Wednesday Bubble: 10 is the loneliest number…

Posted by on May 11, 2011 in hot flash | 0 comments


I’m using this Bubble to burst a few illusions, such as hot flashes during menopause don’t actually last very long.

How about 10 years?!

Right now, one year for hot flashes to come and then go sounds pretty tempting, doesn’t it?

A few years ago, I wrote about a study in the journal Menopause that alluded to the fact that hot flashes were likely to last for five years or more. Just this week, I ran across another study in Obstetrics & Gynecology that adds another 5 years to the evidence. Yikes!

How long is long enough?

Clinical Guidelines suggest that hot flashes peak one year into menopause and for most women, last anywhere from six months to two years. So, why is popular opinion, if you will, being challenged in research circles?

Using data from the Penn Ovarian Aging Study, which followed and monitored women over a 13-year period, researchers evaluated moderate-to-severe hot flashes on average, every 9 months. The women did not report having hot flashes at the study’s start, but developed them between the first year and near the study’s end. During each assessment, interviews were conducted on overall health, height, weight, hip and waist measures were taken and blood samples collected (to evaluate hormone levels).  Menopausal status was also delineated by  five stages:

  • premenopausal (regular menstrual periods)
  • late premenopausal (cycle change of 7 days or more in either direction observed one time)
  • early transition (change of 7 days or more observed at least twice in a row)
  •  late transition (three to 11 months without a menstrual cycle)
  • postmenopausal

More than 90% of women in the study were pre or late premenopausal at the study’s start.

Unfortunately, the results of the study are not very promising. On average, the median duration of moderate to severe hot flashes was 10.2 years, with only 37% of women reporting that their hot flashes stopped during the study. However, researchers found a relationship between length of time and when hot flashes began. For example. hot flashes tended to last longer (i.e. more than 11 years) in women who reported their hot flashes started in the premenopausal or late premenopausal stage compared to women whose hot flashes began in the early transition (average 7 years) and late transition (average 4 years).

Age was also a factor as the median duration of hot flashes tended to be longest in women who started flashing before the age of 40. Most commonly, however, more than a third of women tended to have the worst flashes when they were between the ages of 45 and 49.  Other factors such as African American race and a body mass index less than 30 were also associated with having hot flashes for longer periods of time.

If you are wondering about the silver lining in this story, there actually is one. The researchers say that it may be a good idea to start addressing vasomotor symptoms like hot flashes in younger women who are starting to have irregular menstrual periods.  Because “traditional hormonal therapy may not be the ideal choice for this population, given, for example, the problems with breakthrough bleeding and the need for contraception,” other treatments need to be evaluated.

I’ve long espoused the value of taking steps to shut symptoms down sooner rather than later, which is why alternative strategies may be so useful. If duration of hot flashes last longer when they start a younger age, and it is recommended that hormonal therapy be used for the shortest period of time possible, it’s not a bad idea to speak to a health practitioner about incorporating things like black cohosh into a daily routine. As always, there’s no time like the present to start taking charge of your health and get ahead of the change.

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