The Relationship Between Daily Stress and Hot Flashes in Women of Menopausal Age

OBJECTIVE: The menopause transition is accompanied by various psychological and physical symptoms including hot flashes. There is emerging evidence on the link between stress and hot flashes, yet findings have been limited and mixed. Most studies have relied primarily on between-person relationships and have overlooked important nuances of whether stress on any given day is associated with more severe hot flashes on that same day. Our study bridges this gap by examining both the between- and within-person relationships between daily psychological stress (number of stressors, stressor severity sum, and stressor severity average) and hot flash severity among women who reported experiencing at least one hot flash. We also tested the potential moderating role of neuroticism. METHODS: We conducted a secondary analysis of data from Midlife Development in the United States (MIDUS), and analyzed data from an 8-day self-report diary phase. Participants were 130 women aged 42 to 60 who reported experiencing at least 1 day of hot flashes in the 8-day period. RESULTS: Results showed that on days when hot flash was reported, daily stress was significantly associated with hot flash severity on both the between- and within-person levels. However, the relationship between daily stress and hot flash occurrence was not significant. Neuroticism did not significantly moderate any of the relationships. CONCLUSIONS: These findings indicate that among women who experienced hot flashes, on days when hot flash was reported, higher perceived stress is associated with higher hot flash severity; more importantly, hot flash severity is higher on days when stress is higher. If the within-person association is replicated in future studies, these findings may have implications for therapeutically targeting stress as a potential avenue for alleviating hot flashes.