A new study in JAMA Internal Medicine shows that the severe disturbances associated with menopause primarily night sweats and hot flashes often last 7 years or more, and, in a cruel irony, the earlier these symptoms start, the more likely they are to last longer.
The authors, led by Dr. Nancy E. Avis of the Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, along with a number of investigators at several American medical centers, followed almost 1,500 women with severe vasomotor symptoms. They found that among that group, the average duration was 7.4 years.
That's much longer than the six months to two years long thought typical. It is also longer than the time limits many doctors put on treating the symptoms with hormones. The findings suggest a need for better, longer-lasting treatments, and they also should reassure some women that having these symptoms for year after year does not mean that there s anything wrong with them. In total, 4 out of 5 women experience some degree of menopausal symptoms.
If VSM (vasomotor symptoms) start while still menstruating, the problem may persist longer, on average almost 12 years; while if they start later, the duration on average was only 3.4 years.
The best treatment for VSM is hormone therapy: some combination of estrogen and progesterone, most often. This fell into disfavor ten-plus years ago with the publication of the Women s Health Initiative, which seemed to indicate that women on hormone replacement, especially older women on longer-term treatment, had a significantly increased risk for breast cancer. Subsequent analyses of these data showed much less cause for concern; we here at ACSH analyzed the data and came to the same conclusion: not that much for anyone to be worried about.
As the authors wrote: Women in menopause who have symptoms that seriously affect the quality of their lives should feel secure in taking HRT at the start of menopause and for as many years after as they must to control those symptoms. Any woman worried about her health and longevity should quit smoking before she quits hormones...
ACSH s Dr. Gil Ross added, The disturbing VMS of menopause can really ruin a woman s life. Even if there is a slightly increased risk of breast cancer, there is no other substitute for VMS that works as well. (The National Institute on Aging has these alternatives listed.) This is a decision a woman must make based on her distress from menopause vs. her concern about possibly raising her risk of breast cancer.
