Hot Flashes

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Roughly 75-85% of women in the United States experience hot flashes when they are in the perimenopausal stage and between 20-50% continue to get them for many years after menopause. Hot flashes are sudden waves of mild or intense body heat caused by a rush of hormonal changes as a result from decreased estrogen levels. Unpredictable in length, hot flashes can last from a few seconds to a half-hour. Some women experience up to 30-50 of these episodes each day. Anxiety, increased stress, warm temperatures and the use of substances such as caffeine, alcohol and nicotine, can trigger hot flashes. Hot flashes are associated with flushing of the entire face and upper body and can be followed by perspiration.

What are Hot Flashes?

Hot flashes, also known as “hot flushes” are momentary sensations of heat that may be accompanied by a red, flushed face and excessive sweating. Typically caused by a menopause-related drop in the body’s level of female hormones called estrogen, this drop affects the hypothalamus, an area of the brain that closely regulates body temperature. The hypothalamus senses that the body is too hot, due to mixed signals, and tells the body to release the excess heat. The body dilates the blood vessels near the skin, face, head, neck and chest. One’s heart begins to pump much faster and sweat glands release sweat as a cooling mechanism. Once the blood vessels return to the usual size, your body return to its normal temperature and you feel cool again.

Causes of Hot Flashes

The severity, duration and frequency of hot flashes vary among women, but hot flashes are directly related to the changing levels of hormones in one’s body, although there are other systemic medical conditions that can cause hot flashes, as well. Hormonal Whether due to surgical, chemical or natural age-related changes, the majority of hot flashes are caused by decreased estrogen levels, causing a direct effect on the hypothalamus, the part of the brain that is responsible for the regulation of body temperature. Due to this drop, the hypothalamus sends mixed signals and stimulates various physiological reactions, such as hot flashes. Other Causes Certain medical conditions, diseases and medications can cause hot flashes due to secreting chemicals into the blood stream that stimulate the nerves and blood vessels of the brain. Thyroid disease, cancer, panic disease, diabetes, infection, obesity and spinal chord injuries are some of the conditions that can accelerate blood flow and increase internal heat. Medications that lower estrogen levels, such as Tamoxifen (a breast cancer drug) can make for more intense hot flashes, as well as Raloxifene (an osteoporosis drug) and Gonadotropin analogues (Lupron). Also, women who experienced rapid menopause, usually characterized as the transition from being perimenopausal to postmenopausal within three to four years, often experience hot flashes more severely and for a longer duration than those whose symptoms are spread out over a period of seven to ten years.

How Long Will Hot Flashes Last For?

Hot flashes can be categorized as mild, moderate or severe. Typically, mild hot flashes last less than one minute long and produce a feeling of warmth with little sweat. Moderate hot flashes produce perspiration and can last two to four minutes. Severe hot flashes cause heavy perspiration and can last up to ten to twenty-five minutes, interfering with daily activity.

Managing Your Hot Flashes

If hot flashes are disrupting your daily routine and sleeping patterns, there are a number of self-care, diet adjustments, daily changes and medical treatments that you can make to help manage your hot flashes. Most importantly, there are certain triggers that can bring hot flashes on more frequently or cause them to be more severe.

Common Triggers

Self-care

• If you don’t already have one, consider buying an air conditioning unit, ceiling or floor fan or a hand-held battery-operated fan.
• Take a cold shower before bed
• Always have a water bottle full of ice water at hand throughout the day.
• Use cotton sheets only, not synthetics.
• Wear cotton pajamas or a nightgown to sleep.
• Use your freezer at home or in the supermarket and stick your head in when you feel a hot flash coming on.
• Adopt an abdominal breathing routine. Practice deep and slow breathing techniques to use when a hot flash arises.

Dietary Change

• Stay hydrated – One of the most important diet changes to minimize hot flashes is to drink at least eight glasses of water a day.
• Phytoestrogens – Adopt a dietary plan that includes foods that contain phytoestrogens. These plant estrogens bind to estrogen receptors in your body and can alleviate hot flashes. Soy, tofu, beans, legumes, seaweed, potatoes, apples and carrots are all wonderful sources of phytoestrogens.
• Replenishing Your Diet – Eating more calcium-rich foods, magnesium-rich foods and Vitamin E-foods, like green vegetables, nuts and almonds, are other easily adaptable diet changes to help replenish necessary electrolytes lost through perspiration.

Daily Lifestyle Changes

• Exercise – Any activity that will increase your physical exertion can make a difference in how often your hot flashes occur. Adopting an exercise regime doesn’t have to be difficult, nor boring. Some ideas: Opting for the stairs at work, walking to the local grocery store, taking a yoga or dance class with friends or chair workouts in your own home. Exercise increases endorphin levels, which increases your threshold for pain.
• Stress Reduction and Relaxation – Relaxation exercises, breathing exercises, massage, hypnosis, yoga and visualization techniques are all wonderful ways to help deal with stress and minimize the effects of stress on your body during menopause.

Treatment

• Vitamins – Increase your Vitamin E intake to 800mg/day and increase Vitamin B6 to 200-250mg/day
• Alternative Medicine – Chinese medicine (acupuncture and herbology) has been a long standing treatment for hot flashes around the world. Acupuncture stimulates endorphins and neurotransmitters, including serotonin, which helps maintain a positive sense of well-being. Two commonly used points for hot flash treatment are Spleen 6, which is above the inside of the ankle and Kidney 6, which is below the bump on the interior side of the ankle. If you have underwent a surgical menopause or a medical menopause, Chinese herbs are not strong enough to eliminate your menopausal hot flashes. According to Chinese medicine, hot flashes are considered to be a result of a decline in the yin energy of the body. Yin, known as the feminine, nourishing fluidic, structural energy of the body is closely related to estrogen and progesterone. Herbs, such as Chine wild yam, cornus, mountain bark, poria and alisma, are known to moisten the body and nourish the yin with their phytoestrogenic properties. Other herbs, such as chasteberry and vitex adnus castus, are used to reduce discomfort.

Black Cohosh
One of the most commonly used herbal remedies is Black Cohosh, a perennial plant that is a member of the buttercup family. It provides powerful phytoestrogens that mimic the hormone’s effects and bind to hormone receptors in the uterus and other parts of the body, alleviating hot flashes. Black Cohosh is also known to relieve hot flashes efficiently and is a good alternative to HRT. It is also used effectively for treating PMS, arthritis and lowering blood pressure. Red Clover, Dong Quai, Ginseng, Kava and evening primrose oil can be used as natural therapies, although there are some risks involved. Herbal supplements are not as closely regulated as prescription drugs and the amount of the herbal product, quality and safety may vary between brands.
• Herbal Remedies – Black Cohosh, Red Clover, Dong Quai, Ginseng, Kava and evening primrose oil can be used as natural therapies, although there are some risks involved. Herbal supplements are not as closely regulated as prescription drugs and the amount of the herbal product, quality and safety may vary between brands.
• Prescription Treatments – Catapres and Aldomet (blood pressure medications); Birth control pills; Zoloft and Effexor(antidepressants); Provera and Megace (other hormones); and Neurontin (anti-seizure drug)
• Hormone Therapy Treatments (HRT) – For more severe cases of menopause, women may seek surgical or pharmaceutical treatments, although it is important to keep in mind that there are many studies showing hormone replacement therapy (HRT) increases a woman’s risk of elevated blood pressure, endometrial and breast cancers, strokes, blood clots and gallbladder disease. It is advised to speak with your doctor or healthcare professional regarding the negative side effects before you begin treatment.