Moderate to severe hot flushes and other menopausal vasomotor symptoms severely affect women's sense of well-being, according to a cross-sectional study published in the August issue of Maturitas.

Women reported poorer psychological well-being, with greater symptoms of sweating, hot flashes, and night sweats, report Pragya Gartoulla, MSc, and colleagues from Monash University in Melbourne, Australia.

"That the independent adverse impact of moderate-severely bothersome [vasomotor symptoms] on wellbeing was as great as housing insecurity, and greater than that of obesity and being a carer, is a striking, and a previously unrecognised finding," the authors write.

"Our data also provides evidence that participation in paid and/or voluntary work has a positive impact on wellbeing and that the impact of being a carer is complex."

Gartoulla and colleagues analyzed data from 1524 Australian women, aged 40 to 65 years, after excluding women who were taking psychotropic medications, hormonal contraception, or replacement therapy from the original sample of 2020 women.

The researchers defined moderate-severely bothersome symptoms as a rating of more than 5 to 8 on an 8-point Likert scale for hot flushes, night sweats, and sweating. The Psychological General Wellbeing Index assessed women's levels of anxiety, depressed mood, positive well-being, self-control, general health, and vitality.

Nearly half the women (48.5%) reported any vasomotor symptoms, a quarter of whom (11.4% of the total sample) experienced moderate to severe symptoms. Before adjustment for confounders, moderate to severely bothersome vasomotor symptoms, housing insecurity, being single, being a carer, smoking, obesity, and being perimenopausal compared with being premenopausal were associated with poorer wellbeing scores.

In the overall analysis, moderate to severely bothersome vasomotor symptoms were still negatively associated with well-being (β = −8.17; 95% confidence interval [CI], −10.90 to −5.45) after adjustment for a wide range of confounders: age, body mass index, relationship status, residential education (metro or not), education, employment status, number of children, housing security, smoking status, alcohol consumption, and being a caregiver for a family member with special needs.

In addition, those with obesity (β = −5.46; 95% CI, −7.24 to −3.68), those who smoked (β = −3.47; 95% CI, −6.10 to −0.84), and those who were unpartnered (β = −2.80; 95% CI, −4.74 to −0.86) had lower well-being scores in the multivariate analysis. However, older age (β = 0.29; 95% CI, 0.16 - 0.42) and involvement in paid or volunteer work (β = 2.72; 95% CI, 0.61 to 4.82) were linked to higher psychological well-being scores.

"Work income is a determinant of housing, health and education and provides security through retirement savings, and self-esteem," write the authors. "Volunteer work also favorably contributes to social status and relationships, self-esteem, community engagement and protection from physical and psychosocial stress."

Meanwhile, housing status played a role in how vasomotor symptoms and being a caregiver related to one another, the authors found.

"A significant interaction term (p < 0.05) in the adjusted multivariate linear regression indicated that the relationship between psychological general wellbeing and carer status differed between the levels of housing security," Gartoulla and colleagues write. "For those with insecure housing, being a carer increased overall wellbeing by 5.55 points. For those with secure housing, being a carer reduced overall wellbeing by 3.61 points."

Less affluent women may be more likely to receive financial remuneration from the welfare system for being a caregiver, and this may explain why caregiver status is positively associated with psychological wellbeing only for women with insecure housing, the authors explain.

"The strength of the association between moderate-severely bothersome VMS and reduced wellbeing, in the context of other factors, is an important consideration for health practitioners caring for women at midlife, the authors conclude.

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