Hot flashes can be debilitating for more than 50 percent
of menopausal women, said Dr. Taraneh Shirazian, an assistant professor of
obstetrics, gynecology and reproductive science at the Icahn School of Medicine
at Mount Sinai Hospital in New York City. About one-third of menopausal women
experience more than 10 hot flashes a day, and she added that hot flashes are
more common in obese women.
Another expert, Dr. Jill Rabin, co-chief of ambulatory
care and women's health programs at North Shore-LIJ Health System in New Hyde
Park, N.Y., said estrogen can also be produced in fat tissue.
Rabin said she has found that obese and overweight women
have, in general, more severe and more frequent hot flash symptoms.
"They have a harder time with the menopausal
transition," she said. "It may be the extra fat that makes heat
dissipation more difficult."
Connecting the results of this study and others similar
to it, experts have proposed two different explanations. The first is that fat
could be acting as an insulator. Excess adiposity could make heat dissipation
harder for your body. The second is that overweight and obese women may suffer
from recurrent diet-binge or yo-yo diet cycles. This back-and-forth can impact
your body's estrogen levels, making it harder for your hypothalamus to regulate
your internal temperature.
These findings were supported by other similar studies,
but, surprisingly not reinforced by others. The long lasting clarification has
been received from the recent study, performed at UC Davis, which suggested
that greater weight increases the likelihood of night sweats and hot flashes
during early stages of the menopause transition but reduces those symptoms
throughout menopause and beyond.
Thus, the study clarified mixed results from previous
research indicating that higher weight was both a prevention and potential
cause of hot flashes and night sweats, also known as vasomotor symptoms, which
affect up to 80 percent of menopausal women and are a major reason for doctors'
office visits.
"The relationship between weight and these symptoms
differs depending on the timing," said lead author Ellen Gold, a UC Davis
professor of public health sciences and women's health researcher.
"It's possible that the greater heat insulation
provided by excess weight predisposes women to these symptoms early in the
menopause transition, when the ovaries are still producing estrogen and women
are still menstruating," Gold said. "Higher estrogen production that
occurs with higher body fat plays a more influential role and becomes
protective later -- after the final menstrual period and when estrogen
production by the ovaries is greatly reduced."
In conducting the study, Gold and her colleagues used
data from the Study of Women's Health Across the Nation, or SWAN, a
longitudinal, multicenter study of more than 3,000 women aged 42 to 52 years
from five racial/ethnic groups.
During annual visits over the course of 10 years,
participants were measured for body mass index (BMI) and responded to questions
about their experiences with frequently occurring menopausal symptoms. Those
undergoing treatments that could trigger or reduce vasomotor symptoms were
excluded.
The longitudinal results showed that being obese, or
having a BMI greater than 30, was significantly related to increased occurrence
of vasomotor symptoms in the premenopausal or early perimenopausal stage, when
women were still menstruating but periods may have started to become somewhat
irregular. Being obese, however, was negatively associated with these symptoms
during later stages of menopause, when periods were 3 to 11 months apart or had
ceased. Changes in weight during either stage did not alter the outcomes.
The results suggest that maintaining a healthy weight
just prior to and at the onset of the menopause transition could be helpful for
reducing hot flashes and night sweats, but some excess weight late in the
transition or after the final menstrual period may be protective.
While the study benefited from a large, diverse study
sample, Gold said that much still needs to be learned about these frequent
menopause symptoms.
"We really need additional research on the
underlying biologic mechanisms by which weight and women's circulating hormone
levels interact to help us develop safe and effective preventive strategies for
hot flashes and night sweats," Gold said.
The outline of the study results may be quote comforting
to many women –rushing to drop your weight drastically may cause you by
intensification of the unwanted hot flashes and night sweats symptoms of your
menopausal life stage.
Sources and
Additional Information:
