Epidemiology
The average age of the menopause in the developed world is 51 years, a benchmark useful for counselling women in the perimenopause (also called menopausal transition or climacteric).[2] Hot flushes (vasomotor symptoms [VMS]) are the most common menopausal symptom: moderate to severe hot flushes were reported by 24% of women aged 50 to 54 years in the Women's Health Initiative.[3] Prevalence decreased rapidly with age, from 15% in women aged 55 to 59 years to 6% in the 60- to 69-year age group, and to only 3% in women aged >70 years.[3] The Study of Women's Health Across the Nation (SWAN), a multi-ethnic observational study of menopausal transition among 3302 women, found that the median total VMS duration was 7.4 years.[4] Among the women who had a specific final menstrual period, the median length of VMS was 4.5 years, but women who reported hot flushes when they were premenopausal or in early perimenopause had a median total duration of >11.8 years.[4] African-American women reported a median 10.1 years of VMS, the longest of any ethnicity in the study. Longer duration of VMS occurred in patients of younger age, lower educational level, greater perceived stress, and with higher depressive symptoms and anxiety.[4]
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