Hot Flashes Common Before Menopause

Most women expect hot flashes as a part of the "change of life", but more than half start sweating before menopause has actually begun, according to a survey.

The study and others "indicate that women start having hot flashes and night sweats, the primary symptoms of the menopause transition, before they have their final menstrual period, contrary to the perception of many clinicians", according to Ellen Gold, of the University of California, Davis School of Medicine.

Previous studies put the number of women with hot flashes at 15 or 20%, but those specifically asked about hot flashes in the past two weeks, which may be a better measure of early onset menopause symptoms than the current study, which asked, "Have you ever had a hot flash?", said Gold, who was not involved in the study.

The findings, published in the journal Menopause, shouldn't be a concern for women, but it may change how researchers look at hot flashes, according to lead author Dr Susan Reed who studies women's mid-life health at the University of Washington in Seattle.

Oestrogen mimic

Usually associated with menopause, hot flashes and night sweats occur when hormone changes cause blood vessels near the surface of the skin to open rapidly. Women with regular menstrual cycles should have enough oestrogen to stave off hot flashes, but they may have to re-evaluate that idea, Reed told Reuters Health by email.

Reed and her co-authors sent questionnaires to 18500 women between 45 and 56. About half responded. Of the 1500 who still had regular cycles and weren't taking medications such as antibiotics or hormone replacement, 55% reported having experienced a hot flash or night sweat at some point in their lives.

More than half of white, black and Native American women reported the symptoms, compared to 30% or fewer of Asian and Hispanic women. The study was funded by Otsuka Pharmaceutical Co., Ltd., which is developing S-Equol, a compound that may mimic oestrogen and could be a potential treatment for menopausal symptoms. Many women have hot flashes but don't find that they disrupt daily life, said Ellen Freeman, of the University of Pennsylvania Perelman School of Medicine in Philadelphia.

Women who experienced hot flashes

"Note that only 22% were 'bothered', so more than half of the women who had experienced a hot flash weren't troubled by it," Freeman told Reuters Health by email. Though it wasn't their primary aim, the researchers also looked at how much soy the women reported eating. Soybeans contain weak oestrogen-like compounds, which are not as strong as oestrogen but have been linked to reduced fertility and early puberty in women.

Among white women, those with menopausal symptoms seemed more likely to eat soy regularly, while white women without symptoms were more likely to never have eaten soy. There was no relationship with soy in the other ethnic groups. Though a recent study found that eating soy doesn't alleviate hot flashes, "given the design of the study, it is possible that those women with hot flashes had increased soy intake to try to manage their hot flashes -- we don't know which came first", Reed's co-author Katherine Newton told Reuters Health.

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