A Systematic Review of Anxiety and Depressive Symptoms Among Women Experiencing Vasomotor Symptoms Across Reproductive Stages in the US
Bibliographic record
Abstract
Carolyn J Gibson,1 Mayank Ajmera,2 Fiona O’Sullivan,3 Aki Shiozawa,2 Greta Lozano-Ortega,3 Elizabeth C Badillo,3 Maanasa Venkataraman,3 Shayna Mancuso2 1Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA; 2Astellas Pharma Inc., Northbrook, IL, USA; 3Broadstreet HEOR, Vancouver, BC, CanadaCorrespondence: Carolyn J Gibson, Department of Psychiatry and Behavioral Sciences, University of California, 505 Parnassus Ave, San Francisco, CA, 94143, USA, Email carolyn.gibson@ucsf.eduPurpose: Vasomotor symptoms (VMS) due to menopause affect up to 80% of women and are associated with fatigue, depressive symptoms, and anxiety although the exact nature of these associations is not fully understood. This systematic review aimed to examine the existing evidence on the relationship between VMS, fatigue, depressive symptoms, and anxiety among women in any stage of reproductive aging in the United States.Methods: A comprehensive search of MEDLINE and Embase databases was performed to identify observational studies (2010– 2022) that reported on the target population. Exposure of interest was VMS; data related to the outcomes of interest (measures of fatigue, depressive symptoms, and/or anxiety) were extracted and analyzed descriptively.Results: Twenty-six studies met the inclusion criteria, with 19 reporting on depressive symptom outcomes, 16 on anxiety outcomes, and none on fatigue. The mean age of women with VMS ranged from 41.3 to 62.0 years; 34.8% to 91.1% of women were premenopausal or in the late stage of reproductive aging, 0.6% to 61% were perimenopausal or in menopause transition, and 0% to 49% were postmenopausal. The most frequent comorbidities were hypertension and diabetes. Baseline depressive symptom rates ranged from 1.4% to 58%, with higher rates and more severe symptoms among women with more frequent and severe VMS. Anxiety rates at baseline ranged from 2.2% to 52%, with higher rates reported among women with frequent VMS. Anxiety levels varied, with the highest levels observed among women with sleep disturbances and severe hot flashes. In regression model analyses, VMS were associated with increased risk, duration, frequency, and severity of both depressive symptoms and anxiety.Conclusion: VMS are strongly and consistently associated with depressive symptoms and anxiety, negatively affecting a woman’s health beyond physical discomfort. There is a need to reduce this burden and improve quality of life for women with VMS.Keywords: depressive symptoms, hot flashes, menopause transition, night sweats, perimenopausal women, quality of life
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.007 |
| Bibliometrics | 0.013 | 0.016 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".