Hormone variability and hot flash experience: Results from the midlife women's health study

Catheryne Chiang, Lisa Gallicchio, Howard Zacur, Sue Miller, Jodi A Flaws, Rebecca Lee Smith

Research output: Contribution to journalArticle

Abstract

Objective: Hot flashes are believed to be related to hormonal changes. However, the relationship between hormonal fluctuations and hot flashes has not been studied. The objective of this study is to determine hormone measurement summaries that best explain the incidence of hot flashes in midlife women. Study design: In a cohort study of 798 midlife women over 1–7 years, women provided 4 weekly blood samples annually and completed a survey detailing life history, ongoing behaviors, and menopausal symptoms. Estradiol, progesterone, and testosterone were measured in all serum samples. Annual summary variables of each hormone were median, mean, maximum, minimum, variance, and range. The association of these values with hot flashes was assessed using multivariable logistic regression and Bayesian network analysis, controlling for smoking history and menopausal status. Main outcome measures: Hot flash incidence, severity, and frequency. Results: For most outcomes, the best-fit model included progesterone variability; increased progesterone variance or range was correlated with decreased hot flash frequency (OR = 0.82, 95% CI = 0.74–0.91) and severity (OR = 0.82, 95% CI = 0.77-0.88). In the Bayesian network model, the maximum estradiol value was negatively correlated with many outcomes (OR for hot flashes = 0.68). Relationships between progesterone variability, maximum estradiol level, maximum progesterone level, and hot flashes indicate that the effects of progesterone variance on hot flash outcomes are likely mediated through progesterone's relationship with maximum estradiol level. Conclusions: Variability of progesterone, as opposed to mean values, should be used as an indicator of risk of hot flashes in midlife women.

LanguageEnglish (US)
Pages1-7
Number of pages7
JournalMaturitas
Volume119
DOIs
StatePublished - Jan 1 2019

Fingerprint

Hot Flashes
Women's Health
Progesterone
Hormones
Estradiol
Bayesian networks
Electric network analysis
Bayes Theorem
Incidence
Testosterone
Logistics
Blood
Cohort Studies
Logistic Models
Smoking
History
Outcome Assessment (Health Care)

Keywords

  • Estradiol
  • Hot flashes
  • Menopause
  • Progesterone

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Obstetrics and Gynecology

Cite this

Hormone variability and hot flash experience : Results from the midlife women's health study. / Chiang, Catheryne; Gallicchio, Lisa; Zacur, Howard; Miller, Sue; Flaws, Jodi A; Smith, Rebecca Lee.

In: Maturitas, Vol. 119, 01.01.2019, p. 1-7.

Research output: Contribution to journalArticle

Chiang, Catheryne ; Gallicchio, Lisa ; Zacur, Howard ; Miller, Sue ; Flaws, Jodi A ; Smith, Rebecca Lee. / Hormone variability and hot flash experience : Results from the midlife women's health study. In: Maturitas. 2019 ; Vol. 119. pp. 1-7.
@article{606965dfde02421389065222719746f4,
title = "Hormone variability and hot flash experience: Results from the midlife women's health study",
abstract = "Objective: Hot flashes are believed to be related to hormonal changes. However, the relationship between hormonal fluctuations and hot flashes has not been studied. The objective of this study is to determine hormone measurement summaries that best explain the incidence of hot flashes in midlife women. Study design: In a cohort study of 798 midlife women over 1–7 years, women provided 4 weekly blood samples annually and completed a survey detailing life history, ongoing behaviors, and menopausal symptoms. Estradiol, progesterone, and testosterone were measured in all serum samples. Annual summary variables of each hormone were median, mean, maximum, minimum, variance, and range. The association of these values with hot flashes was assessed using multivariable logistic regression and Bayesian network analysis, controlling for smoking history and menopausal status. Main outcome measures: Hot flash incidence, severity, and frequency. Results: For most outcomes, the best-fit model included progesterone variability; increased progesterone variance or range was correlated with decreased hot flash frequency (OR = 0.82, 95{\%} CI = 0.74–0.91) and severity (OR = 0.82, 95{\%} CI = 0.77-0.88). In the Bayesian network model, the maximum estradiol value was negatively correlated with many outcomes (OR for hot flashes = 0.68). Relationships between progesterone variability, maximum estradiol level, maximum progesterone level, and hot flashes indicate that the effects of progesterone variance on hot flash outcomes are likely mediated through progesterone's relationship with maximum estradiol level. Conclusions: Variability of progesterone, as opposed to mean values, should be used as an indicator of risk of hot flashes in midlife women.",
keywords = "Estradiol, Hot flashes, Menopause, Progesterone",
author = "Catheryne Chiang and Lisa Gallicchio and Howard Zacur and Sue Miller and Flaws, {Jodi A} and Smith, {Rebecca Lee}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.maturitas.2018.10.007",
language = "English (US)",
volume = "119",
pages = "1--7",
journal = "Maturitas",
issn = "0378-5122",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Hormone variability and hot flash experience

