This article is more than 5 years old. Information may no longer be current.
Moderate to severe menopausal vasomotor symptoms associated with increased hip fracture risk
Click Here to Manage Email Alerts
Women with moderate to severe vasomotor symptoms during menopause showed lower bone mineral density and higher rates of hip fracture than women without the symptoms, according to research published in The Journal of Clinical Endocrinology & Metabolism.
“Compared with women who did not have hot flashes at the beginning of the study, women who reported having hot flashes at the beginning of the study had almost double the risk of hip fractures,” Carolyn J. Crandall, MD, of David Geffen School of Medicine, University of California, Los Angeles, told Endocrine Today. “Women who reported hot flashes also had lower bone density at the lumbar spine and the hip.”
Carolyn J. Crandall
Gaining a better understanding of the factors underlying these associations could inform the design of strategies that could avert fractures in women at risk, the researchers said.
“We need to determine the biological mechanisms that explain the links between hot flashes and hip fracture risk so that we can develop preventive measures to help women reduce their hip fracture risk,” Crandall said.
Using data on women aged 50 to 79 years involved in the Women’s Health Initiative clinical trial (n=23,573), Crandall and colleagues prospectively observed associations of baseline vasomotor symptoms (VMS) with fracture incidence and BMD during an average of 8.2 years from 1993 to 2005.
The women, from 40 clinical centers across the United States, were not on menopausal hormone therapy; 4,867 women had BMD data from participating in a substudy.
The investigators measured baseline VMS, incident adjudicated fractures and BMD at baseline and four annual visits, separated by 3 years. Adjustments were made for age, BMI, race/ethnicity, smoking and education.
The HR for hip fracture among women with baseline moderate/severe VMS compared with no VMS was 1.78 (95% CI, 1.2-2.64); no association was observed between VMS and vertebral fracture. Severity of VMS was inversely associated with BMD (P=.004 for femoral neck; P=.045 for lumbar spine).
Women with moderate/severe VMS demonstrated 0.015 g/cm2 lower femoral neck BMD (95% CI, –0.025 to –0.005) and 0.016 g/cm2 lower lumbar spine BMD (95% CI, –0.032 to –0.004) than women who reported no VMS in repeated measures models.
“Hot flashes are common — experienced by at least 60% of women,” Crandall said. “We clearly have to start exploring the reasons for our findings. In the meantime, women with hot flashes may benefit from greater attention to healthy lifestyle habits to maintain bone health, such as avoiding excessive alcohol intake and smoking, maintaining adequate calcium and vitamin D intake, and getting adequate physical activity.” – by Allegra Tiver
Carolyn J. Crandall, MD, can be reached at the David Geffen School of Medicine at University of California, Los Angeles, UCLA Medicine/GIM, 911 Broxton Ave., First floor, Los Angeles, CA 90024; email: CCrandall@mednet.ucla.edu.
Disclosure: Crandall reports no relevant financial disclosures. Please see the study for a full list of researchers’ financial disclosures.
Click Here to Manage Email Alerts