Factors associated with resilience or vulnerability to hot flushes and night sweats during the menopausal transition

The aim of this study was to explore factors associated with "resilience" and "vulnerability" to hot flushes and night sweats.

A total of 4,407 women aged 45 to 54 years who were recruited from family practices in northeast Scotland responded to a postal questionnaire. Among respondents reporting high-frequency hot flushes (n = 628) or night sweats (n = 628), we compared those with low levels of bother ("resilient") with the rest. Similarly, among women reporting low-frequency hot flushes (n = 459) or night sweats (n = 459), those with high bother ("vulnerable") were compared with the rest. Forward stepwise logistic regression examined social, psychological, and physical factors associated with resilience or vulnerability to each symptom.

Women resilient to hot flushes were those who had previously not been bothered by their menstrual periods; were not experiencing somatic symptoms or night sweats; and perceived their symptoms as having low consequences on their lives. Those vulnerable to hot flushes had children; had a high body mass index; reported night sweats; and perceived their symptoms as having high life consequences. Women resilient to night sweats were nonsmokers; were not experiencing sleep difficulties; were not using psychological symptom management strategies; and perceived their menopausal symptoms as having low life consequences. Those vulnerable to night sweats had low educational attainment; had previously been bothered by their menstrual periods; had below-average physical health; reported musculoskeletal symptoms and hot flushes; and perceived their menopausal symptoms as having high life consequences.

Factors associated with resilience or vulnerability differ by symptom studied, although relationships with illness perceptions exist in all models. Our results suggest that a single approach to managing these symptoms is likely to be unsuccessful.