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Vasomotor Symptoms Around Menopause Transition Predict Weight Gain

— Sleep problems responsible for some, but not all, changes in body weight

MedpageToday

ATLANTA -- High rates of hot flashes or night sweats during the menopause transition were tied to subsequent weight gain in a longitudinal cohort study reported here.

Women experiencing vasomotor symptoms that increased in frequency over the course of three visits had an average of 0.3% weight gain (P<0.01) and an absolute increase of 0.24 kilograms, reported Carolyn Gibson, PhD, of the University of California San Francisco.

Those who experienced more days of vasomotor symptoms also experienced a 0.3% increase in BMI and a 0.2% increase in waist circumference (P<0.01 and P<0.05, respectively), Gibson said in a presentation at the North American Menopause Society (NAMS) annual meeting.

"Increases in vasomotor symptom frequency and the onset of high frequency vasomotor symptoms were followed by statistically significant -- not huge, but some -- increases in weight, BMI, and particularly waist circumference," Gibson said. She added that this was the first study to find an independent relationship between vasomotor symptom frequency and weight gain.

"This was explained a bit -- but just a little bit -- by sleep," Gibson added, stating that mediation by simultaneous sleep problems contributed to no more than a quarter of the association between vasomotor symptoms and weight gain. Gibson also noted that menopausal status did not seem to affect this relationship.

Prior studies have consistently shown that higher body mass index, body fat, and waist circumference are all associated with an increased risk of hot flashes and night sweats, specifically within the perimenopausal period, Gibson said. In this study, Gibson and colleagues looked into the opposite relationship, assessing whether the increased frequency of days women experienced vasomotor symptoms, or onset of new symptoms, might predict weight gain.

Gibson's group obtained data from the , a longitudinal cohort project examining the health and menopause transition of U.S. women at midlife. Participants in SWAN attended visits for up to 10 years from 1995 to 2008, reporting their vasomotor symptoms, weight measures, sleep quality measures, and more.

In this analysis, the researchers included participants who had two lagged visits, measuring changes in weight across that time. At each visit, participants reported how many days in the past two weeks that they experienced hot flashes or night sweats, with 6 or more days of vasomotor symptoms indicating high frequency. Additionally, the investigators evaluated the relationship between cumulative exposure to vasomotor symptoms and long-term weight gain.

Overall, 2,361 women who attended more than 12,000 study visits were included in this analysis. Participants' mean age was 51, and 54% were in the premenopausal or early perimenopausal period. Just under half were white.

Rising frequency of hot flashes and night sweats over the course of three visits was associated with an absolute increase of 0.08 BMI points and 0.20 centimeters in waist circumference.

Onset of any new sleep problem was responsible for 7.3% to 10.5% of the association between weight gain and the increase of vasomotor symptom frequency, Gibson said. New sleep issues were responsible for 9.5% to 15.4% of the increase in high frequency vasomotor symptoms.

Long-term exposure to vasomotor symptoms was also associated with increased waist circumference over time, Gibson noted. Women reporting at least one recent day of vasomotor symptoms at each study visit over a period of 10 years experienced a 2.6% increase in waist circumference, an absolute increase of 2.14 centimeters. However, BMI did not increase significantly in this analysis (up 1.7%, P=0.06).

  • Amanda D'Ambrosio is a reporter on ֱ’s enterprise & investigative team. She covers obstetrics-gynecology and other clinical news, and writes features about the U.S. healthcare system.

Disclosures

This study was funded in part by Astellas Pharma.

Gibson's co-authors disclosed potential conflicts of interest with Medicus Economics and Astellas Pharma.

Primary Source

North American Menopause Society

Gibson C, et al "Association between vasomotor symptom frequency and weight gain in the Study of Women's Health Across the Nation (SWAN)" NAMS 2022; Abstract S-24.