Journal List > J Korean Soc Menopause > v.19(2) > 1052103

Chun: The Relationship of Hot Flush to Other Menopausal Symptoms and Chronic Disease Related to Menopause


Hot flush is one of the most commonly reported symptoms during menopause and it is referred to as vasomotor symptoms along with night sweats. I have summarized the current available knowledge on the relationships between hot flush to other menopausal symptoms and the related chronic diseases to menopause in this article.


1. The North American Menopause Society. Treatment of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Menopause. 2004; 11:11–33.
2. Palacios S, Henderson VW, Siseles N, Tan D, Villaseca P. Age of menopause and impact of climacteric symptoms by geographical region. Climacteric. 2010; 13:419–428.
3. Stearns V, Ullmer L, López JF, Smith Y, Isaacs C, Hayes D. Hot flushes. Lancet. 2002; 360:1851–1861.
4. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins;2011.
5. Kronenberg F. Hot flashes: epidemiology and physiology. Ann N Y Acad Sci. 1990; 592:52–86. discussion 123-33.
6. Huang AJ, Grady D, Jacoby VL, Blackwell TL, Bauer DC, Sawaya GF. Persistent hot flushes in older postmenopausal women. Arch Intern Med. 2008; 168:840–846.
7. National Institutes of Health. National Institutes of Health State-of-the-Science Conference statement: management of menopause-related symptoms. Ann Intern Med. 2005; 142:1003–1013.
8. Choi H, Lee HK, Park HM. The Korean menopausal women's attitudes and awareness on menopause: results of Korean gallup epidemiologic survey on menopause and HRT. J Korean Soc Menopause. 2003; 9:36–43.
9. Avis NE, Crawford S, Stellato R, Longcope C. Longitudinal study of hormone levels and depression among women transitioning through menopause. Climacteric. 2001; 4:243–249.
10. Dennerstein L, Dudley EC, Hopper JL, Guthrie JR, Burger HG. A prospective population-based study of menopausal symptoms. Obstet Gynecol. 2000; 96:351–358.
11. Kim H, Choi YM. Non-hormonal management of vasomotor symptoms. J Korean Soc Menopause. 2007; 13:157–163.
12. Rossmanith WG, Ruebberdt W. What causes hot flushes? The neuroendocrine origin of vasomotor symptoms in the menopause. Gynecol Endocrinol. 2009; 25:303–314.
13. Rapkin AJ. Vasomotor symptoms in menopause: physiologic condition and central nervous system approaches to treatment. Am J Obstet Gynecol. 2007; 196:97–106.
14. Freedman RR. Pathophysiology and treatment of menopausal hot flashes. Semin Reprod Med. 2005; 23:117–125.
15. Deecher DC, Dorries K. Understanding the pathophysiology of vasomotor symptoms (hot flushes and night sweats) that occur in perimenopause, menopause, and postmenopause life stages. Arch Womens Ment Health. 2007; 10:247–257.
16. Sassarini J, Lumsden MA. Hot flushes: are there effective alternatives to estrogen? Menopause Int. 2010; 16:81–88.
17. Col NF, Guthrie JR, Politi M, Dennerstein L. Duration of vasomotor symptoms in middle-aged women: a longitudinal study. Menopause. 2009; 16:453–457.
18. Freeman EW, Sammel MD, Lin H, Gracia CR, Kapoor S, Ferdousi T. The role of anxiety and hormonal changes in menopausal hot flashes. Menopause. 2005; 12:258–266.
19. LeBlanc ES, Neiss MB, Carello PE, Samuels MH, Janowsky JS. Hot flashes and estrogen therapy do not influence cognition in early menopausal women. Menopause. 2007; 14:191–202.
20. Thurston RC, Joffe H. Vasomotor symptoms and menopause: findings from the Study of Women's Health across the Nation. Obstet Gynecol Clin North Am. 2011; 38:489–501.
21. Gold EB, Colvin A, Avis N, Bromberger J, Greendale GA, Powell L, et al. Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: study of Women's health across the nation. Am J Public Health. 2006; 96:1226–1235.
