Feb 28, 2013

Severe Hot Flashes a Burden to Women, Society

Severe menopausal vasomotor symptoms (VMS) are significantly associated with lower work productivity, lower levels of health status, and greater use of healthcare resources.

Jennifer Whitely, EdD, from Pfizer Inc, New York City, and colleagues report results from the 2010 US National Health and Wellness Survey online February 11 in Menopause. The study adds to our understanding of the economic burden of VMS.

The authors analyzed data from 3267 women (age 40 – 75 years) who reported no history of menstrual bleeding or spotting for 1 year. The study included women with hysterectomies.

The retrospective survey asked women to recall 6 months of actions and symptoms. The authors then extrapolated those 6 months for a longer period. For example, if a patient visited a physician once during 6 months, the authors assumed that the patient would visit a physician twice in a year.

The authors identified 4 cohorts: no VMS (n = 1740), mild VMS (n = 931), moderate VMS (n = 462), and severe VMS (n = 134). Using these cohorts, the authors identified a relationship between severity of VMS and age, education level, comorbidity burden, and body mass index.

After controlling for demographic and health characteristics, the authors found that women who had severe and moderate VMS had lower mean health status scores when compared with women with no symptoms (P < .0001). In general, perceived health status decreased as the severity of VMS increased.

When comparing women with mild symptoms with those with severe symptoms, the authors documented a 20-point increase in the level of presenteeism, productivity loss, and activity impairment (Work Production and Activity Impairment questionnaire). The investigators defined “presenteeism” as the percentage of impairment resulting from VMS while at work. The annual costs associated with presenteeism and activity impairment were calculated to be US$1100 for the mild group and US$6500 for the severe group.

Approximately 40% of women experience hot flashes for more than 7 years, and up to 15% experience hot flashes for longer than 15 years. The survey found that the effects of VMS were especially significant for women whose symptoms lingered for many years.

Judith Volkar, MD, from the Cleveland Clinic in Ohio, discussed the research withMedscape Medical News. She acknowledged that the results are “not a terrible surprise for most OB-Gyns.” She explained that VMS really do severely affect a woman’s quality of life, elaborating that “it was nice that this was actually the first study to talk about how quality of life affects work productivity.” She sees this is an important addition to the medical conversation, “since everything in medicine is moving towards value-based purchasing.” Dr. Volkar was not involved in the study.

The study was conducted by Kantar Health and sponsored by Pfizer Inc. Dr. Whitely and 2 coauthors were employees and stock option holders of Pfizer Inc. The other authors and Dr. Volkar have disclosed no relevant financial relationships.

Menopause. Published online February 11, 2013. Abstract


— Lara C. Pullen, PhD


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