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Self-awareness may alter perception of hot flashes in menopause

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December 17, 2018

Women who are more self-aware of their body may perceive hot flash sensations as more severe and use a broader range of severity to describe their symptoms, according to findings published in Menopause.

“An unexplored topic is to what extent self-awareness may alter [hot flash] evaluation,” Lisa J. Taylor-Swanson, PhD, assistant professor of health systems and community-based care at the University of Utah College of Nursing, and colleagues wrote in the study background. “Self-awareness, defined as engagement in a thought process of categorizing, planning, reasoning, judging and evaluating perceived symptoms or sensations or as an attentional focus on internal body sensations, may play a role in perception and evaluation of symptoms.”

Taylor-Swanson and colleagues analyzed data from 232 women aged 35 to 55 years between 1990 and 1992 who reported experiencing the menopause transition, as part of the Seattle Midlife Women’s Health Study (mean age at study entry, 41 years; 83.6% white; 72% married or partnered). The women completed health reports in 1997 and 2000. Researchers assessed two dimensions of self-awareness: balanced self-awareness and self-mistrust or rumination. Researchers used a self-awareness subscale of the Self-Consciousness Scale to assess internal state awareness, rating items such as “I’m generally attentive to my inner feelings” on a scale of 0 (extremely uncharacteristic) to 4 (extremely characteristic). Self-reflectiveness was assessed with a subscale of the same tool, rating items such as “I sometimes have the feeling that I’m off somewhere watching myself” on a similar scale of 0 to 4.

Additional concepts measured included perceived stress, anxiety, attitudes of continuity toward menopause, health perceptions of resilience and hot flash severity. Researchers assessed hot flash severity using a single item from the annual health report, with severity scored from 0 to 4 (“none” to “severe”) as a categorial variable.

Researchers found that women with greater internal self-awareness reported greater hot flash severity (beta = 0.17; P < .05). Additionally, women in later menopause transition stages reported greater hot flash severity (beta = 0.2; P < .01), whereas women with attitudes of continuity toward menopause reported less severe hot flashes (beta = –0.3; P < .001). Researchers observed no associations between self-reflection and hot flash severity; however, women reporting higher levels of self-reflection also reported a higher level of anxiety (beta = 0.63; P < .001) and attitudes of continuity toward menopause as less continuous with earlier life (beta = –0.3; P < .001).

“As [self-reflection] levels increased, perceived stress levels increased, as did anxiety, and attitudes toward menopause became less neutral and reflected more change from earlier phases of life,” the researchers wrote. “Dimensions of self-awareness, perceived stress, anxiety and attitudes toward menopause are plausible targets for future intervention design and testing.” – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.

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