Current alcohol use is associated with a lower risk of hot flashes through a mechanism that does not include changes in sex steroid hormone levels. The menopausal hot flash is described as a sensation of heat in the upper torso, neck, or face that is often followed by sweating or chills 1.
For millions of women, this sensation of heat can be so disruptive that it negatively impacts their quality of life 12. Thus, hot flashes are a major reason that women seek medical attention during the menopausal transition 3. Although this is an issue of public health concern, little is known about the factors that may precipitate hot flashes in certain women. Several modifiable health factors have been examined in association with the risk of hot flashes.
Body mass index 4 - 8smoking 7 - 10 and alcohol use 451112 are some of the most commonly studied modifiable risk factors for hot flashes. Both body mass index 4 - 8 and smoking 7 - 10 have been consistently associated with an increased risk of experiencing hot flashes. In contrast, data regarding the effects of alcohol use on the risk of hot flashes have been equivocal.
Studies in pre-menopausal "Drinking and hot flashes" post-menopausal women have shown a higher risk of hot flashes with alcohol use 4 Conversely, alcohol use has been associated with a lower risk of experiencing hot flashes in peri-menopausal women 5 The mechanism of the association between alcohol use and hot flashes is unknown. Some studies have shown that alcohol use alters sex steroid hormone levels 13 - 16and sex steroid hormones have been shown to be associated with the risk of hot flashes Previously, we showed that levels of estradiol, estrone, and testosterone were not significantly different between current alcohol users and never users of alcohol 12 and did not explain the observed decrease in the risk of hot flashes among current alcohol users compared to never users.
Therefore, the purpose of this study was to examine other sex steroid hormone levels progesterone, dehydroepiandrosterone-sulfate, androstenedione, sex hormone binding globulin as well as the free estradiol index FEI and free testosterone index FTItheir associations with alcohol use and hot flashes, and their potential as mediating variables. Sample methods
Drinking and hot flashes been previously described in detail elsewhere All participants in this study gave written informed consent according to the procedures and protocol approved by the University of Maryland School of Medicine and Johns Hopkins University Institutional Review Boards.
All clinic visits were scheduled in the morning and participants had their blood drawn for hormone assays, were weighed, and had their height measured. Participants completed the study survey, which included questions regarding alcohol use and a detailed hot flash history. Based on responses to the questions, never users were defined as those women who had not consumed at least 12 alcoholic beverages in their entire life, former users those who had at least 12 alcoholic beverages in any one year, but not in the past 12 months, and current users as those who had consumed at least 12 alcoholic beverages in the previous 12 months.
The assays were run using the manufacturers' instructions. Other hormones measured do not bind appreciably Drinking and hot flashes SHBG 1920 "Drinking and hot flashes" therefore free index calculations were not performed. Geometric means of hormone levels were calculated using a general linear model with adjustment for age, smoking status, race, body mass index BMIand number of days since last menstrual period.
Hormone variables, BMI, and number of days since last menstrual period were log-transformed because none were normally distributed. Risk ratios were adjusted for participant age and smoking status. A p-value of less than 0.
The levels of sex steroid hormones based on alcohol use categories are shown in Table 1. Consistent with our previous report 12we saw a lower risk of hot flashes for women who currently use alcohol compared to Drinking and hot flashes who never use alcohol. Our results are similar to those of several studies that showed no association between alcohol consumption and progesterone 1422androstenedione 1622and FEI 22 levels.
These results agree with several studies that have shown higher DHEA-S levels with alcohol consumption 13 Conversely, our results differ from those of other studies that examined alcohol use and hormone levels. Further, previous studies of pre-menopausal women differ from our results and conflict with each other regarding androstenedione levels and alcohol use. In pre-menopausal women, Garcia-Closas et al. In our study of midlife women, we saw no change in androstenedione levels alcohol use.
The reasons for the differences between our findings and those of some other studies "Drinking and hot flashes" unknown. Our study, however, was much larger than previous studies and would therefore have greater power to detect small differences in hormone levels. Current alcohol use in this study was associated with a lower risk of hot flashes compared to never use of alcohol. This is consistent with a previous study showing a lower risk of hot flashes in peri-menopausal women 5but contrary to studies in pre-menopausal 4 and post-menopausal 11 women that have shown a higher risk of hot flashes with alcohol use.
Differences between studies may be due to smaller sample size, categorization of alcohol use, and populations studied.
Our data indicate that limited alcohol use may be associated with a lower risk of hot flashes in midlife women, although the association is not explained by changes in levels of sex steroid hormones. Therefore, it may be possible that alcohol use is associated with hot flashes through another mechanism.
Previous studies indicate that alcohol consumption increases glucose levels in blood 24and that women who had experimentally elevated glucose levels experience fewer hot flashes compared to being given only saline Thus, women who consume alcohol may have higher blood glucose levels and therefore experience fewer hot flashes than women who do not consume alcohol.
The results of this study suggest that light, infrequent alcohol consumption may benefit some women experiencing hot flashes. Future studies should be conducted to confirm our findings and focus on the mechanism by which alcohol use could affect the risk of hot flashes. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript.
The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. National Center for Biotechnology Information Drinking and hot flashes, U.
Author manuscript; available in PMC Jun 1. Chrissy Schilling
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The publisher's final edited version of this article is available at Fertil Steril. See other articles in PMC that cite the published article. Abstract Current alcohol use is associated with a lower risk of hot flashes through a mechanism that does not include changes in sex steroid hormone levels.
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