Up to a quarter of women suffer a poorer quality of life because of hot flushes and night sweats associated with the menopause. Now the International Menopause Society (IMS) is marking World Menopause Day (18th October) with a new report* highlighting the problems associated with the menopause, and by calling for women and doctors to be more aware of the treatment possibilities for troubling menopausal symptoms.
The majority of women suffer from hot flushes or night sweats (also known as vasomotor symptoms or VMS) during the menopause. The exact numbers vary by culture, ethnic group, and individual health background, but on average 25% of women experience debilitating or distressing symptoms. These symptoms include depression, discomfort and embarrassment, causing real problems for women, their partners and their families. On average these symptoms may last 4 years, although some women are less troubled whereas some women have significant symptoms which are longer-lasting.
The IMS commissioned a multi-disciplinary comprehensive review of the evidence behind hot flushes and night sweats (published in the peer-reviewed journal Climacteric). As a result of the review, the IMS concludes that women should be less accepting of the problems caused by menopausal symptoms, and calls for women to be more proactive in asking for treatment.
Hot flushes are caused by dilation of the blood vessels and increased flow of blood to the trunk, head and neck. This can cause reddening of the skin, and sweating. Night sweats are hot flushes which take place during sleep, so disrupting sleep and causing fatigue and stress.
These symptoms can lead to physical discomfort, embarrassment, fatigue, and loss of confidence, often leading women to avoid social situations. The impact of hot flushes on quality of life varies with a variety of factors, including the frequency and duration of the flushes, a woman's lifestyle and how she views her symptoms. A woman may enter a 'vicious cycle', where the symptoms lead to problems in coping with her everyday life, which in turn leads to problems in coping with the symptoms.
The review concludes that Hormone Replacement Therapy (HRT) shows the best results in treating VMS, with up to 90% of symptoms being abolished within 3 months of starting the treatment. However, not all women can take HRT, and for them there may be alternatives such as SSRIs and other non hormonal medications as well as psychological methods of treatment (e.g. using cognitive behavioural therapy).
The IMS review cautions against the use of untested or unproven methods of counteracting VMS, and singles out 'bioidentical hormones' as an area of concern. Some techniques such as acupuncture have shown mixed results. Similarly, most relaxation therapies and yoga have not shown significant benefits.
IMS President, Dr Tobie de Villiers** (Cape Town, South Africa) said
"Too often the distressing symptoms associated with the menopause are not taken seriously enough. The stresses caused by these symptoms can have a significant effect on not only a woman's life, but also the lives of those close to her, over a period of years. A woman can't just "grin and bear it" - if only it were that simple. These are troubling symptoms caused by the menopause, which lead to physical and psychological problems in everyday life. Women need to realise that they don't need to put up with this. For most women there are ways of overcoming these problems, and a woman going through a difficult menopause should make sure that she talks this over with her doctor to find the best solution for her".
In a supporting statement, the International Osteoporosis Foundation (IOF) joined the International Menopause Society to urge women as well as health professionals to take action against menopausal symptoms.
“Millions of women around the world suffer silently and unnecessarily through the extreme discomfort and often debilitating symptoms associated with menopause,” said IOF CEO Patrice McKenney. “Postmenopausal women are also the highest risk group for osteoporosis. We urge women who are experiencing hot flushes, night sweats or other menopausal symptoms to discuss the problem with their doctors. There are effective treatments available that can significantly improve quality of life".
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