22. Gibson CJ, Thurston RC, Bromberger JT, Kamarck T, Matthews KA. Negative affect and vasomotor symptoms in the Study of Women's Health Across the Nation Daily Hormone Study. Menopause. 2011; 18:1270–1277.
23. Bromberger JT, Kravitz HM. Mood and menopause: findings from the Study of Women's Health Across the Nation (SWAN) over 10 years. Obstet Gynecol Clin North Am. 2011; 38:609–625.
24. Bromberger JT, Matthews KA, Schott LL, Brockwell S, Avis NE, Kravitz HM, et al. Depressive symptoms during the menopausal transition: the Study of Women's Health Across the Nation (SWAN). J Affect Disord. 2007; 103:267–272.
25. Freeman EW, Sammel MD, Lin H, Nelson DB. Associations of hormones and menopausal status with depressed mood in women with no history of depression. Arch Gen Psychiatry. 2006; 63:375–382.
26. Oppermann K, Fuchs SC, Donato G, Bastos CA, Spritzer PM. Physical, psychological, and menopause-related symptoms and minor psychiatric disorders in a community-based sample of Brazilian premenopausal, perimenopausal, and postmenopausal women. Menopause. 2012; 19:355–360.
27. Cohen LS, Soares CN, Vitonis AF, Otto MW, Harlow BL. Risk for new onset of depression during the menopausal transition: the Harvard study of moods and cycles. Arch Gen Psychiatry. 2006; 63:385–390.
28. Fuh JL, Wang SJ, Lee SJ, Lu SR, Juang KD. A longitudinal study of cognition change during early menopausal transition in a rural community. Maturitas. 2006; 53:447–453.
29. Sullivan Mitchell E, Fugate Woods N. Midlife Women's attributions about perceived memory changes: observations from the Seattle Midlife Women's Health Study. J Womens Health Gend Based Med. 2001; 10:351–362.
30. Balabanovic J, Ayers B, Hunter MS. Women's experiences of Group Cognitive Behaviour Therapy for hot flushes and night sweats following breast cancer treatment: an interpretative phenomenological analysis. Maturitas. 2012; 72:236–242.
31. Joffe H, Hall JE, Gruber S, Sarmiento IA, Cohen LS, Yurgelun-Todd D, et al. Estrogen therapy selectively enhances prefrontal cognitive processes: a randomized, double-blind, placebo-controlled study with functional magnetic resonance imaging in perimenopausal and recently postmenopausal women. Menopause. 2006; 13:411–422.
32. Maki PM, Drogos LL, Rubin LH, Banuvar S, Shulman LP, Geller SE. Objective hot flashes are negatively related to verbal memory performance in midlife women. Menopause. 2008; 15:848–856.
33. Greendale GA, Wight RG, Huang MH, Avis N, Gold EB, Joffe H, et al. Menopause-associated symptoms and cognitive performance: results from the study of Women's health across the nation. Am J Epidemiol. 2010; 171:1214–1224.
34. Holte A. Influences of natural menopause on health complaints: a prospective study of healthy Norwegian women. Maturitas. 1992; 14:127–141.
35. Hunter M. The south-east England longitudinal study of the climacteric and postmenopause. Maturitas. 1992; 14:117–126.
36. Avis NE, Brambilla D, McKinlay SM, Vass K. A longitudinal analysis of the association between menopause and depression. Results from the Massachusetts Women's Health Study. Ann Epidemiol. 1994; 4:214–220.
37. Baker A, Simpson S, Dawson D. Sleep disruption and mood changes associated with menopause. J Psychosom Res. 1997; 43:359–369.
38. Kuh DL, Wadsworth M, Hardy R. Women's health in midlife: the influence of the menopause, social factors and health in earlier life. Br J Obstet Gynaecol. 1997; 104:923–933.
39. Kravitz HM, Ganz PA, Bromberger J, Powell LH, Sutton-Tyrrell K, Meyer PM. Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause. 2003; 10:19–28.
40. Kravitz HM, Zhao X, Bromberger JT, Gold EB, Hall MH, Matthews KA, et al. Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. Sleep. 2008; 31:979–990.
