The steep decline in the use of hormone therapy has spawned a prevalent but preventable side effect: millions of women suffering in silence with hot flashes, according to a study by a Yale School of Medicine researcher and colleagues.
In the study published in the Aug. 27 online issue of the journal Menopause, the team found that moderate to severe hot flashes -- also called vasomotor symptoms (VMS) -- are not treated in most women. Women with VMS experience more than feeling hot; other frequently occurring symptoms include fatigue, sleep disturbance, depression, anxiety, and impaired short-term memory.
"Not treating these common symptoms causes many women to drop out of the labor force at a time when their careers are on the upswing," said Philip Sarrel, M.D., emeritus professor in the Departments of Obstetrics, Gynecology & Reproductive Sciences, and Psychiatry. "This also places demands on health care and drives up insurance costs."
Sarrel and colleagues used data on health insurance claims to compare over 500,000 women, half with and half without hot flashes. The team calculated the costs of health care and work loss over a 12-month period. Participants were all insured by Fortune 500 companies.
The team found that women who experienced hot flashes had 1.5 million more health care visits than women without hot flashes. Costs for the additional health care was $339,559,458. The cost of work lost was another $27,668,410 during the 12-month study period.
Hot flashes are the result of loss of ovarian hormones in the years just before and after natural menopause. For women who have a hysterectomy, symptoms may occur almost immediately following surgery and are usually more severe and long lasting. More than 70% of all menopausal women and more than 90% of those with hysterectomies experience VMS that affect daily function.
In the past, hot flashes were readily treated with either hormone therapy or alternative approaches. However, following the 2002 publication of the findings in the Women's Health Initiative Study, there has been a sharp drop in the use of hormone therapy due to unfounded fears of cancer risks, according to Sarrel.
"Women are not mentioning it to their healthcare providers, and providers aren't bringing it up," said Sarrel. "The symptoms can be easily treated in a variety of ways, such as with low-dose hormone patches, non-hormonal medications, and simple environmental adjustments such as cooling the workplace."
- Philip Sarrel, David Portman, Patrick Lefebvre, Marie-Hιlθne Lafeuille, Amanda Melina Grittner, Jonathan Fortier, Jonathan Gravel, Mei Sheng Duh, Peter M. Aupperle. Incremental direct and indirect costs of untreated vasomotor symptoms. Menopause, 2014; 1 DOI: 10.1097/GME.0000000000000320
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