Caffeine May Worsen Vasomotor Symptoms of Menopause‏

Laurie Barclay, MD

July 29, 2014

Caffeine intake is associated with worse hot flashes and night sweats, but fewer problems with mood, memory, and concentration, in menopausal women, according to findings of a cross-sectional survey published online July 21 in Menopause.

"While these findings are preliminary, our study suggests that limiting caffeine intake may be useful for those postmenopausal women who have bothersome hot flashes and night sweats," lead author Stephanie S. Faubion, MD, director of the Women's Health Clinic at Mayo Clinic in Rochester, Minnesota, said in a clinic news release. "Menopause symptoms can be challenging but there are many management strategies to try."

In the United States, approximately 85% of people drink a caffeinated beverage daily, and about 79% of perimenopausal women and 65% of postmenopausal women have hot flashes and night sweats. Conventional wisdom is that caffeine consumption exacerbates menopausal vasomotor symptoms, but study findings have been equivocal, with caffeine positively associated with hot flashes in some studies and negatively associated in others.

Therefore, Dr. Faubion and colleagues performed a cross-sectional survey of women who presented with menopausal concerns at the Women's Health Clinic. Between July 25, 2005, and July 25, 2011, 2507 consecutive women completed the Menopause Health Questionnaire, a comprehensive survey of menopause-related health information. The current analysis included data from 1806 women who met all inclusion criteria.

The investigators compared menopausal symptom ratings between women who did and did not use caffeine, using the 2-sample t-test and analysis of covariance, with smoking and menopausal status as covariates.

Caffeine use was significantly and positively associated with mean vasomotor symptom scores (2.30 ± 0.91 vs 2.15 ± 0.94; P = .011) after adjustment for menopausal status and cigarette smoking (P = .027).

There was also an association between caffeine intake and fewer problems with mood, memory, and concentration in premenopausal, but not postmenopausal, women, which may relate to the known effects of caffeine on increasing arousal, mood, and attention.

In addition to limiting caffeine consumption, Dr. Faubion recommended other strategies to control vasomotor symptoms, including:

  • avoid spicy foods, hot beverages, and other potential triggers;

  • stop or limit alcohol and tobacco use;

  • dress in layers to cool the body by removing clothing;

  • stay cool at night with wicking sheets and sleepwear, fans, and/or cooling pillows;

  • consider stress management strategies such as acupuncture and massage;

  • maintain a healthy weight, exercise regularly, and keep active; and

  • consider hormone therapy and nonhormonal prescription medications, if needed, for symptom reduction.

Limitations of this study include its subjective reporting of menopausal symptoms, cross-sectional design, possible recall bias with underreporting of caffeine use, and lack of generalizability to women not evaluated at a subspecialty menopause clinic. In addition, detailed information was lacking about the type and amount of caffeinated beverages consumed, and the investigators could not control for the use of hormone therapy.

"Given the exploratory nature of this study, we cannot make conclusions on how clinicians should advise symptomatic perimenopausal or postmenopausal women about caffeine use in relation to their menopausal symptoms," the authors conclude. "Future investigations using well-validated questionnaires to assess menopausal symptoms, caffeine intake, diet, physical activity, and hormone therapy use in large samples of midlife women would be helpful."

The authors have disclosed no relevant financial relationships.

Menopause. Published online July 21, 2014. Abstract

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