Menopausal Stage–Specific Associations of Body Fat Content and Total Body Water With Vasomotor Symptoms

ABSTRACT Objective To determine whether associations of body fat content and hydration status with the frequency and bothersomeness of hot flashes and night sweats differ between perimenopausal and postmenopausal women. Methods This cross‐sectional study included 408 Polish women aged 40–65 years. Body composition was assessed using anthropometry and multifrequency bioelectrical impedance analysis and included body mass index (BMI), fat mass index (FMI), relative fat mass (RFM), total body water (TBW), and the fat mass to fat‐free mass ratio (FM/FFM). Vasomotor symptoms (VMS) frequency and bothersomeness were categorized as low, moderate, or high and analyzed using ordinal logistic regression. Results In perimenopausal women, higher FMI was associated with greater hot flash frequency (OR 1.66, 95% CI 1.16–2.38) and night sweat frequency (OR 1.32, 95% CI 1.03–1.70), whereas higher BMI was associated with greater hot flash bothersomeness (OR 1.84, 95% CI 1.22–2.76). Higher TBW was associated with lower hot flash frequency (OR 0.66, 95% CI 0.46–0.95) and bothersomeness (OR 0.58, 95% CI 0.38–0.88). In postmenopausal women, higher RFM was associated with lower hot flash frequency and bothersomeness and lower night sweat frequency (OR 0.66, 95% CI 0.50–0.87), whereas higher FM/FFM was associated with greater hot flash frequency (OR 1.81, 95% CI 1.18–2.79) and bothersomeness (OR 1.54, 95% CI 1.02–2.34). Associations varied according to menopausal stage and adiposity measure. Conclusions Associations of body fat content and total body water with VMS differed by menopausal stage and adiposity measure. Assessment of VMS may benefit from considering menopausal status together with indicators of adiposity and hydration.