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Research Article| Volume 89, P43-51, July 2016

Hot flushes and reproductive hormone levels during the menopausal transition

      Highlights

      • Bangladeshi migrants and non-migrants were significantly more likely to report hot flushes than the migrants’ European neighbors.
      • Higher levels of anti-Müllerian hormone decreased the likelihood that hot flushes occurred in the past two weeks.
      • Higher levels of follicle-stimulating hormone significantly increased the probability that hot flushes occurred in the last two weeks.
      • A higher body mass index increased the likelihood of hot flushes, and a higher educational level decreased the probability of hot flushes.
      • Inhibin B and estradiol were not associated with hot flushes.

      Abstract

      Introduction

      Evidence suggests that hot flushes are associated with fluctuating levels of oestradiol (E2) during menopause, as well as changes in the levels of follicle-stimulating hormone (FSH) and inhibin B. The relationship between hot flushes and anti-Müllerian hormone (AMH) is unknown.

      Aim

      To examine specific hormone levels and ethnic differences in relation to hot flushes.

      Methods

      Data were drawn from 108 women aged 40–59 years. There were three groups of participants: European women in London, UK; Bangladeshi women in Sylhet, Bangladesh; and Bangladeshi women who had migrated to London as adults. Symptom information was collected via questionnaires. Serum blood samples were collected to detect inhibin B, AMH, FSH, and E2.

      Results

      AMH and FSH were significantly associated with the experience of hot flushes in the past 2 weeks. Inhibin B and E2 were not associated with hot flushes. Body mass index (BMI), ethnicity, and education level were associated with both the occurrence and the frequency hot flushes. Menopausal status was also associated with the frequency of hot flushes.

      Conclusion

      Relationships between AMH, FSH and symptoms are indicative of women’s progress through the menopausal transition. The influence of BMI and education suggest that lifestyle changes may contribute to the management of symptoms. This merits further research.

