Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: Study of women's health across the nation

Objectives. We investigated whether vasomotor symptom reporting or patterns of change in symptom reporting over the perimenopausal transition among women enrolled in a national study differed according to race/ethnicity. We also sought to determine whether racial/ethnic differences were explained by sociodemographic, health, or lifestyle factors. Methods. We followed 3198 women enrolled in the Study of Women's Health Across the Nation during 1996 through 2002. We analyzed frequency of vasomotor symptom reporting using longitudinal multiple logistic regressions. Results. Rates of vasomotor symptom reporting were highest among African Americans (adjusted odds ratio [OR] = 1.63; 95% confidence interval [CI] = 1.21, 2.20). The transition to late perimenopause exhibited the strongest association with vasomotor symptoms (adjusted OR =6.64; 95% CI = 4.80/9.20). Other risk factors were age (adjusted OR = 1.17; 95% CI = 1.13, 1.21), having less than a college education (adjusted OR = 1.91; 95% CI = 1.40, 2.61), increasing body mass index (adjusted OR = 1.03 per unit of increase; 95% CI = 1.01, 1.04), smoking (adjusted OR = 1.63; 95% CI = 1.25, 2.12), and anxiety symptoms at baseline (adjusted OR = 3.10;95% CI = 2.33, 4.12). Conclusions. Among the risk factors assessed, vasomotor symptoms were most strongly associated with menopausal status. After adjustment for covariates, symptoms were reported most often in all racial/ethnic groups in late perimenopause and nearly as often in postmenopause.