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Am Fam Physician. 2005;71(7):1421

Hot flashes are common among women during the perimenopausal period, and 50 percent of women who experience hot flashes have symptoms for at least five years. Although hormone therapy is effective in treating hot flashes, patients and physicians have responded to the risks associated with this therapy by seeking alternative treatments. In this study, Riley and colleagues sought to determine whether lifestyle factors (e.g., smoking, drinking, or being overweight) have an impact on hot flashes. If there is an association between these risk factors and vasomotor event occurrence and frequency, management of hot flashes may be possible by modifying the implicated lifestyle behaviors.

Eligible women were invited to participate in a yearlong randomized controlled trial of a menopausal risk-management program. Participants were administered a baseline survey that included a question about experience of bothersome hot flashes. Questions also addressed lifestyle behaviors that have been identified in previous studies as possible modulators of hot flashes. A statistical analysis divided subjects into perimenopausal and postmenopausal groups, with the latter group defined as women experiencing cessation of menses for at least 12 months or with a history of hysterectomy without oophorectomy and at least 55 years of age.

Of the 755 eligible women completing the survey, 468 women were perimenopausal and 287 were postmenopausal. Adjusted analysis showed that in this group, having a body mass index of at least 25 kg per m2 and an alcohol consumption of one to five drinks per week was positively associated with hot flashes. Of borderline significance in increasing hot flashes was multivitamin use. In postmenopausal women, only daily fat intake correlated with a decreased frequency of hot flashes, independent of body mass index.

These findings are similar to those of previous studies and help to show that modifiable risk factors for hot flashes are different in perimenopausal women and postmenopausal women. In perimenopausal women, lower body mass index and moderate alcohol consumption were associated with fewer bothersome hot flashes. An interaction was noted suggesting an increase of hot-flash symptoms in smokers who have depression, but there was no significant correlation between symptoms and smoking alone. The fact that the association between hot flashes and vitamin use was only borderline may reflect a tendency for women who have bothersome symptoms to try modulating these with vitamins, rather than any specific negative effect of vitamins. In postmenopausal women, only high dietary fat intake appeared to influence hot flashes.

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Copyright © 2005 by the American Academy of Family Physicians.

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