      Keywords

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      References

        • Lee S.J.
        • Lenton E.A.
        • Sexton L.
        • Cooke I.D.
        The effect of age on the cyclical patterns of plasma LH, FSH, oestradiol and progesterone in women with regular menstrual cycles.
        Hum. Reprod. 1988; 3: 851-855
        • Rannevik G.
        • Jeppsson S.
        • Johnell O.
        • Bjerre B.
        • Laurell-Borulf Y.
        • Svanberg L.
        A longitudinal study of the perimenopausal transition: altered profiles of steroid and pituitary hormones, SHBG and bone mineral density.
        Maturitas. 1995; 21: 103-113
        • Santoro N.
        • Randolph J.F.
        Reproductive hormones and the menopause transition.
        Obstet. Gynecol. Clin. North Am. 2011; 38: 455-466
        • Takahashi T.A.
        • Johnson K.M.
        Menopause.
        Med. Clin. North Am. 2015; 99: 521-534
        • Grisendi V.
        • Spada E.
        • Argento C.
        • Plebani M.
        • Milani S.
        • Seracchioli R.
        • Volpe A.
        • La Marca A.
        Age-specific reference values for serum FSH and estradiol levels throughout the reproductive period.
        Gynecol. Endocrinol. 2014; 30: 451-455
        • Lie Fong S.
        • Visser J.A.
        • Welt C.K.
        • de Rijke Y.B.
        • Eijkemans M.J.
        • Broekmans F.J.
        • Roes E.M.
        • Peters W.H.
        • Hokken-Koelega A.C.
        • Fauser B.C.
        • Themmen A.P.
        • de Jong F.H.
        • Schipper I.
        • Laven J.S.
        Serum anti-müllerian hormone levels in healthy females: a nomogram ranging from infancy to adulthood.
        J. Clin. Endocrinol. Metab. 2012; 97: 4650-4655
        • Lipson S.F.
        • Ellison P.T.
        Normative study of age variation in salivary progesterone profiles.
        J. Biosoc. Sci. 1992; 24: 233-244
        • Sievert L.L.
        A biocultural perspective.
        Menopause. Rutgers University Press, New Brunswick, NJ2006
        • Gold E.
        • Colvin A.
        • Avis N.
        • Bromberger J.
        • Greendale G.A.
        • Powell L.
        • Sternfeld B.
        • Matthews K.
        Longitudinal analysis of vasomotor symptoms and race/ethnicity across the menopausal transition: study of women’s health across the nation (SWAN).
        Am. J. Public Health. 2006; 96: 1226-1235
        • Hunter M.S.
        • Gentry-Maharaj A.
        • Ryan A.
        • Burnell M.
        • Lanceley A.
        • Fraser L.
        • Jacobs I.
        • Menon U.
        Prevalence, frequency and problem rating of hot flushes persist in older postmenopausal women: impact of age body mass index, hysterectomy, hormone therapy use, lifestyle and mood in a cross-sectional cohort study of 10,418 British women aged 54–65.
        BJOG. 2012; 119: 40-50
        • Freedman R.R.
        Pathophysiology and treatment of menopausal hot flashes.
        Semin. Reprod. Med. 2005; 23: 117-125
        • Archer D.F.
        • Sturdee D.W.
        • Baber R.
        • de Villiers T.J.
        • Pines A.
        • Freedman R.R.
        • Gompel A.
        • Hickey M.
        • Hunter M.S.
        • Lobo R.A.
        • Lumsden M.A.
        • MacLennan A.H.
        • Maki P.
        • Palacios S.
        • Shah D.
        • Villaseca P.
        • Warren M.
        Menopausal hot flushes and night sweats: where are we now?.
        Climacteric. 2011; 14: 515-528
        • Freedman R.R.
        • Krell W.
        Reduced thermoregulatory null zone in postmenopausal women with hot flashes.
        Am. J. Obstet. Gynecol. 1999; 181: 66-70
        • Freedman R.R.
        Physiology of hot flashes.
        Am. J. Hum. Biol. 2001; 13: 453-464
        • Freedman R.R.
        Menopausal hot flashes: mechanisms endocrinology, treatment.
        J. Steroid Biochem. Mol. Biol. 2014; 142: 115-120
        • Rance N.E.
        • Dacks P.A.
        • Mittleman-Smith M.A.
        • Romanovsky A.A.
        • Krajewski-Hall S.J.
        Modulation of body temperature and LH secretion by hypothalamic KNDy (kisspeptin: neurokinin B and dynorphin) neurons: a novel hypothesis on the mechanisms of hot flushes.
        Front. Neuroendocrinol. 2013; 34: 211-227
        • Henderson K.
        • Bernstein L.
        • Henderson B.
        • Kolonel L.
        • Pike M.C.
        Predictors of the timing of natural menopause in the multiethnic cohort study.
        Am. J. Epidemiol. 2008; 167: 1287-1294
        • Thomas F.
        • Renaud F.
        • Benefice E.
        • De Meeus T.
        • Guegan J.-F.
        International variability of ages at menarche and menopause: patterns and main determinants.
        Hum. Biol. 2001; 73: 271-290
        • Sievert L.L.
        Anthropology and the study of menopause: evolutionary developmental, and comparative perspectives.
        Menopause. 2014; 21: 1151-1159
        • Kaczmarek M.
        • Pacholska-Bogalska J.
        • Kwaśniewski W.
        • Kotarski J.
        • Halerz-Nowakowska B.
        • Goździka-Józefiak A.
        A microsatellite polymorphism in IGF1 gene promoter and timing of natural menopause in Caucasian women.
        Int. J. Med. Sci. 2015; 12: 32-41
        • Markatseli A.E.
        • Hatzi E.
        • Pamporaki C.
        • Bouba I.
        • Xita N.
        • Tigas S.
        • Georgiou I.
        • Tsatsoulis A.
        Association of the (TAAAA)n repeat polymorphism of SHBG gene with the age at menopause in Greek postmenopausal women.
        Maturitas. 2014; 78: 113-116
        • Stolk L.
        • Perry J.R.
        • Chasman D.I.
        • He C.
        • Mangino M.
        • Sulem P.
        • Barbalic M.
        • Broer L.
        • Byrne E.M.
        • et al.
        Meta-analyses identify 13 loci associated with age at menopause and highlight DNA repair and immune pathways.
        Nat. Genet. 2012; 44: 260-268
        • Murphy L.
        • Sievert L.L.
        • Begum K.
        • Sharmeen T.
        • Chowdhury O.
        • Muttukrishna S.
        • Bentley G.R.
        Life course effects on age at menopause among Bangladeshi sedentees and migrants to the UK.
        Am. J. Hum. Biol. 2013; 25: 83-93
        • Begum K.
