Menopausal Vasomotor Symptoms Differ Among Race and Ethnicity



Hot flashes are a common vasomotor symptom (VMS), whereby sudden heat appears in the face and upper body and then spreads to the rest of the body. Hot flashes typically last 2-4 minutes. Sometimes they cause anxiety, shivering, heart palpitations, or perspiration. VMS affects up to 85% of women during the menopause transition. Symptoms can be worse in people with low physical activity levels, low socioeconomic status, hysterectomy, smoking, and symptoms of anxiety and depression. Symptoms usually worsen if a person’s body fat increases. Hot flashes during the night are called night sweats, and often result in poor sleep and reduced quality of life.


The most severe VMS typically appears within 1-2 years from the last day of menstruation and continues for 4-5 years. However, symptoms often begin prior to menopause and duration varies greatly. In 10% of people, VMS can last more than 12 years. 



The prevalence of VMS differs according to race and ethnicity. Studies show the rate of VMS is highest in Black women and lowest in East Asian women. Women of African and Caribbean decent not only have a high prevalence of VMS, but also the longest duration and more severe symptoms. Some have suggested this may be due to evidence that these women have a higher allostatic load when compared with Caucasian women. White women have the highest prevalence of sleep disturbance. East Asian women (China, Japan, etc.) have the lowest level of VMS but more sleep disturbance.


Another ethnic consideration is in South Asian women (India, Pakistan, Bangladesh, Sri Lanka, etc.). This population is at greater risk of long-term health conditions such as cardiovascular disease, osteoporosis, and dementia because of their lower average age of menopause, which is 47. In many cultures, menopause is not discussed, and women are unaware of effective treatment options.



The good news is there are ways to manage the discomfort often experienced with VMS. Physical therapists and other providers can encourage patients to increase their activity and manage their weight and stress. Patients should seek appropriate treatment for addressing anxiety and depression. Menopausal hormone therapy (MHT) using oral or percutaneous administration is the gold-standard option to reduce VMS and can be very effective. MHT is more commonly prescribed to White women compared with Black and/or East Asian women. Non-hormonal prescription medications are also effective in treating VMS and include SSRIs, SNRIs, gabapentin, and pregabalin. 


Treatments should be individualized based on a person’s risk factors and goals. People need to consult with their doctor to determine the right management strategy for them. Healthcare professionals owe it to their female patients to educate them about the menopause transition, safe treatments to lessen VMS and encourage them to talk to their provider about the best options to manage their symptoms for improved quality of life. 




anxiety, bone health, cardiac health, health education, healthy lifestyle, heart disease, heart disease risk, hormone therapy, hot flashes, menopause, reduce heart disease, reduce heart disease risk, women's health, women's heart health

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