VMS in Menopause: Clinical Impact and Cardiovascular Risk

Welcome back to another Patient Care Online Peers & Perspectives series. The segment opens with introductions from moderator, Dr. Kristi DeSapri, a board-certified internist with fellowship training in midlife and menopause care, and panelist, Dr. Erin Michos, a cardiologist who directs a women's cardiovascular health and multidisciplinary menopause program. The discussion centers on vasomotor symptoms (VMS) — clinically defined as hot flashes and night sweats — and their broad effects on women's health during the menopausal transition.

Dr. DeSapri explains that VMS typically manifest as episodes of heat rising from the chest to the head and face, lasting one to three minutes, and affect approximately 70–80% of women during menopause. Drawing on data from the SWAN study (Study of Women Across the Nation), the expert notes that hot flashes often persist for seven or more years, with women of Hispanic and Black ethnicities reporting longer duration and greater severity. Beyond disrupting sleep and daily functioning, VMS are shown to negatively affect mood and overall productivity.

The cardiovascular dimension of VMS is a central focus of the discussion. Dr. Michos emphasizes that severe and persistent VMS serve as markers of underlying vascular risk, associated with increased rates of incident hypertension, diabetes, and cardiovascular events in longitudinal studies. The 2020 American Heart Association and ACC guidelines are cited, which recognize menopause as a vital cardiovascular risk factor. Both panelists stress the importance of all clinicians — not just menopause specialists — routinely asking patients about VMS to enable earlier cardiovascular risk identification and more proactive preventive intervention.

In the next episode, "VMS and Cardiovascular Risk: Mechanisms, Risk Factors, and Prevention," panelists continue their discussion on VMS and cardiovascular health, highlighting the key physiological mechanisms linking VMS to cardiovascular risk and emphasizing menopause as a critical window for cardiovascular screening and preventive intervention.