Menopausal vasomotor symptoms: social aspects, dynamics, cardiometabolic risks, hormone therapy options


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Vasomotor symptoms (hot flashes and night sweats) are the most characteristic symptoms of menopause. However, mounting evidence points to hot flashes as a manifestation of underlying autonomic neurovascular dysregulation that put an individual woman at risk for chronic conditions of aging. The review addresses the following issues: women’s attitudes towards menopause and hot flashes, the dynamics and duration of vasomotor symptoms across the different stages of reproductive aging, vasomotor symptoms as markers of cardiometabolic risk and their relationship with sleep disturbance, advantages of menopausal hormonal therapy with antimineralocorticoid progestin.

Full Text

Restricted Access

About the authors

Svetlana V. Yureneva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: syureneva@gmail.com
MD, senior researcher of the Department of Gynecological Endocrinology, professor of the Department of Obstetrics and Gynecology

Lilia M. Ilyina

Association of gynecologists and endocrinologists

Email: bseiljina@mail.ru
MD, medical advisor on menopause

Zukhra K. Ebzieva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: zu87@list.ru
graduate student of the Department of Gynecological Endocrinology

References

  1. Sturdee D.W., Hunter M.S., Maki P.M., Gupta P., Sassarini J., Stevenson J.C., Lumsden M.A. The menopausal hot flush: a review. Climacteric. 2017; 20(4): 296-305.
  2. Gartoulla P., Islam M.R., Bell R.J., Davis S.R. Prevalence of menopausal symptoms in Australian women at midlife: a systematic review. Climacteric. 2014; 17(5): 529-39.
  3. Miller V.M., Kling J.M., Files J.A., Joyner M.J., Kapoor E., Moyer A.M. et al. What’s in a name: are menopausal ‘‘hot flashes’’ a symptom of menopause or a manifestation of neurovascular dysregulation? Menopause. 2018; 25(6): 700-3.
  4. Franco O.H., Muka T., Colpani V., Kunutsor S., Chowdhury S., Chowdhury R., Kavousi M. Vasomotor symptoms in women and cardiovascular risk markers: systematic review and meta-analysis. Maturitas. 2015; 81(3): 353-61.
  5. Muka T., Oliver-Williams C., Colpani V., Kunutsor S., Chowdhury S., Chowdhury R. et al. Association of vasomotor and other menopausal symptoms with risk of cardiovascular disease: a systematic review and meta-analysis. PLoS One. 2016; 11(6): e0157417.
  6. Harlow S.D., Gass M., Hall J.E., Lobo R., Maki P., Rebar R.W. et al. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Menopause. 2012; 19(4): 387-95.
  7. Woods N.F., Cray L.A., Mitchell E.S., Farrin F., Herting J. Polymorphisms in estrogen synthesis genes and symptom clusters during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study. Biol. Res. Nurs. 2018; 20(2): 153-60.
  8. Moyer A.M., de Andrade M., Weinshilboum R.M., Miller V.M. Influence of SULT1A1 genetic variation on age at menopause, estrogen levels, and response to hormone therapy in recently postmenopausal white women. Menopause. 2016; 23(8): 863-9.
  9. Freedman R.R. Menopausal hot flashes: mechanisms, endocrinology, treatment. J. Steroid Biochem. Mol. Biol. 2014; 142: 115-20.
  10. Archer D.F., Sturdee D.W., Baber R., de Villiers T.J., Pines A., Freedman R.R. et al. Menopausal hot flushes and night sweats: where are we now? Climacteric. 2011; 14(5): 515-52.
  11. Sievert L.L. Subjective and objective measures of hot flashes. Am. J. Hum. Biol. 2013; 25(5): 573-80.
  12. Ayers B., Forshaw M., Hunter M.S.A. The impact of attitudes towards the menopause on women’s symptom experience: a systematic review. Maturitas. 2010; 65: 28-36.
  13. Morrison L.A., Brown D.E., Sievert L.L., Reza A., Rahberg N., Mills P., Goodloe A. Voices from the Hilo Women’s Health Study: talking story about menopause. Health Care Women Int. 2014; 35(5): 529-48.
  14. Griffiths A., Ceausu I., Depypere H., Lambrinoudaki I., Mueck A., Pérez-Löpez F.R.et al. EMAS recommendations for conditions in the workplace for menopausal women. Maturitas. 2016; 85: 79-81.
  15. Jack G., Riach K., Bariola E., Pitts M., Schapper J., Sarrel P. Menopause in the workplace: what employers should be doing. Maturitas. 2016; 85: 88-95.
  16. Gartoulla P., Bell R.J., Worsley R., Davis S.R. Menopausal vasomotor symptoms are associated with poor self-assessed work ability. Maturitas. 2016; 87: 33-9.
