OBJECTIVES: Menopausal transition is characterized by progressive decrease of estrogen levels causing various symptoms. Vasomotor symptoms (VMS; known as hot flashes) are the most common and have a significant impact on affected women. This review synthesizes the humanistic burden, economic burden and current treatment landscape of VMS associated with menopause.

METHODS: A targeted burden of illness review was conducted including searches of MEDLINE®, Embase® and the National Health Service Economic Evaluation Database (NHS EED) to identify studies assessing the burden of VMS associated with menopause. Supplementary grey literature searches provided further evidence.

RESULTS: Of 6,614 records identified, 276 studies were included into this review. Menopause affects 1 billion women worldwide. Approximately 80% of menopausal women experience VMS, with around 46% overall experiencing moderate-to-severe symptoms, lasting for up to 10 years. 24% of women with VMS reported that symptoms have a substantial impact on their quality of life (QoL), increasing with greater severity (mild: 11%; moderate: 27%; severe: 52%). More than 50% of women with VMS reported that VMS impacted their sleep, subsequently affecting their ability to perform daily tasks and work productivity. Furthermore, a greater severity of VMS has been associated with a marked increase in work impairment (mild or moderate: 4–14%; severe: 25–26%). Currently there are limited treatment options for menopausal symptoms, including VMS, with approximately 36% of women reporting dissatisfaction with their level of VMS control. Hormone therapy may not be suitable for all women, with 53–68% of women who are eligible for hormone therapy being averse to using it.

CONCLUSIONS: VMS associated with menopause can be severe and have a detrimental impact on QoL and work/productivity. Despite this, there are limited effective treatment options and a significant percentage of women are unable or unwilling to use current therapy, highlighting the considerable unmet need.