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Discusses Women's Health

As I sipped my afternoon cup of coffee, I came across an article in the journal Menopause that examined the association between caffeine and menopausal symptoms. How relevant I thought…after all 85% of the US population consumes some form of caffeine containing beverage daily. And 80% of women going through perimenopausal and menopause have vasomotor symptoms i.e. hot flashes and night sweats.

This was an article from researchers at the Mayo Clinic in Rochester. They gave questionnaires to 2507 (to be exact) women who were presented with menopausal concerns at their Women’s Health Clinic between 2005 and 2011. Of these, only 1806 women filled out their forms properly and were analyzed. A vasomotor symptom bother score was used. (If I had my patients fill out any type of bother score they would congregate for hours in my office.) They also asked them to score other issues that included cognitive function, bowel and bladder function, sexual function and general symptoms. They then assessed caffeine intake by asking whether the women consumed drinks with caffeine such as coffee tea or soda.The researchers then ascertained menopausal status as well as tobacco use.

We may have to sweat a bit through the results… Caffeine use was positively associated with greater motor symptom bother scores in those who consumed caffeine. The bother score was 2.3 for women drinking coffee or having other caffeine beverages versus 2.15 for those who did not. They found that this was significant even after they adjusted for cigarette smoking (which is a menopausal and health bother). Other functions including sleep, bowel/bladder function, sexual function and general symptoms were not impacted. There may have been a decrease in what they called neurocognitive symptom bother in perimenopausal women. These women felt that their memory and cognition was slightly better with caffeine… I will continue my coffee as I write this.

The researchers couldn’t come up with the reason for this discovery but hypothesized that because caffeine and estradiol are both metabolized by the same liver enzyme, perhaps having caffeine impacts estradiol levels. Other research has not shown this correlation. Another theory they proposed was that caffeine could alter circulating levels of sex hormones by increasing the protein that binds these hormones and renders them less effective (Sort of like Sampson after a haircut.) Furthermore, studies that have examined this are mixed. However the researchers were sure that this is the largest study to date to examine the association between caffeine intake and menopausal symptom bother, particularly hot flashes and night sweats. So should I suggest to patients who have significant symptoms during menopause and don’t want to or can’t go on hormones to go off caffeine? I am not sure…the authors state at the end of the article that “given the exploratory nature of the study, we cannot make conclusions on how clinicians should advise symptomatic perimenopause or postmenopausal women about caffeine use in relation to their menopausal symptoms.” Oy! And as usual in these types of reports they suggested further investigations. I leave you to come to your own conclusions.

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