Variability of bothersome menopausal symptoms over time – a longitudinal analysis using the Estonian postmenopausal hormone therapy trial (EPHT)

In a trial comparing combined hormone therapy to placebo or no treatment (control groups), a cohort of women aged 50–59 at recruitment were followed annually by questionnaires. Women in the control groups (n？=？486) were grouped by the number of years followed, with the prevalence and severity of symptoms calculated both cross-sectionally and longitudinally.About two thirds of the women (67%) reported vasomotor symptoms and half (46%) bothersome symptoms at recruitment. In the cross-sectional analysis, their prevalence declined between recruitment and 1-year follow-up (32% bothersome symptoms) and 2-year follow-up (27%). Thereafter it remained about the same level. In the longitudinal analysis, there was a notable variation in the prevalence of disturbing vasomotor symptoms over time, time entering the study and the compliance to the surveys. In the two groups having most follow-up times, the proportion of women with bothersome symptoms first increased and then decreased.There was a notable variability in the development of disturbing vasomotor symptoms over time in a selected group of women aged 50–59. Population-based follow-up studies of untreated women would be useful to estimate the symptom burden.A number of studies have reported a high prevalence of vasomotor symptoms among middle-aged women [1-5]. In a large review by the National Institutes of Health [6], 14–51% of premenopausal and 30–80% of peri- and postmenopausal women reported hot flashes and night sweats. However, not all women consider hot flushes bothersome [5,7-10]. Sleep disturbances are common among all menopausal women (occurring in 16–42% of premenopausal, 39–47% of perimenopausal and 35–60% of postmenopausal women). In a Finnish population-based study by Hemminki et al. (1995), 28% of women aged 45–64 years reported hot flushes, 38% reported tiredness and 27% different kind of pains (head-, back-, and joint ache). The probability of other symptoms is higher if the woman has vasomotor symptoms [