More and more studies are being down on women’s health issues than in the past, some surprising and perhaps not so surprising suggests that both race and life style choices can impact menopause, even education level plays a part in how women transition through menopause. All this can play a part in what symptoms are reported, the severity of the symptoms and the frequency of the symptoms.
One study of 3198 women conducted from 1996 – 2002 referred to as SWAN which stands for Study of Women’s Health Across the Nation set out to determine exactly what impact race, education and life style has on vasomotor symptoms. Vasomotor is the constricting or dilating of blood vessels that leads to hot flashes and night sweats. This study is interesting because it addresses some conflicts that have existed in other studies conducted on menopause. For example, of three previous studies conducted to determine whether African American women were more susceptible to vasomotor symptoms, two of the studies stated yes, while the third one said no. In addition, previous studies have shown that a higher weight may actually prove to be beneficial to the reduction of vasomotor symptoms as the fat helps raise estrogen levels. Several studies have shown that Asian women experience fewer vasomotor symptoms and this is a contradiction of the studies that show extra fat can reduce vasomotor symptoms because on the whole, Asian women weigh less than African American women.
The study established a baseline for the women in the study that was:
“Age 42 to 52 years, intact uterus and at least one ovary, not currently using exogenous hormones affecting ovarian function, menstrual period in the previous 3 months, and self-identification as a member of a site’s designated racial/ethnic group. Each site recruited approximately 450 eligible participants (a total of 3302), and annual clinical examinations were conducted. We excluded women who had missing baseline data on vasomotor symptoms (n = 104) or missing covariate data (n = 414) from the present longitudinal analyses, which included data through the fifth annual visit (2001-2002). Thus, the sample size for our final multivariate longitudinal models (including baseline through the fifth annual visit) was 2784. Each woman could contribute up to 6 observations; the average number of observations was 4.3. The overall SWAN retention rate was 79.3% through the fifth visit.”
What was found after establishing this baseline was that great difference did exist. Chinese and Japanese women at the established baseline were much more likely to be premenopausal, less likely to be subjected to tobacco smoke and had much fewer premenstrual symptoms as well as less reported depression and anxiety. Compared to the other ethnic groups, low income (below $20,000) Hispanic women with less than a high school education, non-English speaking, with minimal exercise, unemployed and difficulty paying for essential had the “highest perceived stress scores”. White women when compared to the other ethnic groups consumed more alcohol, exercised more and gave birth to fewer children. African American women had higher levels of smoking, more environmental tobacco exposure, higher BMI and were less likely to be married.
This study also found that African American women reported the highest levels of vasomotor symptoms overall, while Asian women had the lowest. Other factor that were found to lead to a higher incidence of vasomotor symptoms in descending order age, less than a college education, obesity (high BMI – body mass index), smoking, and anxiety symptoms. The study found that across all ethnic groups, vasomotor symptoms are more frequent during the late perimenopause phase or early postmenopause phase. Factors that were found to be not significantly relevant to vasomotor symptoms were exercise, alcohol, caffeine and dietary factors.