By: Maayan S. Heller for Uterus1
A sudden, intense sensation throughout the body – a hot flash. Its name alone instigates an immediate visceral response for many.
| Hot Flash Trivia: |
In the “Western world,” about 75-85 percent of women experience hot flashes; in contrast only about 12 percent of Japanese women and 30 percent of Nigerian women report having experienced hot flashes.
Hot flashes are considered a vasomotor symptom – the biochemical events that result from your body’s temperature controlling mechanism gets “off kilter.”
Hormone Replacement Therapy (HRT) is the most common and successful means of beating the symptoms, but some medications have also had success. Talk to your doctor. Examples include venlafaxine (Effexor), paroxetine (Paxil), or fluoxetine (Prozac)
Hot flashes are not the only expression of symptoms – sometimes the same process is expressed differently. Some women have chest discomfort, palpitations, chest pain, or symptoms elsewhere in the body. Other symptoms can include itchy skin, leg cramps, “restless leg” syndrome and headaches.
Other methods of alternative management of symptoms have also been explored. Some herbal therapies like black cohosh and soy are used with varying degrees of success.
Statistics show that about four out of five women will experience hot flashes. But for those who do, some will have many over several years while others will only experience this menopausal symptom a few times.
So what exactly is a hot flash?
Some “insiders” offer these definitions:
“When I’m sitting, it feels like I’m on a heating pad, only I don’t realize it at first, and then all of a sudden the heat starts at my toes and rushes up to my head – like a thermometer.”
“I was lucky... my hot flashes were not as bad as others’. I mainly remember being damp on my neck and upper lip all of the time for about a year!"
“It’s indescribable… it’s a wave - not a wave you usually see coming - it’s a gush of radiating heat and it overwhelms every pore of the skin with sweat.”
“The feeling was a warm sensation over all of my body but especially focusing around my head and face with flushing and a dewy sensation with dewing (not sweating per se) over my whole body.”
“Within a minute my chest gets really on fire, then my neck, next my cheeks almost burn right through the skin and I'm just bright red all over.”
And what do the doctors say?
A hot flash “is the typical feeling of warmth, most commonly described as coming on suddenly, usually emanating from the upper chest, neck and face, and associated with diffuse sweating,” says Austin Wertheimer, MD, a gynecologist in private practice in Brookline and Waltham, Massachusetts.
Though the exact cause or trigger of hot flashes isn’t clear, adds Susan Hong, MD MPH, a general internist at the University of Chicago with a special interest in women’s health, it is thought “that hot flashes are due to a thermoregulatory dysfunction from estrogen withdrawal in the hypothalamic region of the brain.”
The hypothalamus – an area near the pituitary gland in the middle of the brain – is the body’s “message center” for hormone production and temperature regulation.
So as menopause approaches, hormone levels begin fluctuating. According to Dr. Wertheimer, this “fools” the hypothalamus into thinking the body is too warm. The heart then beats faster to pump blood to the body’s surface where the heat is dispersed, and the sweat glands kick in to cool the body.
“Thus,” he says, “the symptoms of palpitations, flushing and sweating.”
The intensity of a hot flash will vary from person to person, but many experts agree that certain factors have a direct correlation. Emotional stress, anxiety and lack of exercise are associated with increased intensity, as are caffeine and alcohol intake, smoking and spicy foods.
But if all women eventually go through the menopause “rite of passage,” why is it that one woman will sweat through a dozen hot flashes a day while another woman with similarly fluctuating hormone levels will stay cool and comfortable? There is not one clear answer.
“There is probably a familial predisposition to the intensity and frequency of hot flashes,” acknowledges Dr. Wertheimer.
Body fat content may play a role, he adds. “Estrogen can be synthesized by body fat tissue, so the heavier woman’s levels remain higher, thus reducing her symptoms.”
Surgeries and medical conditions have also been associated with intensity and frequency. “Women who have had their ovaries surgically removed, or whose ovarian function has been compromised through chemotherapy, some medications or certain emotional conditions, are also at risk,” says Dr. Wertheimer.
Additionally, research has shown that incidences vary among different cultures, raising questions of lifestyle factors like diet, activity and environment.
So what to do if you feel the heat?
“The first line medication treatment for hot flashes and night sweats is still hormone replacement,” says Dr. Hong. If that isn’t an option, she adds, alternative prescription medications have also been successful.
And for anyone experiencing hot flashes, simply responding to obvious “triggers” can help. Limiting alcohol consumption, drinking cold beverages at the onset of a hot flash, dressing in layers, sleeping with a fan and exercising regularly will help most women.
But since every menopausal experience is unique, there isn’t just one solution.
While hormone replacement offers the fastest and most reliable symptom relief, individual “trial and error is usually the hallmark of management for its alternatives,” says Dr. Wertheimer.
If you enjoyed this article, you might also be interested in the following: Menopause Management (Parts 1-4)