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Vasomotor Symptoms and Their Association with Depressive and Anxiety Symptoms in Peri- and Postmenopausal Women: A Systematic Review of Observational Studies

Neda-Stepan O, Enătescu VR, Giurgi-Oncu C, Bernad ES, Neamțu R, Bernad BC, Kadaș AV, Bredicean C

Medicina (Kaunas, Lithuania), 2026

9,900 participants

Abstract

Background and Objectives: Vasomotor symptoms (VMS), including hot flushes and night sweats, often co-occur with depressive and anxiety symptoms during the menopausal transition. This systematic review assessed the observational evidence for a quantitative association between VMS burden and affective symptoms in peri- and postmenopausal women. Materials and Methods: PubMed and PubMed Central were searched from database inception to 30 June 2025 for English-language, open-access observational studies reporting VMS and depressive and/or anxiety outcomes in peri- or postmenopausal women. Two reviewers independently screened records and full-text reports, and extracted data were independently verified. Study characteristics, symptom measures, prevalence or severity data, and quantitative association estimates were extracted. Owing to substantial heterogeneity of exposure and outcome measures, a structured narrative synthesis was conducted in accordance with the Synthesis Without Meta-analysis (SWiM) guideline. Risk of bias was appraised at item level using the Joanna Briggs Institute checklists and the Newcastle-Ottawa Scale, and the certainty of the evidence was rated using the GRADE approach. Results: Twelve studies involving approximately 9900 women from seven countries were included. In studies reporting adjusted estimates, greater VMS burden was associated with higher odds of depressive symptoms, with adjusted odds ratios ranging from 1.67 to 2.99; one longitudinal cohort…

How strong is the evidence?

Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 9,900 participants or records.

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