Older women still suffer from hot flushes and night sweats years after the menopause, finds study

Hot flushes and night sweats (HF/NS) are the main physical signs of the menopause, however their prevalence, frequency, severity and duration vary considerably.

The average age of the menopause in US and European women is 50-51 years and it is generally assumed that HF/NS last between 2 to 5 years.

This study looked at 10,418 postmenopausal women (defined as more than 12 months amenorrhea or hormone replacement therapy commenced for menopausal symptoms) aged between 54 and 65.

The average age of the participating women was 59 and the majority were white, living in urban localities and of slightly above average socioeconomic status.

The study looked at the impact of age, BMI, hysterectomy, hormone therapy use, lifestyle and mood on women's experience of HF/NS.

The participating women completed a questionnaire, which included sociodemographics, weight and height, and medical history. Three and a half years later, they were sent a follow up questionnaire asking them about lifestyle factors, skirt size at age 20, current skirt size, hot flushes and night sweats and current hormone therapy (HT) use.

The majority (89.6%) of women had experienced HF/NS at some time, more women having had hot flushes (86%) than night sweats (78%). However, over half (54%) of the women were currently having HF/NS and the prevalence was fairly even across the age range. The frequency of HF/NS was 33.5 per week and this remained broadly at this level across the age range.

The study also found that factors such as previous hysterectomy, having been a smoker and higher alcohol intake helped predict women who had ever had HF/NS. Moreover, anxiety, hysterectomy, depressed mood, years since last menstrual period and (less) education helped predict current HF/NS prevalence.

Women who were currently taking HT (12%) were less likely to report current HF/NS, while past users who had discontinued HT were more likely to have HF/NS across the age range.

Professor Myra Hunter, Institute of Psychiatry, King's College London and co-author said:

"Our study looked at a large number of older postmenopausal women and we were surprised to find that menopausal symptoms persisted in over half of the women. They were still having hot flushes on average ten years after their last period.

"Age didn't seem to affect the prevalence or frequency of the symptoms. Health professionals need to be aware that women can still have hot flushes and night sweats in their late 50s and 60s. There is a need for effective non-hormonal treatments for women with problematic hot flushes and night sweats, and for women who have a recurrence of hot flushes after they stop taking hormone therapy."

Professor Philip Steer, BJOG editor-in-chief added:

"This paper highlights how many older women continue to experience menopausal symptoms and these may vary in severity and how they affect a woman's quality of life. Interestingly age appears to be less of a significant factor in predicting these symptoms.

"There needs to be increased awareness of this amongst women and health professionals and more research into future treatments."

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