High blood pressure or hypertension during pregnancy appears to be associated with having “more bothersome” menopausal symptoms – such as hot flashes, sleep disturbances and psychological symptoms – later in life, according to a new study.
The study, published in the journal Menopause on Wednesday, also suggests that women with a history of hypertension during pregnancy who use hormone therapy are more likely to report more bothersome symptoms than women with no such history.
Overall, high blood pressure during pregnancy and severe menopausal symptoms are both risk factors for cardiovascular disease in women, said Dr. Stephanie Faubion, director of the Mayo Clinic Center for Women’s Health and medical director for the North American Menopause Society. Yet just because they are linked does not mean one actually causes the other.
“The hypertensive disorder of pregnancy didn’t cause a woman to have more hot flashes, and the hot flashes aren’t going to cause heart disease,” said Faubion, who worked on the study.
“But they both appear to be markers of heart disease, and I think we just picked up the fact that they’re linked together and that women who have one are more likely to have another,” Faubion added. Heart disease is the leading cause of death for American women.
“We’re starting to understand that women have these unique things that they experience that can put them in a different category for heart disease risk and the finding that two of them seem to be linked to each other certainly was an interesting finding,” she said, adding, “We know hormone therapy reduces or eliminates hot flashes. We don’t know if that modifies the risk.”
Hypertension in pregnancy and menopausal symptoms
The new study included data from the medical records of 2,684 women between the ages of 40-65 who reported they were close to menopause or postmenopausal during consultations at Mayo Clinic women’s health campuses in Rochester, Minnesota, and Scottsdale, Arizona, between 2015 and 2019.
The Mayo researchers analyzed that data, taking a close look at each woman’s history of pregnancy and menopausal symptoms.
They found that 18.7% of women who had never been pregnant and close to 20% of those with no history of hypertension during pregnancy reported having severe or very severe hot flashes.
And more than 23% of women who had a history of high blood pressure during pregnancy reported having severe or very severe hot flashes.
The researchers found that 7.8% of women using hormone replacement therapy who had no history of pregnancy reported severe or very severe hot flashes. Among women on HRT, 13.8% of those who had no hypertension during pregnancy had bad hot flashes.
But women who took HRT and who had also suffered high blood pressure during pregnancy had the highest risk of severe hot flashes: 27% of them.
‘We used to think of hot flashes as transient and benign … they’re neither’
Most of the women in the study were White, employed and had partners. More research is needed to determine whether similar findings would emerge among a more diverse group of women. Also, some of the information on the women’s history of hypertension during pregnancy and menopausal symptoms were self-reported and therefore subject to recall bias.
Even though more research is needed, Faubion said that the new findings help shed light on what severe menopausal symptoms could mean for some women.
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“Women who are having a rough time during menopause with lots of hot flashes need to say, ‘You know what – could this be a little more than just a nuisance?’” Faubion said.
“We used to think of hot flashes as transient and benign, but we’re finding out now that they’re neither,” she said. “Hot flashes last a mean duration of seven to nine years and for a third of women last a decade or more, and we also are learning that they’re not so benign, that they are associated with some risk.”
This isn’t the first time that a connection has been found between hypertension during pregnancy and certain menopausal symptoms.
One study, published in the journal Menopause in 2013, found among women in the Netherlands that those with a history of hypertension during pregnancy reported menopausal symptoms relating to blood vessels significantly more often than women who do not have a history of hypertension during pregnancy.