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Menopausal hot flashes and insulin resistance

Tuomikoski, Pauliina MD, PhD; Ylikorkala, Olavi MD, PhD; Mikkola, Tomi S. MD, PhD

doi: 10.1097/gme.0b013e3182503d5d
Original Articles

Objective Recent data have indicated that menopausal hot flashes may be a determinant for cardiovascular health. Therefore, we studied the impact of hot flashes on insulin resistance, one of the most powerful markers of cardiovascular health, in recently postmenopausal women.

Methods We studied 143 recently postmenopausal (amenorrhea 6-36 mo) healthy and normal-weight women without previous hormone therapy use. The women prospectively recorded the number and severity of hot flashes for 2 weeks, and a validated total symptom score, the hot flash weekly weighted score, was calculated for each woman. Insulin resistance was assessed from fasting blood levels of glucose and insulin with the homeostasis model assessment.

Results In 12 women, the assessment of insulin (n = 11) or glucose (n = 1) failed, and they were excluded from further analysis. Thus, hot flashes were absent in 19, mild in 32, moderate in 27, and severe in 53 women. The levels of glucose or insulin, or HOMA showed no differences between these groups, nor was insulin resistance related to the number or severity of hot flashes or to the levels of C-reactive protein or sex hormone–binding globulin. Overall, insulin resistance showed a positive association with body mass index (mean difference, 0.058; 95% CI, 0.015-0.102; P = 0.009) and a negative association with level of estradiol (mean difference, −0.002; 95% CI, −0.003 to −0.001; P = 0.009).

Conclusions Insulin resistance may not be involved in hot flash–related changes in cardiovascular health. However, because of the small sample size, these findings need to be interpreted with caution.

From the Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.

Received December 22, 2011; revised and accepted February 14, 2012.

Funding/support: This work was supported by unrestricted grants from the Päivikki and Sakari Sohlberg Foundation, the Emil Aaltonen Foundation, the Finnish Medical Foundation, Finska Läkaresällskapet, Orion Farmos Research Foundation, and the Paavo Nurmi Foundation and by a special governmental grant for health sciences research. The funding sources had no role in the study design, data handling, or manuscript preparation.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Tomi S. Mikkola, MD, PhD, Department of Obstetrics and Gynecology, Helsinki University Central Hospital, PO Box 140, 00029 HUS, Helsinki, Finland. E-mail:

©2012The North American Menopause Society