  17. Mishra G.D., Kuh D. Health symptoms during midlife in relation to menopausal transition: British prospective cohort study. BMJ. 2012; 344: e402.
  18. Tepper P.G., Brooks M.M., Randolph J.F. Jr., Crawford S.L., El Khoudary S.R., Gold E.B. et al. Characterizing the trajectories of vasomotor symptoms across the menopausal transition. Menopause. 2016; 23(10): 1067-74.
  19. Avis N.E., Crawford S.L., Greendale G., Bromberger J.T., Everson-Rose S.A., Gold E.B. et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern. Med. 2015; 175(4): 531-9.
  20. Freeman E.W., Sammel M.D., Sanders R.J. Risk of long-term hot flashes after natural menopause: evidence from the Penn Ovarian Aging Study cohort. Menopause. 2014; 21(4): 339-46.
  21. Gartoulla P., Worsley R., Bell R.J., Davis S.R. Moderate to severe vasomotor and sexual symptoms remain problematic for women aged 60 to 65 year. Menopause. 2015; 22(7): 694-701.
  22. Herber-Gast G., Brown WJ., Mishra G.D. Hot flushes and night sweats are associated with coronary heart disease risk in midlife: a longitudinal study. BJOG. 2015; 122(11): 1560-7.
  23. Thurston R.C., Chang Y., Barinas-Mitchell E., Jennings J.R., von Känel R., Landsittel D.P., Matthews K.A. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause. 2017; 24(8): 886-93.
  24. Thurston R.C., El Khoudary S.R., Sutton-Tyrrell K., Crandall C.J., Sternfeld B., Joffe H. et al. Vasomotor symptoms and insulin resistance in the Study of women’s health across the nation. J. Clin. Endocrinol. Metab. 2012; 97(10): 3487-94.
  25. Duffy O.K., Iversen L., Aucott L., Hannaford P.C. Factors associated with resilience or vulnerability to hot flushes and night sweats during the menopausal transition. Menopause. 2013; 20(4): 383-92.
  26. Wenger N.K., Arnold A., Bairey Merz C.N., Cooper-DeHoff R.M., Ferdinand K.C. et al. Hypertension across a woman’s life cycle. J. Am. Coll. Cardiol. 2018; 71(16): 1797-813.
  27. Jackson E.A., El Khoudary S.R., Crawford S.L., Matthews K., Joffe H., Chae C., Thurston R.C. Hot flash frequency and blood pressure: data from the Study of Women’s Health across the Nation. J. Womens Health. 2016; 25(12): 1204-9.
  28. Silveira J.S., Clapauch R., Souza M., Bouskela E. Hot flashes: emerging cardiovascular risk factors in recent and late postmenopause and their association with higher blood pressure. Menopause. 2016; 23(8): 846-55.
  29. Hitchcock C.L., Elliott T.G., Norman E.G., Stajic V., Teede H., Prior J.C. Hot flushes and night sweats differ in associations with cardiovascular markers in healthy early postmenopausal women. Menopause. 2012; 19(11): 1208-14.
  30. Slopien R., Wender-Ozegowska E., Rogowicz-Frontczak A., Meczekalski B., Zozulinska-Ziolkiewicz D., Jaremek J.D. et al. Menopause and diabetes: EMAS clinical guide. Maturitas. 2018; 117: 6-10.
  31. Gray K.E., Katon J.G., LeBlanc E.S., Woods N.F., Bastian L.A., Reiber G.E. et al. Vasomotor symptom characteristics: are they risk factors for incident diabetes? Menopause. 2018; 25(5): 520-30.
  32. Kravitz H.M., Avery E., Sowers M., Bromberger J.T., Owens J.F., Matthews K.A. et al. Relationships between menopausal and mood symptoms and EEG sleep measures in a multi-ethnic sample of middle-aged women: the SWAN sleep study. Sleep. 2011; 34(9): 1221-32.
  33. Freeman E.W., Sammel M.D., Gross S.A., Pien G.W. Poor sleep in relation to natural menopause: a population-based 14-year follow-up of midlife women. Menopause. 2015; 22(7): 719-26.
  34. National Sleep Foundation. National sleep foundation recommends new sleep times. Available at: http://sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times/page/0/1. Accessed June 27, 2018.
  35. Covassin N., Singh P. Sleep eduration and cardiovascular disease risk: epidemiologic and experimental evidence. Sleep Med. Clin. 2016; 11(1): 81-9.
  36. Yin J., Jin X., Shan Z., Li S., Huang H., Li P. et al. Relationship of sleep duration with all-cause mortality and cardiovascular events: a systematic review and dose-response meta-analysis of prospective cohort studies. J. Am. Heart Assoc. 2017; 6(9). pii: e005947.
  37. Kabat G.C., Xue X., Kamensky V., Zaslavsky O., Stone K.L., Johnson K.C. et al. The association of sleep duration and quality with all-cause and cause-specific mortality in the Women’s Health Initiative. Sleep Med. 2018; 50: 48-54.
  38. Freedman R.R., Kruger M.L., Wasson S.L. Heart rate variability in menopausal hot flashes during sleep. Menopause. 2011; 18(8): 897-900.
