September 18, 2014
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Study: Anxiety, smoking, body weight may worsen menopause symptoms

As Paris Hilton might say, when it comes to your health, smoking, being overweight, and feeling stressed are not "hot." But if you are approaching or experiencing menopause, those factors could make you feel a lot hotter, increasing the number and severity of hot flashes.

Two studies that appeared in Menopause, the journal of the North American Menopause Society, looked at the role of various lifestyle factors on women's symptoms during menopause and found a link between certain preventable factors and hot flashes.

In the first study, researchers at the University of Pennsylvania followed more than 430 women for a period of six years, measuring their anxiety through psychological tests conducted at both the beginning and end of the study. The women were between the ages of 35 and 47 at the start of the study and were still experiencing regular menstrual periods. By the end of the study, 32% of the women were in the early stages of menopause while 20% were in the late stages or had not had a period in more than one year.

At the end of the study, 37% of the premenopausal women, 48% of those in the early stages, and 63% of those in the late stages reported hot flashes. Of the women who were postmenopausal, 79% reported hot flashes.

After accounting for differences in such factors as stage of menopause, depression, smoking, levels of the hormone estradiol, race, age, and body mass index, the researchers found a significant association between anxiety and hot flashes. In fact, according to their findings, women with moderate anxiety face a three times greater risk of having hot flashes than women with a normal level of anxiety, while women with a high level of anxiety have five times the risk. What's more, women with higher anxiety levels reported having more frequent and more severe hot flashes than their non-anxious peers.

And while these findings don't necessarily mean that reducing anxiety could improve hot flashes, the researchers say their results warrant further research on whether treating anxiety, perhaps using antidepressants, could be helpful.

Participants in the second study were part of a larger, 10-year study on bone health. In that case, researchers at the University of Michigan followed women between the ages of 24 and 44 over a 10-year period. The women were asked to rate their menopausal symptoms on a scale of 1 (low) to 8 (high), and underwent annual blood tests measuring their levels of estradiol, follicle-stimulating hormone, and testosterone.

While the researchers found a hormonal link to some symptoms of menopause - hot flashes and sexual symptoms, in particular - they noted that smoking and having a high BMI seemed to be associated with more menopausal symptoms.

The strongest association for women who smoked or were overweight was with hot flashes, with current smokers reporting nearly twice as many hot flashes as nonsmokers, and women who were overweight reporting seven times more hot flashes that were "very bothersome" than women who were not overweight

Both smokers and obese women also reported earlier onset of hot flashes.

"The strong associations between smoking and body size with symptoms, particularly vasomotor symptoms (hot flashes), suggest that interventions directed at these personal characteristics might be effective in dampening their impact," wrote the study's authors.


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