Vasomotor symptoms: viewpoint from the Indian subcontinent and management of a common menopausal problem

Vasomotor symptoms (VMS) are recognized to adversely affect the quality of life. The prevalence and the magnitude of VMS may vary across populations. Although a natural regression of VMS may be expected over a period of time, it remains the most common of symptoms for which women seek help. Menopausal hormone therapy (MHT) is currently the only treatment approved by the Food and Drug Administration that has shown uniform benefit in the management of VMS. In clinical situations when estrogen is or may be contraindicated, a finite number of alternative options, including use of neuroactive agents (SSRIs, SSNRs, and gabapentin), lifestyle changes, and nonprescription remedies such as phytoestrogens and black cohosh have been shown to provide relief, albeit with mixed results and questionable safety. Existing data identify an ethnic variation in the degree and frequency of VMS of aging; in this latter context, the Asian woman's perspective is dominantly conveyed from the perspective of Chinese and Japanese ethnicities, whereas data regarding the magnitude of burden of VMS in the postmenopausal women from other Asian ethnicities and races are sparse. This article reviews the symptoms and relates that VMS are of significant concern for the aging Asian women.