Menopausal Symptoms

Difference between vasomotor and other symptoms of menopause

By Monazza Ahmad, B.Pharm, MSc

Menopause is undeniably the most confusing phase of a woman’s life. The irregular menstrual cycle and unpredictable biological changes and emotional state can negatively affect her social, work, and daily life.
​
Seeking help for these symptoms could feel awkward since many times women don’t know how to communicate these concerns and whether it would be empathetically understood or not. At times, the complex medical terms associated with menopause can make it tough to follow the course of treatment plan.

Let’s discuss the major signs and symptoms of menopause and the terminologies associated with it that may help you understand your situation as well as convey your concerns to your provider.

What are vasomotor symptoms (VMS)?
The word “vaso” is originated from the Latin1 meaning vessel, and “motor” relates to movement. So vasomotor symptoms are the movement of blood vessels characterized by their constriction and dilation that causes temporary irregular blood pressure that in turn alters the body temperature, making us feel hot or sweat.2

This temperature alteration results in hot flashes and night sweats that are the most common indication of perimenopause and menopause.3,4
Other chronic and progressive symptoms are characterized by vaginal dryness, painful intercourse, and reduced lubrication. It is seen in both premenopausal and postmenopausal phases.5

Why do I feel like I’m the only one suffering from these symptoms?
During menopausal transition, the vasomotor symptoms impact about 80% of the women in the US and differ widely from region to region.6,7
Even though a variety of symptoms is common during menopause, some are not much reported due to their mild and nonspecific nature. Up to 84% of postmenopausal women tend to just deal with the menopausal discomfort rather than seeking medical attention.5,8

How long do these symptoms last?
Don’t worry if you have been experiencing vasomotor symptoms for more than a few years. For many women, it can last over a decade or two, with 4-20 hot flashes daily being common during menopause.9

A new long-term study of women from various races and ethnicities suggests that hot flashes and night sweats can take up to 11 years to resolve for some women. Interestingly, the study further discovered that hot flashes lasted longer, for 9-10 years, if started before the menstrual period ended, while their duration was much shorter, with 3.5 years if women had their first hot flash after the periods ended.10

Some menopausal symptoms can get worse with age as opposed to the other menopausal symptoms that improve with time.

How do these symptoms impact women’s quality of life?
Hot flashes, night sweats, vaginal dryness, low libido, sleeplessness, and menopausal anxiety all add to the decline in quality of life. The sudden outburst of sweat with hot flashes can be daunting when it occurs in a gathering, making women nervous. Vaginal dryness and decreased interest in sexual activities go hand in hand, impacting intimate relationships. All of these stressful changes in daily routine are enough to make any woman anxious.5

Some of the other concerns include brain fog, urinary incontinence, weight gain, hair loss, bone loss, and heart health, to name a few.11

Therefore, women are highly encouraged to not ignore menopausal discomfort and instead have informed discussions with their healthcare providers to find safe solutions for their health needs.12

What are my relief options?
There are several options to reduce the impact of these menopausal symptoms and claim your lifestyle back. The solutions include prescription medications, well-studied supplements, lifestyle changes, and nutrition. Since the trial and error of wrong choices can become painful and lengthy during menopause, it is important to discuss the best option with your provider at the right time.

Hormone replacement therapy (HRT): 
This is the most common prescription option for hot flashes, but it is not usually the first choice. The common forms are tablets, gels, skin patches, injections, and vaginal inserts. HRT is generally best-suited for healthy women and those that are in the early phase of menopause. It is not recommended to start HRT after the age of 60. However, there are some side effects associated with HRT, and it is generally considered unsafe for people with a history of heart conditions, deep vein thrombosis, cancer, and smoking.12

Rheum rhaponticum (ERr 731®): 
This nonhormonal solution is the top recommended natural ingredient by OBGYNs. It has shown to improve 12 of the main menopausal symptoms by 83%. In addition to hot flashes and night sweats, it also improves sleep disturbances, mood swings, sexual discomfort, anxiety, vaginal dryness, and muscle and joint health, to name a few.13

Lifestyle: 
Daily physical activity is important for menopausal symptom relief. Weight management, stress relief, increased metabolism, and improved overall quality of life as a result of active movement are all related to better management of menopause.14 Eating habits, consuming a healthy diet, practicing relaxation or meditation, drinking enough water, getting quality sleep, and avoiding smoking and alcohol all help with relieving the menopausal discomfort.15

Nutrition: 
Taking necessary supplements or eating food rich in vitamin D, E, B6, folic acid, and omegas help reduce intensity of menopausal symptoms.16
Now that you have learned more about menopausal symptoms and their treatment options, you may want to discuss these concerns with your healthcare provider. In our next post, we will go over a few tips on how a patient and their healthcare provider can effectively communicate these menopausal challenges with each other to come up with the best treatment plan.

References:

1. Medical terms – dissected, defined and explained. https://www.ucl.ac.uk/lapt/medterms.htm. Accessed May 5, 2023.
2. Merriam-Webster Dictionary. https://www.merriam-webster.com/dictionary/vasomotor#. Accessed May 5, 2023.
3. Deecher DC et al. Understanding the pathophysiology of vasomotor symptoms (hot flushes and night sweats) that occur in perimenopause, menopause, and postmenopause life stages. Arch Womens Ment Health. 2007;10(6):247-257.
4. Rossmanith WG et al. What causes hot flushes? The neuroendocrine origin of vasomotor symptoms in the menopause. Gynecol Endocrinol. 2009;25(5):303-314.
5. Angelou K et al. The genitourinary syndrome of menopause: an overview of the recent data. Cureus. 2020;12(4):e7586.
6. Nappi RE et al. Global cross-sectional survey of women with vasomotor symptoms associated with menopause: prevalence and quality of life burden. Menopause. 2021;28(8):875–882.
7. Avis NE et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531-539.
8. Sarmento ACA et al. Genitourinary syndrome of menopause: epidemiology, physiopathology, clinical manifestation and diagnostic. Front Reprod Health. 2021;3:779398.
9. Avis NE et al. Vasomotor symptoms across the menopause transition: differences among women. Obstet Gynecol Clin North Am. 2018;45(4):629–640.  
10. Mahajan A et al. Hot flashes—how long ?? J Midlife Health. 2018;9(2):53–54.
11. Mayo Clinic. Menopause. https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397. Accessed May 5, 2023.
12. NIH. What are the treatments for other symptoms of menopause? https://www.nichd.nih.gov/health/topics/menopause/conditioninfo/treatments. Accessed May 5, 2023.
13. Hasper I et al. Long-term efficacy and safety of the special extract ERr 731 of Rheum rhaponticum in perimenopausal women with menopausal symptoms. Menopause. 2009;16(1):117-131.
14. Mayo Clinic. Fitness tips for menopause: why fitness counts. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/fitness-tips-for-menopause/art-20044602#:~:text=Exercise%20isn’t%20a%20proven,improve%20your%20quality%20of%20life. Accessed May 5, 2023.
15. Mayo Clinic. Menopause: Diagnosis. https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401. Accessed May 5, 2023.
16. Cleveland Clinic. Menopause diet: What to eat to help manage symptoms. https://health.clevelandclinic.org/menopause-diet/. Accessed May 5, 2023.