Menopausal Hot Flashes Improve with Weight Loss Program

Hot flashes are a common concern of postmenopausal women, and adequate symptom control can be difficult to achieve. A new study shows that a weight loss program can help to decrease these troublesome symptoms.

Hot flashes are a symptom which occur due to low estrogen levels that are seen in menopause. They may last for a brief duration for some women, but for at least one third of women, symptoms persist for 5 years or more. Since we learned of the harms of hormone replacement therapy and no longer recommend it (due to the increased risk of breast cancer, heart disease, and blood clots), hot flashes have become more challenging to treat.

Interestingly, a number of studies have suggested that hot flashes worsen in both frequency and severity with increasing body mass index, though the reason for the association is not clear. With this background in mind, Huang and colleagues embarked on a study to determine whether a behavioral weight loss program would help to decrease symptoms of hot flashes amongst post menopausal women.

In this substudy of a larger randomized study looking at postmenopausal urinary incontinence, 154 women who reported menopausal hot flashes received either an intensive lifestyle and behavior change program designed to assist with weight loss, versus a structured education program. The intensive program included weekly meetings led by experts in nutrition, exercise, and behavior change, as well as instruction in following a reduced calorie meal plan. The control group received monthly sessions teaching about nutrition, exercise, and general health promotion.

The results of this study show that women in the intensive program lost more weight after 6 months (average 16.5 lb) than the control group (average 4.4 lb). As for hot flashes, the intensive group reported significantly greater improvement in flushing symptoms than the control group. Improvements in weight, body mass index, and waist circumference were associated with improvements in hot flash symptoms. Interestingly, however, self reported physical activity and caloric intake were not associated with an improvement in symptoms.

It remains unclear why overweight may increase the severity of hot flashes, or why weight loss may improve these symptoms; inflammatory chemicals secreted by fat tissue, neural changes, and psychosocial factors may all play a part.

I see two important messages from this study:

1. On balance, it seems that yet another health benefit to weight loss may be an improvement in menopausal hot flashes.

2. A more intensive lifestyle program, with more support and follow-up, provides better weight loss results than a less intensive program.