        • Muttukrishna S.
        • Sievert L.L.
        • Sharmeen T.
        • Murphy L.
        • Chowdhury O.
        • Kasim A.
        • Gunu R.
        • Bentley G.R.
        Ethnicity or environment: effects of migration on ovarian reserve among Bangladeshi women in the UK.
        Fertil. Steril. 2016; 105: 744-754
        • Freeman E.W.
        • Sherif K.
        Prevalence of hot flushes and night sweats around the world: a systematic review.
        Climacteric. 2007; 10: 197-214
        • Obermeyer C.M.
        Menopause across cultures: a review of the evidence.
        Menopause. 2000; 7: 184-192
        • Melby M.K.
        • Sievert L.L.
        • Anderson D.
        • Obermeyer C.M.
        Overview of methods used in cross-cultural comparisons of menopausal symptoms and their determinants: guidelines for strengthening the reporting of menopause and aging (STROMA) Studies.
        Maturitas. 2011; 70: 99-109
        • Freeman E.W.
        • Sammuel M.D.
        • Lin H.
        • Liu Z.
        • Gracia C.R.
        Duration of menopausal hot flushes and associated risk factors.
        Obstet. Gynecol. 2011; 117: 1095-1104
        • Green R.
        • Santoro N.
        Menopausal symptoms and ethnicity: the study of women’s health across the nation.
        Womens Health (Lond. Engl.). 2009; 5: 127-133
        • Im E.O.
        • Lee B.
        • Chee W.
        • Brown A.
        • Dormire S.
        Menopausal symptoms among four major ethnic groups in the United States.
        West. J. Nurs. Res. 2010; 32: 540-565
        • Sievert L.L.
        • Begum K.
        • Sharmeen T.
        • Chowdhury O.
        • Muttukrishna S.
        • Bentley G.
        Patterns of occurrence and concordance between subjective and objective hot flashes among Muslim and Hindu women in Sylhet, Bangladesh.
        Am. J. Hum. Biol. 2008; 20: 598-604
        • Sharmeen T.
        • Sievert L.L.
        • Begum K.
        • Chowdhury O.
        • Muttukrishna S.
        • Bentley G.R.
        Symptoms at midlife family structure, and household workloads in Sylhet, Bangladesh.
        Anthropol. Rev. 2013; 76: 199-216
        • World Health Organization (WHO)
        Research on the Menopause in the 1990.
        WHO Technical Report Series No. 866. WHO, Geneva1996
        • Bentley G.R.
        • Muttukrishna S.
        Potential use of biomarkers for analyzing inter-population and cross-cultural variability in reproductive aging.
        Menopause. 2007; 14: 668-679
        • LaMarca A.
        • Grisendi V.
        • Griesinger G.
        How much does AMH really vary in normal women?.
        Int. J. Endocrinol. 2013; 2013 (959487)
        • Freeman E.W.
        • Sammel M.D.
        • Lin H.
        • Gracia C.R.
        • Pien G.W.
        • Nelson D.B.
        • Sheng L.
        Symptoms associated with menopausal transition and reproductive hormones in midlife women.
        Obstet. Gynecol. 2007; 111: 230-240
        • Freeman E.W.
        • Sammel M.D.
        • Lin H.
        Temporal associations of hot flashes and depression in the transition to menopause.
        Menopause. 2009; 16: 728-734
        • Gold E.B.
        • Block G.
        • Crawford S.
        • Lachance L.
        • FitzGerald G.
        • Miracle H.
        • Sherman S.
        Lifestyle and demographic factors in relation to vasomotor symptoms: baseline results from the study of women’s health across the nation.
        Am. J. Epidemiol. 2004; 159: 1189-1199
        • Randolph Jr., J.F.
        • Sowers M.
        • Bondarenko I.
        • Gold E.B.
        • Greendale G.A.
        • Bromberger J.T.
        • Brockwell S.E.
        • Matthews K.A.
        The relationship of longitudinal change in reproductive hormones and vasomotor symptoms during the menopausal transition.
        J. Clin. Endocrinol. Metab. 2005; 90: 6106-6112
        • Anderson R.A.
        • Nelson S.M.
        • Wallace W.H.
        Measuring anti-mullerian hormone for the assessment of ovarian reserve: when and for whom is it indicated.
        Maturitas. 2012; 71: 28-33
        • Broer S.L.
        • Eijkemans M.J.
        • Scheffer G.J.
        • van Rooij I.A.
        • de Vet A.
        • Themmen A.P.
        • Laven J.S.
        • de Jong F.H.
        • Te Velde E.R.
        • Fauser B.C.
        • Broekmans F.J.
        Anti-mullerian hormone predicts menopause: a long-term follow-up study in normoovulatory women.
        J. Clin. Endocrinol. Metab. 2011; 96: 2532-2539
        • Tehrani F.R.
        • Solaymani-Dodaran M.
        • Azizi F.
        A single test of antimulluerian hormone in late reproductive-aged women is a good predictor of menopause.
        Menopause. 2009; 16: 797-802
        • Newson L.
        Menopause and Its Management.
        2013 ([online] Available: http//www.patient.co.uk/doctor/menopause-and-it-management [27/08/14])
        • Harlow S.D.
        • Gass M.
        • Hall J.E.
        • Lobo R.
        • Maki P.
        • Rebar R.W.
        • Sherman S.
        • Sluss P.M.
        • de Villiers T.J.
        STRAW 10Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging.
        Menopause. 2012; 19: 387-395
      1. Office of Research on Women’s Health, Highlights of women’s health research for ORWH 20th Anniversary; focus on the menopause transition, NIH Publication No. 10-7606-D, 2010.

        • Gallicchio L.
        • Miller S.R.
        • Kiefer J.
        • Greene T.
        • Zacur H.A.
        • Flaws J.A.
        Change in body mass index weight, and hot flashes: a longitudinal analysis from the midlife women’s health study.
        J. Womens Health (Larchmt). 2014; 23: 231-237
        • Nelson L.R.
        • Bulun S.E.
        Estrogen production and action.
        J. Am. Acad. Dermatol. 2001; 45: S116-124
        • Freedman R.R.
        Hot flash trends and mechanisms.
        Menopause. 2002; 9: 151-152
        • Sievert L.L.
        • Hautaniemi S.I.
        Age at menopause in Puebla, Mexico.
        Hum. Biol. 2003; 75: 205-226
        • Hardy R.
        • Kuh D.
        Social and environmental conditions across the life course and age at menopause in a British birth cohort study.
        BJOG. 2005; 112: 346-354