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The recent medical journal article, "Prospective early adulthood risk factors for vasomotor symptoms in the Coronary Artery Risk Development in Young Adults study," explored how certain factors in early adulthood can predict the patterns and severity of symptoms related to menopause later in life. This study, conducted by Dr. Catherine Kim and her colleagues, aimed to identify early warning signs for vasomotor symptoms (VMS), which include hot flashes and night sweats that are commonly experienced during menopause.
Vasomotor symptoms can significantly impact the quality of life and work productivity for women in midlife, affecting nearly 80% of them, half of whom experience moderate to severe symptoms. The study used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which is a long-term, ongoing investigation into cardiovascular disease risk spanning from young adulthood to approximately 60 years of age.
This particular analysis focused on a subset of 1,966 women who had reported their experience with VMS at least three times between the CARDIA study's 15th year and the 35th year. The researchers sought to determine the relationship between early adult life factors and the trajectory of VMS over two decades.
Their findings disclosed that VMS tends to follow distinct patterns: minimal symptoms, increasing symptoms over time, and persistent symptoms. Several factors identified at the start of the study (when participants were aged 18-30) were linked to persistent VMS. These included being of Black race, having less than a high school education, experiencing depressive symptoms, suffering from migraines, smoking cigarettes, and having undergone a hysterectomy by the 15th year. For increasing VMS over time, Black race and lower body mass index were notable risk factors.
Additional factors contributing to bothersome VMS included thyroid disease; however, thyroid disease did not correlate with the persistence of VMS over time. The authors noted that these associations persisted among women regardless of race and whether they had undergone a hysterectomy or not.
The study implies that by paying attention to migraines, depressive symptoms, and other factors during early adulthood, it might be possible to predict and manage VMS later in life. This could potentially lead to more effective therapies and interventions to address these symptoms, which are often under-treated due to concerns about the perceived risks associated with existing therapies.
By highlighting the importance of the social determinants of health, tobacco use, and obesity, as well as the psychiatric and neurological conditions as potential predictors for persistent and increasing VMS, the research suggests that women and healthcare providers might benefit from early consideration of these factors. This proactive approach could assist in better managing or possibly preventing the onset of bothersome VMS that arise during menopause.
The study outcomes emphasize that particular life experiences and health metrics in early adulthood can have long-standing effects on women’s health. This reinforces the need for early intervention and the importance of broadening the scope of women’s health research to include younger populations when considering long-term health outcomes such as menopausal symptoms.
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References
Kim, Catherine MD, MPH1; Schreiner, Pamela J. PhD2; Yin, Zhe MS3; Whitney, Rachael PhD4; Sidney, Stephen MD, MPH5; Ebong, Imo MD6; Levine, Deborah A. MD, MPH4. Migraines, vasomotor symptoms, and cardiovascular disease in the Coronary Artery Risk Development in Young Adults study. Menopause 31(3):p 202-208, March 2024. | DOI: 10.1097/GME.0000000000002311