The most common symptom of the menopause is hot flashes; according to the American Congress of Obstetrics and Gynecology (ACOG), approximately 75% of menopausal women in the United States experience them. A new study has found that caffeine aggravates hot flashes. The findings were published online on July 21 by researchers at the Mayo Clinic (Rochester, Minnesota) in the journal Menopause.
The goal of the study was to evaluate the association between caffeine intake and menopausal symptom bother, particularly hot flashes. The study group comprised 2,507 women who visited the Women’s Health Clinic at Mayo Clinic between July 25, 2005 and July 25, 2011. The women completed the menopause Health Questionnaire, which is a comprehensive survey of menopause-related health information. Among those women, 1,806 women met all the inclusion criteria for the study. Ratings of menopausal symptom were compared between women who used caffeine and women who did not use caffeine. Data regarding smoking was also included.
The investigators found that caffeine intake was positively associated with flashes. The difference in hot flashes remained significant after adjusting for smoking. They concluded that caffeine use is associated with increased hot flashes in postmenopausal women.
ACOG offers a summary of recommendations for women who suffer from hot flashes:
Hormone replacement therapy (HRT) with estrogen alone or in combination with progestin, is the most effective treatment for hot flashes related to menopause.
Low-dose and ultra-low systemic doses of estrogen are associated with a less adverse effects than standard doses and may reduce hot flashes in some women.
Because of the variable response to HRT and the associated risks, it is recommended that healthcare providers individualize care and treat women with the lowest effective dose for the shortest duration that is needed to relieve vasomotor symptoms.
The risks of combined systemic HRT include thromboembolic disease (blood clots) and breast cancer.
Selective serotonin reuptake inhibitors, SSNRIs, clonidine, and the gabapentin are effective alternatives to HT for the treatment of vasomotor symptoms related to menopause.
Estrogen therapy effectively treats vaginal dryness and irritation related to the menopause. Local therapy is advised for the treatment of women with only vaginal symptoms.
Paroxetine (Paxil) is the only nonhormonal therapy that is approved by the FDA for the treatment of hot flashes.
The FDA approved ospemifene (Osphena) for treating moderate-to-severe dyspareunia (painful intercourse) in postmenopausal women.
The following conclusions are based on limited or inconsistent scientific evidence:
Data do not support the use of progestin-only medications, testosterone, or compounded bioidentical hormones for the treatment of vasomotor symptoms.
Data do not show that phytoestrogens, herbal supplements, and lifestyle modifications are effective for the treatment of hot flashes.
Non-estrogen water-based or silicone-based vaginal lubricants and moisturizers may relieve vaginal symptoms related to menopause.
Common sense lifestyle solutions such as layering of clothing, maintaining a lower ambient temperature, and consuming cool drinks are reasonable measures for the management of vasomotor symptoms.
ACOG also notes that the decision to continue HRT should be individualized and be based on a woman’s symptoms and the risk–benefit ratio, regardless of age.