Factors Associated With The Intensity Of Hot Flashes In Climacteric Women [fatores Associados à Intensidade Das Ondas De Calor Em Mulheres Em Climatério]

OBJECTIVE. To identify factors associated with the intensity of hot flashes in 334 climacteric women living in Campinas, São Paulo, Brasil. METHODS. Secondary analysis of a data bank of a descriptive cross-sectional population-based study. Selection of 334 women reporting hot flashes aged 45-60 years was carried out through cluster sampling. Data were collected by home interviews using a structured, pre-tested questionnaire provided by the International Health Foundation/International Menopause Society and by the North American Menopause Society and adapted by the authors. Intensity of hot flashes was measured using the circulatory index. The variables analyzed were age, use of contraceptive methods and hormonal therapy, tubal ligation, body mass index, menopausal status, time since menopause, hysterectomy, bilateral oophorectomy and smoking. Statistical analysis was performed by using the median, absolute and relative frequencies according to the type of variable. The prevalence ratio (PR) was used to measure association. Bivariate analysis and multiple logistic regression with a 95% confidence interval (95% CI) were used to identify the factors associated with the intensity of hot flashes. RESULTS. Women with time since menopause of over 61 months (PR: 0.59; IC 95%: 0.39-0.88) had a significantly lower chance of presenting intense hot flashes while the antecedent of bilateral oophorectomy (PR: 1.95; IC 95%: 1.08-3.50) was significantly associated with the intensity of hot flashes. CONCLUSION. Both factors, time since menopause and bilateral oophorectomy, suggest hypoestrogenism as a common cause of more intense hot flashes. Women with these factors should receive specialized care to minimize the negative effects of hot flashes.526413418Kronenberg, F., Downey, J.A., Thermoregulatory physiology of menopausal hot flashes: A review (1987) Can J Physiol Pharmacol, 65, pp. 1312-1324Oldenhave, A., Jaszmann, L.J., Haspels, A.A., Everaerd, W.T., Impact of climacteric on well being (1993) Am J Obstet Gynecol, 168, pp. 772-780Pedro, A.O., Pinto-Neto, A.M., Costa-Paiva, L.H.S., Osis, M.J.D., Hardy, E.E., Síndrome do climatério: Inquérito populacional domiciliar em Campinas, SP (2003) Rev Saúde Publica, 37, pp. 735-742Li, C., Samsioe, G., Borgfeldt, C., Lidfeldt, J., Agardh, C.D., Nerbrand, C., Menopause-related symptoms: What are the background factors? A prospective population-based cohort study of Swedish women (The Women's Health in Lund Area study) (2003) Am J Obstet Gynecol, 189, pp. 1646-1653Sherman, S., Natural history of menopause studies and related efforts at the National Institute on Aging, NIH (2005) Climacteric medicine - where do we go, pp. 16-26. , Schneider HPG, Naftolin F, editors, London: Taylor & Francis;Dennerstein, L., Guthrie, J.R., Taffe, J.R., Lehert, P., Burger, H.G., (2005) Climacteric medicine: Where do we go, pp. 27-35. , Schneider HPG, Naftolin F, editors, London: Taylor & Francis;Santos-Sá, D., Pinto-Neto, A.M., Conde, D.M., Pedro, A.O., Oliveira, S.C.M., Costa-Paiva, L.H.S., Fatores associados às ondas de calor em mulheres climatéricas: Inquérito populacional domiciliar (2004) Rev Bras Ginecol Obstet, 26, pp. 765-771Boulet, M.J., Oddens, B.J., Lehert, P., Vemer, H.M., Visser, A., Climacteric and menopause in seven South-east Asian countries (1994) Maturitas, 19, pp. 157-176Jaszmann L. Epidemiology of climacteric and post-climacteric complaints. In: Van Keep PA, Lauritzen C, editors. Ageing and estrogens 3rd ed. Front Hormone Res.. 1973;2:22-34Burger, H.G., Dudley, E.C., Hopper, J.L., Groome, N., Guthrie, J.R., Green, A., Prospectively measured levels of serum follicle-stimulating hormone, estradiol, and the dimeric inhibins during the menopausal transition in a population-based cohort of women (1999) J Clin Endocrinol Metab, 84, pp. 4025-4030Kritz-Silverstein, D., Goldani Von Muhlen, D., Barret-Connor, E., Prevalence and clustering of menopausal symptoms in older women by hysterectomy and oophorectomy status (2000) J Womens Health Gender-Based Med, 9, pp. 747-755Campagnoli, C., Morra, G., Belforte, P., Belforte, L., Prelato Tousijn, L., Climacteric symptoms according to body weight in women of different socio-economic groups (1981) Maturitas, 3, pp. 279-287Erlik, Y., Meldrum, D.R., Judd, H.L., Estrogen levels in postmenopausal women with hot flashes (1982) Obstet Gynecol, 59, pp. 403-407Schwingl, P.J., Hulka, B.S., Harlow, S.D., Risk factors for menopausal hot flashes (1994) Obstet Gynecol, 84, pp. 29-34Whiteman, M.K., Staropoli, C., Langenberg, P., Mccarter, R., Kjerulff, K., Flaws, J.A., Smoking, body mass, and hot flashes in mid-life women (2003) Obstet Gynecol, 101, pp. 264-272Staropoli, C.A., Flaws, J.A., Bush, T.L., Moulton, A.W., Predictors of menopausal hot flashes (1998) J Womens Health, 7, pp. 1149-1155Avis, N.E., Crawford, S., Stellato, R., Longcope, C., Longitudinal study of hormone levels and depression among women transitioning trough menopause (2001) Climacteric, 4, pp. 243-249Cassidenti, D.L., Vijod, A.G., Vijod, M.A., Stanczyk, F.Z., Lobo, R.A., Short-term effects of smoking on the pharmacokinetic profiles of micronized estradiol in postmenopausal women (1990) Am J Obstet Gynecol, 163, pp. 1953-1960Barbieri, R.L., Mcshane, P.M., Ryan, K.J., Constituents of cigarette smoke inhibit human granulose cell aromatase (1986) Fertil Steril, 46, pp. 232-236Blumberg, G., Kaplan, B., Rabinerson, D., Goldman, G.A., Kitai, E., Neri, A., Women's attitudes towards menopause and hormone replacement therapy (1996) Int J Gynaecol Obstet, 54, pp. 271-277Pinto-Neto, A.M., Pedro, A.O., Hardy, E., Osis, M.J., Costa-Paiva, L.H., Martinez, E.Z., Caracterização das usuárias de terapia de reposição hormonal do Município de Campinas, São Paulo (2002) Cad Saude Publica, 18, pp. 121-12