Perceived control, lifestyle, health, socio-demographic factors and menopause: Impact on hot flashes and night sweats

Objective: To develop a model to predict the perceived severity of hot flashes (HF) and night sweats (NS) in symptomatic middle-aged women. Methods: This was a cross-sectional study of a community-based sample of 243 women with vasomotor symptoms. Menopausal status was ascertained using the 'Stages of Reproductive Aging Workshop' criteria. Women's 'perceived control' over their symptoms was measured by a validated Portuguese version of the Perceived Control over Hot Flushes Index. Structural equation modelling was employed to construct a causal model of self-reported severity of both HF and NS, using a set of 20 variables: age, marital status, parity, professional status, educational level, family annual income, recent diseases and psychological problems, medical help-seeking behaviour to manage menopausal symptoms, use of hormone therapy and herbal/soy products, menopause status, intake of alcohol, coffee and hot beverages, smoking, physical exercise, body mass index and perceived control. Results: Significant predictors of perceived severity were the use of hormone therapy for both HF (β = -.245; p =.022) and NS (β = -.298; p =.008), coffee intake for both HF (β = -.234; p =.039) and NS (β = -.258; p =.029) and perceived control for both HF (β = -1.0; p <.001) and NS (β = -1.0; p <.001). The variables explained respectively 67% and 72% of the variability in the perceived severity of HF and NS. Women with high perceived control had a significantly lower frequency (t(235) = 2.022; p =.044) and intensity of HF (t(217) = 3.582; p <.001); similarly, participants with high perceived control presented a lower frequency (t(235) = 3.267; p <.001) and intensity (t(210) = 3.376; p <.001) of NS. Conclusion: Perceived control was the strongest predictor of the self-reported severity of both HF and NS. Other causal predictors were hormone therapy and caffeine intake. All three were associated with less severe vasomotor symptoms.