The menoupase could last up to 14 years - far longer than previously thought - new research suggests. A major US study found that women with frequent hot flushes suffered them for an average of seven years, with some struggling with such symptoms and others, such as night sweats, for twice as long.
The findings are significant because hormone replacement therapy (HRT) to reduce such problems is normally recommended for a maximum of five years.
But the new study suggests women should be warned that symptoms can last almost three times as long.
The study also found that the earlier women started suffering menopause symptoms, the longer they lasted.Those who experienced hot flushes while they were still menstruating continued to have them for far longer than those whose symptoms began after their periods stopped, the study found.
Scientists said the study suggested that efforts need to be made to find new ways of helping women with the menopause, which occurs when periods stop and levels of the hormone estrogen decline.
In the UK, the average age for the menopause is 51 years, and women who are struggling with such symptoms are usually offered HRT, for between two and five years.
The therapy can reduce the severity of such problems, and the chance of health problems such as osteoporosis, which are linked to lowered oestrogen levels later in life.
However, there has been increasing concern about the risks of HRT, especially for longer periods, as it increases the risk of breast and ovarian cancer – although it reduced the risk of other diseases.
Last week research by Oxford University found that using HRT even for less than five years increased the risk of ovarian cancer by 40 per cent.
The new US study of 1,449 women with frequent hot flushes or night sweats is the largest of its kind.
Researchers analysed 17 years’ data from the Study of Women’s Health Across the Nation to track 1,449 women with frequent menopausal vasomotor symptoms (VMS) – meaning they had suffered hot flushes or night sweats on at least six days in the previous fortnight.
The average length of time women endured symptoms was 7.4 years.
Half of the women were affected for less than that time, but half had symptoms longer — some for at least 14 years, researchers reported in JAMA Internal Medicine.
Dr Nancy Avis, a professor of social sciences and health policy at Wake Forest Baptist Medical Centre, and the study’s lead author, said doctors should advise women that symptoms such as hot flushes and night sweats might last far longer than they had been led to believe.
Dr Avis said: “These findings can help health care professionals counsel patients about expectations regarding VMS and assist women in making treatment decisions based on the probability of their VMS persisting.”
She said the study showed the need to find better ways to help women with frequent hot flushes through the menopause.
“The median total VMS duration of 7.4 years highlights the limitations of guidance recommending short-term HT [hormone therapy] use and emphasises the need to identify safe long-term therapies,” she said.
The study found that the earlier hot flushes started the longer they lasted.
Women who got hot flushes while still having regular periods – around one in eight of those in the study – experienced symptoms for longer than those who began to suffer the symptoms after menstruation stopped.
Women who started getting hot flushes when they were still having regular periods, or while periods were becoming more scant, experienced them for around 11.8 years in total.
About nine of those years occurred after menopause, nearly three times the average of 3.4 years for women whose hot flushes did not start until their periods stopped, the study found.
Prof Avis said: “If you start later it’s a shorter total duration, and it’s shorter from the last period on.”
The study also found that women with longer-lasting symptoms tended to have less education, greater perceived stress, and more depression and anxiety.
Hot flushes are caused by dilation of the blood vessels and increased flow of blood to the head and neck, causing reddening of the skin and sweating.
Previous studies have found that women with hot flush symptoms also face increased risk of cardiovascular problems and bone loss.
Night sweats are hot flushes that take place at bedtime, disrupting sleep and causing fatigue and stress.
Researchers followed the women in the study, who came from seven American cities, from 1996 to 2013.
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