Introduction: Menopausal hot flashes are defined as rapid, intense sweating and/or an intense feeling of warmth. Subjective recordings of menopausal hot flashes can be difficult to obtain due to inconvenience to the individual and poor recall. This calls for an improved method to quantify hot flashes that are less dependent on human interaction. The goal of this study was to determine if an ambulatory skin conductance hot flash monitor would detect menopausal hot flash occurrence and frequency to the same degree as those reported by study participants. Methods: Thirty-five peri- and postmenopausal females (age: 53±4 years) participated in this study. An ambulatory, noninvasive sternal skin conductance monitor was placed on each participant for a 24-hour recording period. The monitor recorded a hot flash when an increase of 0.2 micromhos was detected in the participant’s sweat level compared to their baseline (objective). Participants manually recorded perceived hot flash occurrence on the monitor (subjective). For analysis, a monitor recording with ≥20 consecutive hours of intact data was included. Hot flash frequency was defined as the number of hot flashes per recording period. A Mann-Whitney test was conducted to compare subjective and objective hot flash frequencies. Statistical analyses for agreement in hot flash occurrence (yes/no; Cohen’s Kappa) and frequency (Bland-Altman) were completed. Data are reported as mean±SD or median (IQR). Results: The average hot flash monitor recording consisted of 23.8±0.7 hours of data. Twenty-eight females reported at least one hot flash during their recording period (5 3-9 subjective hot flashes) while 7 females did not report any hot flashes. The monitor detected at least one hot flash in 30 females (10 5-21 objective hot flashes) and no hot flashes in 5 females. For 3 participants, both the subjective and objective reports showed zero hot flashes. There was a significant difference between the frequency of hot flashes reported by all participants (3 1-8 subjective hot flashes) and those detected by the hot flash monitor (8 4-19 objective hot flashes; p=0.006). There was no agreement between the subjective (self-report) and objective (monitor) assessments of hot flash occurrence (k= -0.1734). The Bland-Altman showed a mean bias of 7.1±8.6 towards objective hot flash frequency with limits of agreement of -9.8 to 23.9. Conclusion: The ambulatory sternal skin conductance monitor used in the current study showed no agreement in detecting menopausal hot flashes compared to self-reported hot flashes. Overall, the monitor substantially overestimated the frequency of menopausal hot flashes that participants reported. While further investigation might be needed to improve the monitor’s sensitivity for accurate hot flash detection, it is possible that the monitor may be detecting subclinical menopausal hot flashes that are less recognizable to the individual. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.
Hughes et al. (Fri,) studied this question.