  39. Gao C.C., Kapoor E., Lipford M.C., Miller V.M., Schroeder D.R., Mara K.C., Faubion S.S. Association of vasomotor symptoms and sleep apnea risk in midlife women. Menopause. 2018; 25(4): 391-8.
  40. Sdnchez-de-la-Torre M., Campos-Rodriguez F., Barbé F. Obstructive sleep apnoea and cardiovascular disease. Lancet Respir. Med. 2013; 1: 61-72.
  41. de Villiers T.J., Hall J.E., Pinkerton J.V., Cerdas Pérez S., Rees M., Yang C., Pierroz D.D. Revised global consensus statement on menopausal hormone therapy. Climacteric. 2016; 19(4): 313-5.
  42. Baber R.J., Panay N., Fenton A.; IMS Writing Group. 2016 IMS recommendations on women’s midlife health and menopause hormone therapy. Climacteric. 2016; 19(2): 109-50.
  43. Boardman H.M., Hartley L., Eisinga A., Main C., Roqué i Figuls M., Bonfill Cosp X. et al. Hormone therapy for preventing cardiovascular disease in postmenopausal women. Cochrane Database Syst. Rev. 2015; (3): CD002229.
  44. O’Donnell E., Floras J.S., Harvey P.J. Estrogen status and the renin angiotensin aldosterone system. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2014; 307(5): R498-500.
  45. Luther J.M., Brown N.J. Renin-angiotensin-aldosterone system and glucose homeostasis. Trends Pharmacol. Sci. 2011; 32(12): 734-9.
  46. Jia G., Aroor A.R., Sowers J.R. The role of mineralocorticoid receptor signaling in the cross-talk between adipose tissue and the vascular wall. Cardiovasc. Res. 2017; 113(9): 1055-63.
  47. Joseph J.J., Echouffo Tcheugui J.B., Effoe V.S., Hsueh W.A., Allison M.A., Golden S.H. Renin-angiotensin-aldosterone system, glucose metabolism and incident type 2 diabetes mellitus: MESA. J. Am. Heart Assoc. 2018; 7(17): e009890.
  48. Janssen I., Powell L.H., Kazlauskaite R., Dugan S.A. Testosterone and visceral fat in midlife women: the Study of Women’s Health Across the Nation (SWAN) fat patterning study. Obesity (Silver Spring). 2010; 18(3): 604-10.
  49. Torréns J.I., Sutton-Tyrrell K., Zhao X., Matthews K., Brockwell S., Sowers M., Santoro N. Relative androgen excess during the menopausal transition predicts incident metabolic syndrome in mid-life women: SWAN, the study of Women’s Health Across the Nation. Menopause. 2009; 16(2): 257-64.
  50. Bushnell C., McCullough L.D., Awad I.A., Chireau M.V., Fedder W.N., Furie K.L. et al. Guidelines for the prevention of stroke in women. A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014; 45(5): 1545-88.
  51. Boggia J., Thijs L., Hansen T.W., Li Y., Kikuya M., Björklund-Bodegärd K. et al. Ambulatory blood pressure monitoring in 9357 subjects from 11 populations highlights missed opportunities for cardiovascular prevention in women. Hypertension. 2011; 57(3): 397-405.
  52. Hermida R.C., Ayala D.E., Mojön A., Fernandez J.R. Influence of circadian time of hypertension treatment on cardiovascular risk: results of the MAPEC study. Chronobiol. Int. 2010; 27(8): 1629-51.
  53. White W.B., Pitt B., Preston R.A., Hanes V. Antihypertensive effects of drospirenone with 17ß-estradiol, a novel hormone treatment in postmenopausal women with stage 1 hypertension. Circulation. 2005; 112(13): 1979-84.
  54. de Lauzon-Guillain B., Fournier A., Fabre A., Simon N., Mesrine S., Boutron-Ruault M.C. et al. Menopausal hormone therapy and new-onset diabetes in the French Etude Epidemiologique de Femmes de la Mutuelle Generale de l’Education Nationale (E3N) cohort. Diabetologia. 2009; 52(10): 2092-100.
  55. Manson J.E., Chlebowski R.T., Stefanick M.L., Aragaki A.K., Rossouw J.E., Prentice R.L. et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013; 310(13): 1353-68.
  56. Dinger J., Bardenheuer K., Heinemann K. Drospirenone plus estradiol and the risk of serious cardiovascular events in postmenopausal women. Climacteric. 2016; 19(4): 349-56.
  57. Bairey Merz C.N., Andersen H., Sprague E., Burns A., Keida M., Walsh M.N. et al. Knowledge, attitudes, and beliefs regarding cardiovascular disease in women: the Women’s Heart Alliance. J. Am. Coll. Cardiol. 2017; 70(2): 123-32.
  58. Brown H.L., Warner J.J., Gianos E., Gulati M., Hill A.J., Hollier L.M. et al.; American Heart Association and the American College of Obstetricians and Gynecologists. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists. Circulation. 2018; 137(24): e843-52.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies