Menopausal women who experience more severe vasomotor symptoms such as hot flashes and night sweats have greater volume of white matter hyperintensities, according to a new study published in the journal Neurology.¹

This study included 226 women, aged 45-67 years, who experienced five hot flashes or night sweats in a day (two episodes of night sweats at night during sleep and three hot flashes when they were awake). None of the participants were receiving HRT. They were monitored for three days for hot flashes, night sweats and sleep patterns following which they underwent an MRI brain to measure the white matter hyperintensities.

Researchers found that the white matter hyperintensity volume (WMHV) was greater in women with physiologically measured vasomotor symptoms. The robustness of the association was greatest for symptoms occurring during sleep [sleep VMS, B(SE)= .173, wake VMS, B(SE)=.078, 24-hour VMS, B(SE)=.095). The association between the two persisted after adjusting for variables like age, diabetes, hypertension and other vascular risk factors. The authors also noted that “when considering the spatial distribution of WMHV, sleep VMS were associated with both deep WMHV, periventricular WMHV, and frontal lobe WMHV”.

The amount of white matter hyperintensities increased by around 6% with every extra episode of night sweat. The correlation between the vasomotor symptoms of hot flashes and night sweats was maximum for white matter hyperintensities in the frontal lobe of the brain.

Earlier published studies have linked white matter hyperintensities to increased risk of stroke, Alzheimer’s disease and cognitive decline. The findings of this study that vasomotor symptoms were associated with greater volume of white matter hyperintensities in middle-aged women suggest that hot flashes and night sweats, the hallmark menopausal symptoms, may not be as benign as perceived to be. They may instead be indicative of women likely to have poor brain health later on and therefore merit early intervention to prevent adverse health outcomes.

Reference

1. Thurston RC, et al. Menopausal vasomotor symptoms and white matter hyperintensities in midlife women. Neurology. 2022 Oct 12:10.1212/WNL.0000000000201401. doi: 10.1212/WNL.0000000000201401.