Early Migraines and Depression Linked to Hot Flashes in Later Life

Vascular symptoms like hot flashes and night sweats are common in middle-aged women. Even though studies have characterized risk factors for vasomotor symptoms for women within the same age group, researchers are not certain whether the same factors that appear in early adulthood influence the risk of vasomotor symptoms. 

A new study published in the journal Menopause reports that socioeconomic factors and a history of depression or migraine in early adulthood might increase the risk of vasomotor symptoms in later life. Another study shows that the combined presence of vasomotor symptoms and migraine in midlife could increase the risk of cardiovascular disease later in life. The researchers reported that this association persisted after accounting for other cardiovascular risk factors. Even though migraine headaches and vasomotor symptoms are like cardiovascular risk, new research is being conducted to find their combined impact on cardiovascular disease.  

Hot flashes and night sweats are common occurrences in midlife women, affecting 70% of this age group. These symptoms are typically observed during menopause. These vasomotor symptoms tend to be severe or frequent in about one-third of affected women. Despite the widespread prevalence of vasomotor symptoms, the risk factors for vasomotor symptoms are not well understood. 

Vasomotor symptoms are prominent during the period of menopause, and factors influencing the predisposition for vasomotor symptoms can arise early in life. In addition to their impact on quality of life, studies have shown that vasomotor symptoms are associated with an increased risk of cardiovascular disease. Researchers have also observed an association between migraine and vasomotor symptoms. 

Moreover, migraine is also associated with an increased risk of cardiovascular disease. However, it is not known whether a combined history of migraine and vasomotor symptoms can increase the risk of cardiovascular disease. 

In addition, it is unclear whether vasomotor symptoms can increase cardiovascular risk after accounting for known risk factors such as blood pressure, blood glucose and lipid levels, and smoking. Hence, the other study examined the impact of vasomotor symptoms and migraine headaches on cardiovascular risk. 

Both studies mentioned earlier include more than 1900 women. One study, Coronary Artery Risk Development in Young Adults (CARDIA), is a long-term study designed to evaluate factors in young adulthood that can increase the risk of cardiovascular disease later in life. 

The participants in this study were aged 18 to 30 and were assessed for cardiovascular risk factors every five years. The study has also gathered data on vasomotor symptoms beginning with the visit 15 years after enrollment when the participants were about 40 years old. Data on vasomotor symptoms was then collected every five years. 

The researchers determined the presence and severity of vasomotor symptoms based on the participants’ experiences of hot flashes or night sweats during the three months before each evaluation. Depending on the changes in the severity of these symptoms over time, the researchers classified the participants as experiencing minimal, increasing, or persistent vasomotor symptoms. 

A salient feature of the two studies was that, unlike previous studies, they included women undergoing gynecological procedures or using hormone therapy. 

In one study, the relationship between the history of vasomotor symptoms and migraine was examined. The cardiovascular events included in the study consisted of non-fatal and fatal cardiac events, including heart attacks, heart failure, and stroke. To account for other cardiovascular risk factors, the researchers measured blood pressure, blood cholesterol and glucose levels, body mass index, and tobacco use at the 15-year visit after enrollment. 

The analysis was then conducted after accounting for age, race, and reproductive factors like gynecological surgery, the use of oral contraceptives, or sex hormone therapy. Women who had a history of migraine and persistent vasomotor were at a two-fold higher risk of cardiovascular events than other participants who did not have a history of both. Unlike previous studies, a history of either persistent vasomotor symptoms or migraine did not independently increase the likelihood of experiencing a cardiovascular event. 

More analysis revealed that the inclusion of cardiovascular risk factors like smoking and blood glucose and cholesterol levels weakened the association between a combined history of persistent vasomotor symptoms and migraine and the risk of cardiovascular events. In other words, a history of both persistent vasomotor symptoms in combination with other cardiovascular risk factors could increase the risk of cardiovascular events. Thus, lifestyle changes, such as smoking cessation, could reduce the overall risk for cardiac events associated with vasomotor symptoms and migraine.