Menopause symptoms may be worse for obese women

Obese women may suffer more severe menopause symptoms like hot flashes and night sweats than their slimmer peers, a Brazilian study suggests.

Researchers compared menopause symptoms for women at a healthy weight to women who were either overweight or obese and found that three symptoms got progressively worse as women’s size increased: hot flashes and night sweats, muscle and joint problems and bladder issues.

“Intensity of hot flashes increased progressively with body mass index (BMI) and obesity had a great impact on daily activities such as involuntary interruption of work tasks and decrease of overall performance,” said lead study author Dr. Lucia Costa-Paiva of the State University of Campinas in Sao Paulo.

“There was also a lower level of leisure time activities in these women,” Costa-Paiva said by email. “Thus it adds strong evidence to encourage women on losing weight.”

Women go through menopause when they stop menstruating, which typically happens between ages 45 and 55. As the ovaries curb production of the hormones estrogen and progesterone in the years leading up to menopause and afterwards, women can experience symptoms ranging from vaginal dryness to mood swings, joint pain and insomnia.

Recent research has found that 57 percent of women between ages 40 and 64 worldwide experience hot flashes, 60 percent report sexual dysfunction, 62 percent have joint and muscle pain and 50 percent have sleep problems, the study authors note in the journal Menopause.

Doctors have long believed that obesity might protect against hot flashes because fat tissue boosts the body’s supply of estrogen, a hormone that can help blunt the severity of these symptoms, Costa-Paiva said. But the current study builds on more recent research that points in the opposite direction, suggesting that obesity might make hot flashes worse because fat works as an insulator trapping heat in the body, she said.

To assess the relationship between obesity and menopause symptom severity, Costa-Paiva and colleagues examined survey data from 749 Brazilian women aged 45 to 60 years old. Women scored symptoms from zero for no issues to four points for very severe problems.

Participants were about 53 years old on average and had typically gone through menopause when they were around 47 years old. While most of them, 68 percent, were postmenopausal, about 16 percent had not started going through menopause yet and another 16 percent were midway through the process.

The study included 288 women with a BMI below 25, which researchers classified as a normal or healthy weight, 255 overweight women with a BMI of at least 25 and less than 30, and 206 obese women with a BMI of 30 or more.

It wasn’t a controlled experiment designed to prove whether or how obesity impacts the frequency or severity of menopause symptoms. Another limitation of the survey is that it relied on women to accurately recall and report on previous experiences with symptoms, the authors note.

“To date, the evidence that weight loss will reduce symptoms is lacking as no such clinical trial has been done,” said Dr. Susan Davis, a women’s health researcher at Monash University in Melbourne, Australia, who wasn’t involved in the study.

“But we encourage weight loss at midlife in overweight women to reduce risks of cardiovascular disease, diabetes and breast cancer,” Davis said by email.

Research linking obesity to worse menopause symptoms started emerging more than a decade ago, noted Dr. Mary Jane Minkin, a reproductive health researcher at Yale Medical School in New Haven, Connecticut, who wasn’t involved in the study.

“The theory is that heat is generated centrally, and heavy women have more insulation, so that the heat cannot be dissipated as well and they get hotter,” Minkin said by email.

Losing weight can help with hot flashes as well as with muscle and joint pain associated with menopause that may be exacerbated by the extra pounds, Minkin added.

-Reuters Health

Lisa Rapaport