Epidemiology
The average age of menopause in the developed world is 51 years, a benchmark useful for counseling women in the perimenopause (also called menopausal transition or climacteric).[2] Hot flashes (vasomotor symptoms [VMS]) are the most common menopausal symptom: moderate to severe hot flashes were reported by 24% of women ages 50 to 54 years in the Women's Health Initiative.[3] Prevalence decreased rapidly with age, from 15% in women ages 55 to 59 years to 6% in the 60- to 69-year age group and only 3% in women ages >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 of VMS duration was 7.4 years.[4] Among the women who had a specific final menstrual period, the median length of VMS was lower at 4.5 years, but women who reported first hot flashes when they were premenopausal or early on in perimenopause had the longest median total duration of >11.8 years. 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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