Recent research by University of Victoria suggests that a woman’s insulin levels in midlife plays a major role in the menopausal hot flashes and night sweats, and how long they last.

The study was led by UVic PhD graduate Faria Athar, and was published in The Journal of Clinical Endocrinology & Metabolism.

“The study found that having higher insulin levels at age 47 predicted younger onsets of hot flashes and night sweats,” Athar said.

“Higher insulin at age 47 was also associated with longer durations of hot flashes and cold sweats, and a rise in testosterone levels across the menopausal transition. These findings help us to fill some of the gaps in our understanding of menopause symptoms and why their severity varies for different women.”

Around 75 per cent of women experience hot flashes, night sweats and cold sweats, collectively known as vasomotor symptoms. Researchers say that these can begin up to two years before a woman’s final menstrual period, and may persist for as long as 10 years, often having a significant impact on quality of life.

However, the experience can differ and the age of onset, severity and duration could vary widely. Previous studies show that race, ethnicity and socioeconomic status play a role in how a woman may experience vasomotor symptoms.

Talking to Victoria News, Nicole Templeman, assistant professor of biology at UVic and Tier 2 Canada Research Chair in Metabolic Determinants of Reproduction and Aging, talked about growing awareness of the interplay between metabolic health and reproductive health.

“Given that insulin may be elevated in the early stages of metabolic disorders, we decided to investigate whether insulin levels prior to menopause might inform the incidence and severity of menopause symptoms,” Templeman said.

The research was carried out with the help of data from the Study of Women’s Health Across the Nation (SWAN). This long-running study followed women from a pre or perimenopausal baseline between the ages of 42 and 52 over a 10 year period at seven sites across the United States.

Using metabolic measurements collected when participants were 47 years old, researchers examined how early metabolic traits related to the physical features of the menopausal transition.

They found that both insulin levels and body mass index (BMI) at age 47 predicted the timing and duration of vasomotor symptoms. The strongest association for both measures was that higher insulin or BMI was linked to an earlier onset of hot flashes.

The analyses also suggested differences in how these factors relate to hormones and symptoms. Insulin appeared to be a stronger predictor of hot flashes when other metabolic variables were considered, while BMI was more closely associated with changes in estrogen levels.

The findings raise questions about whether lifestyle changes that lower insulin such as healthy eating and regular physical activity, might help women manage or delay vasomotor symptoms.

Reversing obesity can be difficult, but insulin levels may sometimes respond more readily to lifestyle changes. For example, exercise training can lower insulin even without weight loss.

At the same time, Templeman said that further study is needed to determine if suppressing insulin levels will meaningfully change vasomotor symptoms.

“This work is showing a correlative association, but it doesn’t establish necessarily that suppressing insulin levels will meaningfully change vasomotor symptom incidence.”

Saanich News

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