Johnson on risk of new hot flash drugs
Ockene on hormone therapy: In the final analysis, proceed with caution
