According to conventional medical wisdom, menopause-related hot flashes fade away after six to 24 months. Not so, says a new study of women going through menopause. Hot flashes last, on average, for about seven years and may go on for 11 years or more.
The hormonal roller coaster that comes with the end of a woman’s childbearing years can trigger a range of symptoms. Up to 80% of women going through menopause experience hot flashes. Hot flashes, also known as vasomotor symptoms, are often described as a sudden sensation of heat in the chest, face, and head followed by flushing, perspiration, and sometimes chills. When a hot flash occurs during sleep, it can be accompanied by a drenching sweat. Such night sweats make it difficult to get a good night’s rest.
The new estimates of the duration of these symptoms come from the Study of Women’s Health Across the Nation (SWAN), a long-term study of women of different races and ethnicities who are in the menopausal transition. They were published last week in JAMA Internal Medicine.
“The data from this study confirm what many women already know firsthand. Hot flashes can go on for years and take a toll on a woman’s health and well-being,” says Dr. JoAnn Manson, professor of women’s health at Harvard Medical School and professor of epidemiology at Harvard School of Public Health.
The SWAN researchers found that some women are more likely to deal with long-term hot flashes than others. Women who had their first hot flashes before their menstrual periods ended had hot flashes for an average of nine to 10 years. When hot flashes didn’t start until after the last menstrual period, the average duration was only about three and a half years. But even on the short end of the spectrum, that’s a long time to deal with hot flashes.
Women in the SWAN study who experienced hot flashes for a longer time tended to be current or former smokers, overweight, stressed, depressed, or anxious. Ethnicity also played a role. African American women reported the longest duration of hot flashes (averaging more than 11 years), while Japanese and Chinese women had hot flashes for about half that time.
The “reality check” the SWAN study provides on hot flashes should encourage women to seek solutions. If hot flashes are really bothering you, don’t put up with them. Talk with your doctor about treatment options.
One of the most common treatments is estrogen-based hormone therapy, though it comes with several downsides. “While hormone therapy is very effective at relieving hot flashes, longer-term treatment carries an increased risk for breast cancer, and women at older ages have higher risks of stroke, blood clots, and other health problems. So it’s important that women explore a full range of treatment options — especially women likely to have persistent hot flashes,” advises Dr. Manson.
Several non-hormonal medications can also provide relief from hot flashes. These include some types of antidepressants, some drugs commonly prescribed for nerve pain, and some high blood pressure medications. As with any medication, it’s best to opt for the lowest dose that effectively relieves your symptoms, and to take it for the shortest amount of time possible.
For some women, self-help measures can help ease hot flashes. These include deep-breathing exercises when a hot flash starts; dressing in layers; lowering the thermostat; staying away from caffeine, alcohol, hot beverages, and spicy foods; stress reduction techniques like meditation and mindfulness; and doing your best to stay cool in general.
A free mobile app called MenoPro, recently developed by Dr. Manson and her colleagues at the North American Menopause Society, helps women understand their treatment options and work with their healthcare providers to find the best approach for them. The app is currently available for iPhones and iPads. More information is available at the North American Menopause Society website.
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