As hot flash severity rises, productivity and quality of life may fall
FRIDAY, March 1, 2013 (HealthDay News) -- Women who suffer severe hot flashes during menopause may be less productive on the job and have a lower quality of life, a new study suggests.
The study, by researchers from the drug maker Pfizer, Inc., is based on a survey of nearly 3,300 U.S. women aged 40 to 75. Overall, women who reported severe hot flashes and night sweats had a dimmer view of their well-being. They also were more likely than women with milder symptoms to say the problem hindered them at work.
The cost of that lost work productivity averaged more than $6,500 over a year, the researchers estimated. On top of that, they said, women with severe hot flashes spent more on doctor visits -- averaging almost $1,000 in menopause-related appointments.
Pfizer researcher Jennifer Whiteley and her colleagues reported the results online Feb. 11 in the journal Menopause.
It's not surprising that women with severe hot flashes would visit the doctor more often, or report a bigger impact on their health and work productivity, said Dr. Margery Gass, a gynecologist and executive director of the North American Menopause Society.
But she said the new findings put some numbers to the issue. "What's helpful about this is that the authors tried to quantify the impact," Gass said, adding that it's always good to have hard data on how menopause symptoms affect women's lives.
For women themselves, the findings give reassurance that the effects they perceive in their lives are real. "This validates the experiences they are having," Gass said.
Another gynecologist who reviewed the study pointed out many limitations, however.
The research was based on an Internet survey, so the women who responded are a "self-selected" bunch, said Dr. Michele Curtis, an obstetrician and gynecologist in Houston.
And since it was a one-time survey, Curtis said, it provides only a snapshot of the women's perceptions at that time. "What if they were having a bad day? Or a good day?" she said.
It's also hard to know for sure that hot flashes were the cause of women's less-positive perceptions of their own health.
"This tells us that bad hot flashes are a marker for feeling unhappy," Curtis said. "But are they the cause?"
Still, she commended the researchers for trying to estimate the impact of hot flashes with the data they had. "It's an interesting study, and these are important questions," Curtis said.
Like Gass, Curtis said the results also validate women's experiences. "You're not crazy for feeling bad," she said.
The findings are based on nearly 3,300 women. Most said they either had no hot flashes and night sweats, or mild symptoms. But almost 500 said they had moderate symptoms, while nearly 150 rated them as severe.
One-quarter of employed women with severe symptoms said the problem hindered them at work, compared with just 4 percent of women with mild hot flashes and 14 percent of those with moderate ones. Curtis pointed out, however, that the percentages are based on small numbers: just 43 women with severe hot flashes were employed.
When it came to day-to-day activities, almost one-third of women with severe hot flashes felt held back, versus 6 percent with mild symptoms and 17 percent with moderate ones.
The good news is there are ways to make your hot flashes less frequent or less intense. For severe symptoms, Curtis said, the most effective treatment is hormone therapy -- usually a combination of estrogen and progestin. For now, it's also the only treatment approved by the U.S. Food and Drug Administration specifically for easing hot flashes.
But doctors and patients have been wary of hormones ever since a U.S. study a decade ago linked the therapy to increased risks of blood clots, heart attack, stroke and breast cancer. The general advice now is for women with hot flashes to take hormones at the lowest dose and for the shortest time possible.
For women who cannot or do not want to take hormones, there are other options. Gass noted that some antidepressants have been found to help relieve hot flashes. Certain blood pressure drugs and anti-seizure medications also are sometimes prescribed.
If your menopause symptoms are milder, some lifestyle changes may be enough, including turning down the thermostat at night or dressing in layers so you can remove some when you feel a hot flash coming on, Gass said.
If you need more relief, though, Gass recommended talking to your doctor about your options.
Curtis said it's also important to be sure your hot flashes are the result of menopause, since other conditions -- most commonly an overactive thyroid gland -- can cause the symptoms too.
Study funder Pfizer markets drugs used to treat menopause symptoms and depression.
Learn more about menopause from the U.S. Department of Health and Human Services (http://womenshealth.gov/menopause/menopause-basics/index.html ).
SOURCES: Margery Gass, M.D., executive director, North American Menopause Society, Mayfield Heights, Ohio; Michele Curtis, M.D., obstetrician/gynecologist, Houston; Feb. 11, 2013, Menopause, online