41. Young T, Rabago D, Zgierska A, Austin D, Laurel F. Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the Wisconsin Sleep Cohort Study. Sleep. 2003; 26:667–672.
42. Freedman RR, Roehrs TA. Lack of sleep disturbance from menopausal hot flashes. Fertil Steril. 2004; 82:138–144.
43. Freedman RR, Roehrs TA. Sleep disturbance in menopause. Menopause. 2007; 14:826–829.
44. Thurston RC, Santoro N, Matthews KA. Are vasomotor symptoms associated with sleep characteristics among symptomatic midlife women? Comparisons of self-report and objective measures. Menopause. 2012; 19:742–748.
45. Rossouw JE, Prentice RL, Manson JE, Wu L, Barad D, Barnabei VM, et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA. 2007; 297:1465–1477.
46. Huang AJ, Sawaya GF, Vittinghoff E, Lin F, Grady D. Hot flushes, coronary heart disease, and hormone therapy in postmenopausal women. Menopause. 2009; 16:639–643.
47. Whiteman MK, Staropoli CA, Langenberg PW, McCarter RJ, Kjerulff KH, Flaws JA. Smoking, body mass, and hot flashes in midlife women. Obstet Gynecol. 2003; 101:264–272.
48. Cagnacci A, Cannoletta M, Palma F, Zanin R, Xholli A, Volpe A. Menopausal symptoms and risk factors for cardiovascular disease in postmenopause. Climacteric. 2012; 15:157–162.
49. van der Schouw YT, Grobbee DE. Menopausal complaints, oestrogens, and heart disease risk: an explanation for discrepant findings on the benefits of post-menopausal hormone therapy. Eur Heart J. 2005; 26:1358–1361.
50. Leal M, Díaz J, Serrano E, Abellan J, Carbonell LF. Hormone replacement therapy for oxidative stress in postmenopausal women with hot flushes. Obstet Gynecol. 2000; 95:804–809.
51. Sassarini J, Fox H, Ferrell W, Sattar N, Lumsden MA. Vascular function and cardiovascular risk factors in women with severe flushing. Clin Endocrinol (Oxf). 2011; 74:97–103.
52. Gast GC, Grobbee DE, Pop VJ, Keyzer JJ, Wijnands-van Gent CJ, Samsioe GN, et al. Menopausal complaints are associated with cardiovascular risk factors. Hypertension. 2008; 51:1492–1498.
53. Gast GC, Samsioe GN, Grobbee DE, Nilsson PM, van der Schouw YT. Vasomotor symptoms, estradiol levels and cardiovascular risk profile in women. Maturitas. 2010; 66:285–290.
54. Tuomikoski P, Ylikorkala O, Mikkola TS. Menopausal hot flushes and vascular health. Ann Med. 2011; 43:283–291.
55. Tuomikoski P, Mikkola TS, Hämäläinen E, Tikkanen MJ, Turpeinen U, Ylikorkala O. Biochemical markers for cardiovascular disease in recently postmenopausal women with or without hot flashes. Menopause. 2010; 17:145–151.
56. Yeboah J, Crouse JR, Hsu FC, Burke GL, Herrington DM. Brachial flow-mediated dilation predicts incident cardiovascular events in older adults: the Cardiovascular Health Study. Circulation. 2007; 115:2390–2397.
57. Iribarren C, Sidney S, Sternfeld B, Browner WS. Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. JAMA. 2000; 283:2810–2815.
58. Rumberger JA, Brundage BH, Rader DJ, Kondos G. Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc. 1999; 74:243–252.
59. Thurston RC, Sutton-Tyrrell K, Everson-Rose SA, Hess R, Powell LH, Matthews KA. Hot flashes and carotid intima media thickness among midlife women. Menopause. 2011; 18:352–358.
60. Bechlioulis A, Kalantaridou SN, Naka KK, Chatzikyriakidou A, Calis KA, Makrigiannakis A, et al. Endothelial function, but not carotid intima-media thickness, is affected early in menopause and is associated with severity of hot flushes. J Clin Endocrinol Metab. 2010; 95:1199–1206.
