2005 WHRG Grant Program

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Risk Factors for Hot Flashes
Krissy Schilling
School of Medicine, University of Maryland, Baltimore

Hot flashes during mid-life are commonly described as transient periods of intense heat in the upper body, arms and face that are often followed by flushing of the skin, chills, and profuse sweating. Hot flashes pose a significant public health concern, as they are the most common perimenopausal symptom reported by women in the United States and the primary reason that women seek medical care during the menopausal transition. Approximately 50-70% of perimenopausal women experience hot flashes, and 10-20% of these women obtain medical attention for treatment of their hot flashes. Hot flashes often negatively impact the quality of life for women because they are associated with sleep disturbances resulting in fatigue, irritability, and forgetfulness, as well as acute physical discomfort and negative effects on work. Despite the importance of hot flashes in a woman's life, little is known about risk factors for hot flashes or the events that precipitate them. However, one of the most important risk factors for hot flashes may be body mass index (BMI). Preliminary data indicate that high BMI is positively associated with the occurrence and severity of hot flashes in perimenopausal women. This finding is consistent with the findings from several studies, which show that BMI is positively associated with the risk of hot flashes among women undergoing the menopausal transition. The purpose of the proposed work is to test the hypothesis that obesity is associated with hot flashes through mechanisms that involve altered sex steroid hormone levels and selected genetic polymorphisms. The specific aims of this work are to: 1) determine whether obesity is associated with selected levels of sex steroid hormones, 2) evaluate whether obesity is associated with selected polymorphisms in genes that encode enzymes that synthesize and degrade sex steroid hormones, 3) determine whether the selected polymorphisms are associated with sex steroid hormone levels, and 4) assess whether the association between obesity and hot flashes is mediated by low levels of estrogens, high levels of androgens, and/or selected genetic polymorphisms. This study will utilize 639 blood samples and questionnaires already collected from a previous case-control study on smoking and hot flashes. Genetic polymorphisms will be measured using enzyme-linked immunosorbant assay (ELISA) kits. Statistical models will then be used to determine whether: obesity is associated with altered levels of sex steroid hormones and/or selected polymorphisms in genes that encode enzymes that synthesize and degrade sex steroid hormones, and whether the association between obesity and hot flashes is mediated by low levels of estrogens, high levels of androgens, and/or selected genetic polymorphisms. A better understanding of the risk factors for hot flashes ultimately may lead to the development of preventive strategies and/or new treatments for hot flashes.