Differential Association of Modifiable Health Behaviors with Hot Flashes in Perimenopausal and Postmenopausal Women


  • Received from the Department of Ambulatory Care and Prevention (EHR, KK, MTC), Harvard Medical School, Harvard Pilgrim Health Care, Boston, Mass; Harvard Vanguard Medical Associates (EHR, MTC), Regenstrief Institute, Indiana University School of Medicine; and Health Services Research and Development Program (TSI), Roudebush VAMC, Indianapolis, Ind.

Address correspondence and requests for reprints to Dr. Riley: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, 6th Floor, Boston, MA 02215 (e-mail: erika_riley@harvardpilgrim.org).


OBJECTIVE:  To determine the association of modifiable factors, such as smoking, body mass index, and alcohol use, with hot flashes, and to ascertain whether the association with hot flashes varies by menopausal stage.

DESIGN:  A written survey completed by perimenopausal and postmenopausal women enrolling in a randomized, controlled trial of a menopause risk management program in 1999. Survey items included questions on demographics, health status, and health behaviors.

SETTING:  A Massachusetts-based health maintenance organization.

PATIENTS/PARTICIPANTS:  Female members, age 40 to 65, excluding women with chronic conditions precluding study participation, were randomly selected from an automated medical record system.

MEASUREMENTS AND MAIN RESULTS:  The majority of the 287 postmenopausal and 468 perimenopausal women participating in the study were white, college educated, and nonsmoking. Approximately 30% of both groups reported experiencing hot flashes. Separate multivariable logistic regression models were developed for perimenopausal and postmenopausal women to identify correlates of reporting any versus no hot flashes. After controlling for age, race, oral contraceptive use, hormone replacement therapy use, and depression, correlates of hot flashes in perimenopausal women were body mass index ≥25 kg/m2 (odds ration [OR], 2.00; 95% confidence interval [CI], 1.28 to 3.12) and alcohol use of 1 to 5 drinks per week (OR, 0.52; 95% CI, 0.31 to 0.86). The only significant correlate of hot flashes in the postmenopausal population was high dietary fat intake (OR, 0.35; 95% CI, 0.15 to 0.81).

CONCLUSION:  Although study respondents were from similiar sociodemographic groups and received their health care in the same health maintenance organization, modifiable factors associated with hot flashes were different for perimenopausal and postmenopausal women.