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More Body Fat = More Hot Flashes

Another benefit to being lean

During late perimenopause and the postmenopausal years, most women experience vasomotor symptoms (hot flashes and night sweats) resulting in overall impairment in quality of life. These symptoms respond to estrogen treatment; moreover, endogenous estrogen levels increase with adiposity. Conventional wisdom has held that vasomotor symptoms are more common in slender women than in overweight or obese women; however, this assumption has not been supported by data published during the last 12 years. As part of the Study of Women’s Health Across the Nation, investigators used bioelectric impedance analysis to measure adiposity in an ethnically diverse cohort of women (age range at baseline, 42–52) with intact uteri, at least one ovary, and no current hormone use. The authors also measured reproductive hormone levels and evaluated occurrence and frequency of vasomotor symptoms reported by women at their sixth annual study visit.

Overall, 59% of the women reported vasomotor symptoms. The general mean percent body fat was 37.9%, with African Americans (42.5%) and Caucasians (38.1%) having higher percentages than Japanese (32.1%) and Chinese (31.8%) women. In models controlling for age, menopausal status, race and ethnicity, education, parity, smoking, hormone use, and anxiety symptoms, higher percent body fat was associated with a greater chance of reporting vasomotor symptoms. For each standard deviation increase in adiposity, the odds ratio for reporting vasomotor symptoms was 1.14 (P<0.05). In an analysis accounting for follicle-stimulating hormone and estradiol levels, the relation between adiposity and reported vasomotor symptoms persisted.

Comment: That higher adiposity was associated with vasomotor symptoms supports a thermoregulatory model of vasomotor symptoms, in which adipose tissue (which has greater insulating properties than other tissues) inhibits heat dissipation. In the long term, this information might help in the development of innovative approaches for treating hot flashes. For now, this report provides yet another reason for overweight women to shed pounds.

— Andrew M. Kaunitz, MD

Published in Journal Watch Women's Health February 21, 2008

Citation(s):

Thurston RC et al. Adiposity and reporting of vasomotor symptoms among midlife women: The Study of Women’s Health Across the Nation. Am J Epidemiol 2008 Jan 1; 167:78.

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