The High Cost of Hot Flashes

Summary and Comment |
March 10, 2015

The High Cost of Hot Flashes

  1. Diane E. Judge, APN/CNP

Women with untreated vasomotor symptoms used more outpatient healthcare services and lost more work days than symptom-free women.

  1. Diane E. Judge, APN/CNP

Much has been written about the effects on quality of life of moderate to severe menopausal vasomotor symptoms (VMS), which can persist for many years (NEJM JW Womens Health Mar 10 2015; [e-pub] and JAMA Intern Med 2015 Feb 16; [e-pub]). In a retrospective cohort study, researchers addressed the financial cost of VMS. Using a health insurance claims database for 60 self-insured Fortune 500 companies in the U.S., investigators matched 252,273 women with untreated VMS in a 1:1 ratio to women without VMS (by age, region, payer type, employer industry, hysterectomy history, and menopause-related diagnoses). Work loss data were available for about half the companies.

In a 12-month period, the VMS cohort had significantly more all-cause and VMS-related direct expenditures (pharmacy and outpatient, emergency department, and other healthcare visits) and more medically related work absenteeism than their VMS-free counterparts. The all-cause healthcare resource utilization (direct) cost was US$1346 per patient per year (PPPY) higher for women with VMS, equaling a 1-year total of $339,559,458 for that group. The incremental work absenteeism (indirect) cost for the VMS group was $770 PPPY, or $27,668,410 for 1 year.


The financial consequences of untreated VMS on women, the workplace, and society lead an editorialist to urge recognition that “hot flashes are more than just a nuisance.” Not all symptomatic postmenopausal women work outside the home, and VMS treatment, with its concomitant cost, probably would not totally eliminate the direct cost difference. Regardless of cost, deciding whether to seek treatment for VMS is a personal decision. Some women may find VMS only a nuisance; others may avoid treatment because they lack awareness of the range of remedies or are concerned about safety and side effects. The challenge for clinicians is to provide an objective assessment of the efficacy, risks, and benefits of available treatments versus no treatment.

Editor Disclosures at Time of Publication

  • Disclosures for Diane E. Judge, APN/CNP at time of publication Nothing to disclose


Reader Comments (2)

Andrea Bradford, PhD Other Healthcare Professional, Other

Two questions:

(1) If there are recorded VMS-related health care expenditures, is it really accurate to describe these women as being "untreated"?

(2) All-cause health care expenditures and work losses were greater in the VMS group, suggesting that this was a group of high utilizers at baseline. What proportion of these costs were actually specific to VMS?

Cynthia Dann-Beardsley Other, Other, community

Taking magnesium (preferably glycinate) to bowel tolerance (best choice) or using magnesium gel (for those who resist tablets) on upper arms at night will decrease these symptoms dramatically.

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