Carolyn J. Crandall, MD, MS
What is the natural progression of vasomotor symptoms (VMSs) during the transition to menopause?
Studies selected reported the prevalence of VMSs (hot flushes, hot flashes, night sweats, and cold sweats) during and after the transition to menopause. Studies that reported menopausal symptoms using rating scales, those based only in specific clinics, and randomized trials of menopausal treatments were excluded. Outcomes were prevalence of self-reported VMSs over time in years up to and from final menstrual period (FMP) and by menopausal stage (Stages of Reproductive Aging Workshop criteria).
MEDLINE, clinical manuals, textbooks, and reference lists were searched for longitudinal or cross-sectional studies. 10 studies (n = 35 445, age range 39 to 65 y) met the selection criteria: 2 longitudinal and 8 cross-sectional studies. All studies had high sample representative scores based on the Newcastle-Ottawa Quality Assessment Scale, and both longitudinal studies had > 80% follow-up.
Meta-analysis showed that VMSs started to increase at 2 years before FMP, peaked at 1 year after FMP, and returned to baseline at 8 years after FMP (Table). 50% of women reported VMSs 4 years after FMP, and 10% reported symptoms up to 12 years after FMP.
Vasomotor symptoms peak at 1 year after final menstrual period and may persist for many years.
Prevalence of vasomotor symptoms during and after transition to menopause*
*FMP = final menstrual period; STRAW = Stages of Reproductive Aging Workshop. CI defined in Glossary. Analysis based on a random-effects model
†Meta-analysis of 6 studies (1 longitudinal and 5 cross-sectional).
‡Meta-analysis of 4 studies (1 longitudinal and 3 cross-sectional).
Crandall CJ. Review: Vasomotor symptoms peak at 1 year after final menstrual period and may persist for many years. Ann Intern Med. ;149:JC6–15. doi: 10.7326/0003-4819-149-12-200812160-02015
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Published: Ann Intern Med. 2008;149(12):JC6-15.
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