T2 - Maturitas

AU - Chiang, Catheryne

AU - Gallicchio, Lisa

AU - Zacur, Howard

AU - Miller, Sue

AU - Flaws, Jodi A

AU - Smith, Rebecca Lee

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Hot flashes are believed to be related to hormonal changes. However, the relationship between hormonal fluctuations and hot flashes has not been studied. The objective of this study is to determine hormone measurement summaries that best explain the incidence of hot flashes in midlife women. Study design: In a cohort study of 798 midlife women over 1–7 years, women provided 4 weekly blood samples annually and completed a survey detailing life history, ongoing behaviors, and menopausal symptoms. Estradiol, progesterone, and testosterone were measured in all serum samples. Annual summary variables of each hormone were median, mean, maximum, minimum, variance, and range. The association of these values with hot flashes was assessed using multivariable logistic regression and Bayesian network analysis, controlling for smoking history and menopausal status. Main outcome measures: Hot flash incidence, severity, and frequency. Results: For most outcomes, the best-fit model included progesterone variability; increased progesterone variance or range was correlated with decreased hot flash frequency (OR = 0.82, 95% CI = 0.74–0.91) and severity (OR = 0.82, 95% CI = 0.77-0.88). In the Bayesian network model, the maximum estradiol value was negatively correlated with many outcomes (OR for hot flashes = 0.68). Relationships between progesterone variability, maximum estradiol level, maximum progesterone level, and hot flashes indicate that the effects of progesterone variance on hot flash outcomes are likely mediated through progesterone's relationship with maximum estradiol level. Conclusions: Variability of progesterone, as opposed to mean values, should be used as an indicator of risk of hot flashes in midlife women.

AB - Objective: Hot flashes are believed to be related to hormonal changes. However, the relationship between hormonal fluctuations and hot flashes has not been studied. The objective of this study is to determine hormone measurement summaries that best explain the incidence of hot flashes in midlife women. Study design: In a cohort study of 798 midlife women over 1–7 years, women provided 4 weekly blood samples annually and completed a survey detailing life history, ongoing behaviors, and menopausal symptoms. Estradiol, progesterone, and testosterone were measured in all serum samples. Annual summary variables of each hormone were median, mean, maximum, minimum, variance, and range. The association of these values with hot flashes was assessed using multivariable logistic regression and Bayesian network analysis, controlling for smoking history and menopausal status. Main outcome measures: Hot flash incidence, severity, and frequency. Results: For most outcomes, the best-fit model included progesterone variability; increased progesterone variance or range was correlated with decreased hot flash frequency (OR = 0.82, 95% CI = 0.74–0.91) and severity (OR = 0.82, 95% CI = 0.77-0.88). In the Bayesian network model, the maximum estradiol value was negatively correlated with many outcomes (OR for hot flashes = 0.68). Relationships between progesterone variability, maximum estradiol level, maximum progesterone level, and hot flashes indicate that the effects of progesterone variance on hot flash outcomes are likely mediated through progesterone's relationship with maximum estradiol level. Conclusions: Variability of progesterone, as opposed to mean values, should be used as an indicator of risk of hot flashes in midlife women.

KW - Estradiol

KW - Hot flashes

KW - Menopause

KW - Progesterone

UR - http://www.scopus.com/inward/record.url?scp=85055754806&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055754806&partnerID=8YFLogxK

U2 - 10.1016/j.maturitas.2018.10.007

DO - 10.1016/j.maturitas.2018.10.007

M3 - Article

VL - 119

SP - 1

EP - 7

JO - Maturitas

JF - Maturitas

SN - 0378-5122

ER -