An investigation of discordance between subjective and physiological measures of vasomotor symptoms

Hot flushes and night sweats (HF/NS) can be measured objectively using sternal skin conductance (SSC) monitoring, but objective and subjective measures of HF/NS have only moderate concordance. We aim to investigate this discordance and factors affecting perceptions of HF/NS in a UK sample.

Twenty-seven menopausal women completed questionnaires assessing beliefs about HF/NS, mood, stress, somatic amplification and subjective (frequency and problem-rating) and objective (24-h SSC) HF/NS measures.

On average, 48 HF/NS were reported per week; 47% of objectively recorded HF/NS were accompanied by a subjective response and 56% of subjectively recorded HF/NS were accompanied by an objective recording. Concordant HF/NS were more likely to be moderate or severe, while over-reported (false-positive) HF/NS tended to be mild or moderate; night sweats were more likely to be under-reported. Anxiety, somatic amplification and body mass index were associated with negative beliefs about HF/NS and, in turn, negative beliefs were associated with more problematic HF/NS.

Different patterns of discordance were evident for hot flushes and night sweats. Both subjective and objective measures should be included in the evaluation of treatments for HF/NS. The possible role of beliefs in mediating the influence of anxiety, somatic amplification and body mass index upon HF/NS experience warrants further investigation.