Hot Flashes Linked to Hip Fracture Risk in Menopausal Women

Hot Flashes May Persist After Menopause
Hot Flashes May Persist After Menopause
Women who experience vasomotor symptoms like hot flashes during menopause are at an increased risk for hip fracture than those who do not.

Women who experience moderate to severe hot flashes and night sweats during menopause have higher hip fracture rates and lower bone mineral density (BMD) than women who do not experience these vasomotor symptoms, new data published in the Journal of Clinical Endocrinology & Metabolism suggest.

Vasomotor symptoms like hot flashes and night sweats are common in menopause and can persist for years after the final menstrual period, according to back ground information in the study.

“The peak prevalence of [vasomotor symptoms] coincides with the time period of accelerated bone loss at the hip and spine. Given the high prevalence and potentially long exposure to [vasomotor symptoms], it is clinically important to examine whether these symptoms are indicative of adverse bone health,” the researchers wrote.

To determine if associations exist between vasomotor symptoms and BMD or fracture incidence, the researchers conducted a prospective cohort study examining data from 23,573 participants in the Women’s Health Initiative (WHI). All women were aged 50 to 79 years, were not using menopausal hormone therapy and were followed for an average of 8.2 years.

Women were asked about menopausal symptoms, including hot flashes and night sweats, at an initial visit and were then monitored for fractures during follow-up. As part of a sub-study, 4,867 women also had their BMD measured.

Results showed that, after adjustment for baseline age, BMI, race/ethnicity, smoking and education, the hazard ratio (HR) for hip fracture among women with moderate to severe vasomotor symptoms, as compared with no symptoms, was 1.78 (95% CI, 1.20-2.64). However, there appeared to be no association between vasomotor symptoms and vertebral fracture.

Additionally, an inverse association between severity of vasomotor symptoms and BMD was found at both the femoral neck (P=.004) and lumbar spine (P=.045), according to the study results. Moreover, women with moderate to severe vasomotor symptoms had 0.015 g/cm2 lower femoral neck BMD (95% CI, –0.025 to –0.005) and 0.016 g/cm2 lower lumbar spine BMD (95% CI, –0.032 to –0.004), as compared with women with no symptoms, in repeated measures models.

“Our findings suggest women who exhibit moderate or severe menopausal symptoms are more likely to have issues with bone health than their peers. This is the first large cohort study to examine the relationship between menopausal symptoms and bone health in menopausal women,” study researcher Carolyn J. Crandall, MD, MS, of the David Geffen School of Medicine at the University of California, Los Angeles, said in a press release.

“More research is needed to illuminate the connection between bone health and menopausal symptoms such as hot flashes. Improved understanding would help clinicians advise women on how to better prevent osteoporosis and other bone conditions. Women who have hot flashes and want to protect their bones may benefit from healthy lifestyle habits such as avoiding smoking and excessive alcohol consumption, exercising and getting sufficient calcium and vitamin D,” Dr. Crandall said.


  1. Crandall CJ et al. J Clin Endocrinol Metab. 2014;doi:10.1210/jc.2014-3062.