Endogenous hormones, participant characteristics, and symptoms among midlife women.

OBJECTIVES: The primary aim of this study was to examine the associations between endogenous hormone levels and symptoms other than hot flashes in a sample of midlife women. METHODS: Data from a community-based sample of 603 women aged 45-54 years who had never used hormone therapy were analyzed. Each participant completed a questionnaire to obtain data on demographic and lifestyle characteristics as well as symptoms, including headache, insomnia, vision problems, vaginal discharge and dryness, irritability, and incontinence. In addition, each participant provided a blood sample that was used to measure estrogen, androgen, and sex hormone binding globulin (SHBG) concentrations by enzyme-linked immunosorbent assay. RESULTS: Prevalence rates of symptoms ranged from 51.4% (irritability) to 18.6% (vision problems). In adjusted analyses, the free estradiol index (FEI) was significantly and positively associated with the reporting of insomnia (odds ratio (OR) 1.28; 95% confidence interval (CI) 1.01-1.61). Further, higher SHBG levels were significantly associated with lower odds of reporting vision problems (OR 0.44; 95% CI 0.23-0.81). CONCLUSIONS: This study provides evidence that hormones are associated with insomnia and visual problems during midlife. However, some of these results conflict with previous findings. Given the overall paucity of literature on these issues, more investigation is warranted.

Correlates of depressive symptoms among women undergoing the menopausal transition.

OBJECTIVE: Studies indicate that approximately 25% of women undergoing the menopausal transition experience depressive symptoms. The purpose of this study was to examine whether menopausal status was associated with the experiencing of depression among midlife women, to assess which demographic and health habit characteristics were associated with depressive symptoms experienced during the menopausal transition, and to analyze the associations between hormone levels and depressive symptoms. METHODS: Data from a community-based sample of 634 women aged 45 to 54 years were analyzed. Each participant completed a questionnaire and provided a blood sample that was used to measure estrogen and androgen concentrations by enzyme-linked immunosorbent assay. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D). RESULTS: Approximately 25% of the women in the study were experiencing depressive symptoms (CES-D >or=16). The data showed that being a current smoker, having little/no regular physical activity, being in poor health, and reporting a greater number of menopausal symptoms were independently and significantly associated with depressive symptoms. Menopausal status and the measured hormone levels were not significant independent correlates of depressive symptoms. CONCLUSIONS: These findings confirm the relatively high prevalence of depressive symptoms among midlife women and suggest that certain demographic, health habit, and menopausal symptom characteristics may be more important correlates of depressive symptoms in midlife than menopausal status and hormone levels.

Current alcohol use, hormone levels, and hot flashes in midlife women.

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.

Genetic polymorphisms, hormone levels, and hot flashes in midlife women.

OBJECTIVE: Hot flashes disrupt the lives of millions of women each year. Although hot flashes are a public health concern, little is known about risk factors that predispose women to hot flashes. Thus, the objective of this study was to examine whether sex steroid hormone levels and genetic polymorphisms in hormone biosynthesis and degradation enzymes are associated with the risk of hot flashes. METHODS: In a cross-sectional study design, midlife women aged 45-54 years (n=639) were recruited from Baltimore and its surrounding counties. Participants completed a questionnaire and donated a blood sample for steroid hormone analysis and genotyping. The associations between genetic polymorphisms and hormone levels, as well as the associations between genetic polymorphisms, hormone levels, and hot flashes were examined using statistical models. RESULTS: A polymorphism in CYP1B1 was associated with lower dehydroepiandrosterone-sulfate (DHEA-S) and progesterone levels, while a polymorphism in CYP19 (aromatase) was associated with higher testosterone and DHEA-S levels. Lower progesterone and sex hormone binding globulin levels, lower free estradiol index, and a higher ratio of total androgens to total estrogens were associated with the experiencing of hot flashes. A polymorphism in CYP1B1 and a polymorphism in 3betaHSD were both associated with hot flashes. CONCLUSION: Some genetic polymorphisms may be associated with altered levels of hormones in midlife women. Further, selected genetic polymorphisms and altered hormone levels may be associated with the risk of hot flashes in midlife women.

Cytochrome gene polymorphisms, serum estrogens, and hot flushes in midlife women.

OBJECTIVE: The purpose of this study was to evaluate whether genetic polymorphisms in selected cytochrome P450 enzymes (CYPc17alpha, CYP1A1, and CYP1B1), estradiol (E2) levels, and estrone levels were associated with hot flushes. METHODS: Women with hot flushes were those aged 45-54 years who reported ever experiencing hot flushes (n = 354). Women without hot flushes were those aged 45-54 years who reported never experiencing hot flushes (n = 258). Each participant completed a questionnaire and provided a blood sample for determination of genotypes, E2 levels, and estrone levels. RESULTS: Carriers of the CYP1B1 (Val432Leu) polymorphism were more likely to report having any hot flushes (risk ratio [RR] 1.16, 95% confidence interval (CI) 0.98-1.37) and at least weekly hot flushes (RR 1.29, 95% CI 0.98-1.70) than women without the polymorphism, although these associations were of borderline statistical significance. In addition, carriers of the CYP1B1 polymorphism were likely to have a statistically significant 30% increased risk of reporting moderate to severe hot flushes (RR 1.30, 95% CI 1.02-1.67) and a statistically significant 27% increased risk of reporting hot flushes lasting a year or more (RR 1.27, 95% CI 1.00-1.61) compared with women without the polymorphism. There were no associations between CYP1A1 or CYPc17alpha polymorphisms and hot flushes. Low E2 and estrone levels were associated with hot flushes, but they did not alter the association between the CYP1B1 polymorphism and hot flushes. CONCLUSION: These data suggest that a CYP1B1 polymorphism may be associated with severe and persistent hot flushes, independent of E2 and estrone levels.

Current alcohol use is associated with a reduced risk of hot flashes in midlife women.

AIMS: To examine the relation between current alcohol use, estradiol, estrone, and testosterone levels, and hot flashes in midlife women using a case-control study design. METHODS: Cases were midlife women (45-54 years) who reported ever experiencing hot flashes. Controls were midlife women (45-54 years) who reported never experiencing hot flashes. Each participant completed a questionnaire and provided a blood sample that was used to measure estradiol, estrone, and testosterone levels by enzyme-linked immunosorbent assay. RESULTS: The results indicate that current alcohol use (at least one day per month) was significantly associated with a reduced risk of hot flashes compared to non-use of alcohol, independent of age and smoking habits. The hot flashes experienced by current alcohol users were less severe and less frequent than those experienced by non-users of alcohol. Further, current alcohol users had similar levels of estradiol, estrone, and testosterone compared to non-users of alcohol. CONCLUSIONS: These data suggest that current alcohol use is associated with a reduced risk of any, severe, and frequent hot flashes in midlife women by a mechanism that may not include changes in sex steroid hormone levels.