Daily salivary cortisol patterns in midlife women with hot flashes.

Publication Type:

Journal Article


Clinical endocrinology (2015)


OBJECTIVE: Diurnal salivary cortisol patterns in healthy adults are well-established but have not been studied in midlife women with hot flashes. We hypothesized that frequent hot flashes are associated with aberrant cortisol patterns similar to sleep deficient individuals.

DESIGN: Cross-sectional.

PARTICIPANTS: 306 women, ages 40-62, randomized to a behavioral intervention for hot flashes.

MEASUREMENTS: Baseline comparisons of cortisol geometric means (nmol/L) from 4 daily time-points averaged over 2 consecutive days plus other calculated cortisol measures were made between groups defined by baseline: 1) mean daily hot flash frequency tertile (<5.5, N=103; >5.5-8.8, N=103; >8.8, N=100), and 2) selected characteristics. Repeated measures linear regression models of log-transformed cortisol evaluated group differences, adjusting for covariates.

RESULTS: Women were 67% White 24% African American, with 7.6 (SD 3.9)hot flashes per day. Salivary cortisol geometric means (nmol/L) among all women were: 75.0 (SD 44.8) total, 8.6 (SD 5.6) wake, 10.0 (SD 7.5) wake +30 minutes, 3.7 (SD 3.3) early afternoon, and 1.6 (SD 1.8) bedtime. Wake + 30 minute values showed an 18% median rise from wake values (interquartile range -24 to 96%), and means varied by hot flash frequency tertile, from lowest to highest: 11.4(SD 7.3), 10.3 (SD 6.5) and 8.6 (SD 7.8), respectively, p=0.003. Beside the early afternoon value (p=0.02), cortisol values did not vary by hot flash frequency.

CONCLUSION: Taken together, these findings suggest that high frequency of moderate to severe hot flashes may be associated with subtle abnormalities in cortisol concentrations - a pattern consistent with chronic sleep disturbance. This article is protected by copyright. All rights reserved.