61. Thurston RC, Sutton-Tyrrell K, Everson-Rose SA, Hess R, Matthews KA. Hot flashes and subclinical cardiovascular disease: findings from the Study of Women's Health Across the Nation Heart Study. Circulation. 2008; 118:1234–1240.
62. Allison MA, Manson JE, Aragaki A, Langer RD, Rossouw J, Curb D, et al. Vasomotor symptoms and coronary artery calcium in postmenopausal women. Menopause. 2010; 17:1136–1145.
63. Lobo RA. Evaluation of cardiovascular event rates with hormone therapy in healthy, early postmenopausal women: results from 2 large clinical trials. Arch Intern Med. 2004; 164:482–484.
64. Szmuilowicz ED, Manson JE, Rossouw JE, Howard BV, Margolis KL, Greep NC, et al. Vasomotor symptoms and cardiovascular events in postmenopausal women. Menopause. 2011; 18:603–610.
65. Svartberg J, von Muhlen D, Kritz-Silverstein D, Barrett-Connor E. Vasomotor symptoms and mortality: the Rancho Bernardo Study. Menopause. 2009; 16:888–891.
66. Pines A. Vasomotor symptoms and cardiovascular disease risk. Climacteric. 2011; 14:535–536.
67. Rogers A, Eastell R. Circulating osteoprotegerin and receptor activator for nuclear factor kappaB ligand: clinical utility in metabolic bone disease assessment. J Clin Endocrinol Metab. 2005; 90:6323–6331.
68. Hanada R, Leibbrandt A, Hanada T, Kitaoka S, Furuyashiki T, Fujihara H, et al. Central control of fever and female body temperature by RANKL/RANK. Nature. 2009; 462:505–509.
69. Gast GC, Grobbee DE, Pop VJ, Keyzer JJ, Wijnands-van Gent CJ, Samsioe GN, et al. Vasomotor symptoms are associated with a lower bone mineral density. Menopause. 2009; 16:231–238.
70. Tural A, Yoldemir T, Erenus M. Assessment of bone mineral density should be considered earlier in perimenopausal women with vasomotor symptoms. Int J Gynaecol Obstet. 2009; 107:114–116.
71. Crandall CJ, Zheng Y, Crawford SL, Thurston RC, Gold EB, Johnston JM, et al. Presence of vasomotor symptoms is associated with lower bone mineral density: a longitudinal analysis. Menopause. 2009; 16:239–246.
72. Crandall CJ, Tseng CH, Crawford SL, Thurston RC, Gold EB, Johnston JM, et al. Association of menopausal vasomotor symptoms with increased bone turnover during the menopausal transition. J Bone Miner Res. 2011; 26:840–849.
73. von Mühlen DG, Soroko S, Kritz-Silverstein D, Barrett-Connor E. Vasomotor symptoms are not associated with reduced bone mass in postmenopausal women: the Rancho Bernardo Study. J Womens Health Gend Based Med. 2000; 9:505–511.
74. Huang Y, Malone KE, Cushing-Haugen KL, Daling JR, Li CI. Relationship between menopausal symptoms and risk of postmenopausal breast cancer. Cancer Epidemiol Biomarkers Prev. 2011; 20:379–388.
75. Schilling C, Gallicchio L, Miller SR, Langenberg P, Zacur H, Flaws JA. Genetic polymorphisms, hormone levels, and hot flashes in midlife women. Maturitas. 2007; 57:120–131.
76. Guthrie JR, Dennerstein L, Hopper JL, Burger HG. Hot flushes, menstrual status, and hormone levels in a population-based sample of midlife women. Obstet Gynecol. 1996; 88:437–442.
77. Erlik Y, Meldrum DR, Judd HL. Estrogen levels in postmenopausal women with hot flashes. Obstet Gynecol. 1982; 59:403–407.
78. Cuzick J, Sestak I, Cella D, Fallowfield L. Treatmentemergent endocrine symptoms and the risk of breast cancer recurrence: a retrospective analysis of the ATAC trial. Lancet Oncol. 2008; 9:1143–1148.
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