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Revisiting the Duration of Vasomotor Symptoms of Menopause: A Meta-Analysis

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Abstract

Background

Treatment decisions about menopause are predicated on a transient duration of vasomotor symptoms. However, evidence supporting a specific duration is weak.

Objective

To estimate the natural progression of vasomotor symptoms during the menopause transition by systematically compiling available evidence using meta-analytic techniques.

Data Sources

We searched MEDLINE, hand searched secondary references in relevant studies, book chapters, and review papers, and contacted investigators about relevant published research.

Review Methods

English language, population-based studies reporting vasomotor symptom prevalence among women in menopausal transition in time intervals based on years to or from final menstrual period were included. Two reviewers independently assessed eligibility and quality of studies and extracted data for vasomotor symptom prevalence.

Results

The analyses included 10 studies (2 longitudinal, 8 cross sectional) with 35,445 participants. The percentage of women experiencing symptoms increased sharply in the 2 years before final menstrual period, peaked 1 year after final menstrual period, and did not return to premenopausal levels until about 8 years after final menstrual period. Nearly 50% of all women reported vasomotor symptoms 4 years after final menstrual period, and 10% of all women reported symptoms as far as 12 years after final menstrual period. When data were examined according to symptom severity (‘any’ vs. ‘bothersome’), bothersome symptoms peaked about 1 year earlier and declined more rapidly than symptoms of any severity level.

Conclusions

Our findings suggest a median symptom duration of about 4 years among symptomatic women. A longer symptom duration may affect treatment decisions and clinical guidelines. Further prospective, longitudinal studies of menopausal symptoms should be conducted to confirm these results.

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Acknowledgements

This work was supported by the Agency for Healthcare, Research, and Quality (AHRQ) 2R01 HS013329-04A1. An earlier version was presented at the Society for Medical Decision Making Annual Meeting, October 2007. We would like to thank Nancy Avis, Ph.D. (Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC), Janet Guthrie, M.Sc., Dip. Ed, Ph.D. (Center for Women’s Health, University of Melbourne, Australia), and Martha Hickey, M.D. (School of Women’s and Infants’ Health, University of Western Australia, Australia) for their thoughtful reviews of this manuscript.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Department of Behavioral and Preventive Medicine, Brown Medical School, Providence, RI, USA

    Mary C. Politi Ph.D

  2. Department of General Internal Medicine, Brown Medical School, Providence, RI, USA

    Mark D. Schleinitz M.D., M.S.

  3. Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, USA

    Nananda F. Col M.D., M.P.P., M.P.H., F.A.C.P.

Authors
  1. Mary C. Politi Ph.D
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  2. Mark D. Schleinitz M.D., M.S.
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  3. Nananda F. Col M.D., M.P.P., M.P.H., F.A.C.P.
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Corresponding author

Correspondence to Mary C. Politi Ph.D.

Appendices

Appendix A

Quality assessment based on the Newcastle-Ottawa Quality Assessment Scale

Table 2  
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Appendix B

Characteristics of studies with vague menopausal staging criteria

Table 3  
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Politi, M.C., Schleinitz, M.D. & Col, N.F. Revisiting the Duration of Vasomotor Symptoms of Menopause: A Meta-Analysis. J GEN INTERN MED 23, 1507–1513 (2008). https://doi.org/10.1007/s11606-008-0655-4

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  • DOI: https://doi.org/10.1007/s11606-008-0655-4

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