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Menopausal hot flashes and white matter hyperintensities.

Rebecca C Thurston1, Howard J Aizenstein, Carol A Derby

  • 11Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 2Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 3Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA 4Department of Psychiatry, University of Illinois at Chicago, Chicago, IL.

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Summary

Physiologically monitored hot flashes during sleep in midlife women are linked to increased white matter hyperintensities (WMH), suggesting a connection to brain health and cardiovascular disease risk.

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Area of Science:

  • Neurology
  • Cardiology
  • Women's Health

Background:

  • Hot flashes are a common menopausal symptom with emerging links to cardiovascular disease (CVD) risk.
  • The relationship between hot flashes and brain health, specifically white matter hyperintensities (WMH), is not well understood.

Purpose of the Study:

  • To investigate the association between objectively measured and self-reported hot flashes and WMH in midlife women.
  • To explore potential links between menopausal symptoms and cerebrovascular health.

Main Methods:

  • Twenty midlife women (40-60 years) without clinical CVD underwent 24-hour physiologic hot flash monitoring and MRI for WMH assessment.
  • Sleep and wake hot flashes were quantified, alongside sleep, demographics, and CVD risk factors.
  • Linear regression models were used to test relationships between hot flashes and WMH.

Main Results:

  • A significant association was found between more physiologically monitored hot flashes during sleep and greater WMH burden (P=0.03).
  • This association remained significant after controlling for age, race, BMI, sleep characteristics, and CVD risk factors.
  • No significant relationship was observed between self-reported hot flashes and WMH.

Conclusions:

  • Physiologically monitored hot flashes during sleep are associated with increased WMH in midlife women without clinical CVD.
  • Findings suggest that the peripheral link between hot flashes and CVD risk may extend to brain health.
  • Further research is warranted to understand the role of sleep-related hot flashes in brain health.