Special Report: Managing vasomotor symptoms in menopause

In the first episode of this 10-part Contemporary OB/GYN Special Report, JoAnn V. Pinkerton, MD, and Jill Liss, MD, MSCP, FACOG, discussed the prevalence and impact of vasomotor symptoms (VMS) in menopause, emphasizing the need for greater recognition of their effects beyond discomfort and inconvenience. The discussion highlighted how hot flashes, night sweats, and related symptoms affect women’s quality of life, daily functioning, and long-term health.

Pinkerton noted that nearly 80% of women worldwide experience vasomotor symptoms,¹ with about one-third requiring treatment. These episodes—characterized by sudden heat sensations, sweating, or chills—can disrupt sleep, mood, and cognition. “Moderate to severe hot flushes are associated with reduced quality of life, most pronounced if you have really frequent or severe hot flushes,” she explained, adding that sleep disturbances affect up to 60% of women during the menopausal transition.²

Liss underscored that the cumulative exhaustion caused by disrupted sleep can have cascading effects on relationships, productivity, and overall health. She referenced research indicating that vasomotor symptoms themselves may serve as markers of vascular dysfunction, reinforcing the need to treat them as more than minor nuisances. “We’re not treating nuisance symptoms,” she said. “These are potentially markers of vascular dysfunction and a setup for overall adverse health events.”

Both physicians emphasized incorporating patient-reported outcomes to capture the broader impact of VMS on mood, sleep, and social interactions, not just frequency or severity. Pinkerton noted, “When you’re looking at outcomes from a study, you need to look at more than just the hot flushes and recognize that disrupted sleep, low moods, brain fog, and cognitive function need to be evaluated also.”

Our Experts:
JoAnn V. Pinkerton, MD, division director, Midlife Health Center, University of Virginia.

Jill Liss, MD, MSCP, FACOG, associate clinical professor of Obstetrics and Gynecology, University of Colorado School of Medicine.

Liss has no relevant disclosures to report. Relevant disclosures for Pinkerton include Bayer.

References:

1. Khan SJ, Kapoor E, Faubion SS, Kling JM. Vasomotor Symptoms During Menopause: A Practical Guide on Current Treatments and Future Perspectives. Int J Womens Health. 2023 Feb 14;15:273-287. doi:10.2147/IJWH.S365808
2. Baker FC, Lampio L, Saaresranta T, Polo-Kantola P. Sleep and Sleep Disorders in the Menopausal Transition. Sleep Med Clin. 2018;13(3):443-456. doi:10.1016/j.jsmc.2018.04.011