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Hot Flashes

Posted Oct 23 2008 6:17pm

About 75% of menopausal women experience hot flashes.

Baby_boomer_women_3 The surges of heat and sweat are just as likely to hit women in a corporate board meeting as during the afternoon car pool.  Hot flashes are a daily occurrence for most women, lasting one to five minutes.  A woman is considered to have mild to moderate symptoms if she has fewer than seven a day.  Only about one third of women have severe symptoms, experiencing more than 10 flashes a day.

Hormones are just part of the story

Hot flashes are linked with a woman's declining estrogen levels as she approaches menopause.  Researchers at Wayne State University in Detroit have studied 12 menopausal women prone to hot flashes using magnetic resonance imaging technology that allowed the scientists to track the brain functions of the women during a hot flash.

According to the results, the part of the brain that was affected is the area that perceives things like temperature, pain, hunger and erotic stimuli.   It's unclear whether this area of the brain is the source of hot flashes or just the part of the brain that experiences them.

The fact that hot flashes are related to body-temperature regulation provides compelling evidence that simple methods for staying cool really do help.  Light clothing, cold drinks, fans and air conditioning are practical ways for women to cope.  Losing weight helps because body fat acts as "insulation," keeping women hotter.  The brain-hot flash connection also begins to explain why antidepressant treatments may help stop hot flashes.  But anti-depressants have side effects, including dry mouth, nausea, insomnia and loss of libido.

An American College of Obstetricians and Gynecologists (ACOG) task force concluded that menopause hormones are the most effective treatment, reducing hot flashes by up to 90%.  They also recommend that women adopt lifestyle changes such as wearing lightweight clothing, maintaining cool room temperatures, and avoiding spicy foods, caffeine and alcohol.

The ACOG panel advises women to use the lowest effective dose for the shortest possible time and to reevaluate hormone therapy every year.  The ACOG panel notes that about 10% of menopausal women will continue to have hot flashes beyond the average four years it takes such symptoms to resolve.  "It is inappropriate to withhold HT (hormone therapy) from persistently symptomatic women who prefer to continue HT or who do not derive relief from currently available alternatives," says the ACOG report.

Sources: Home & Family and Health Journal, The Wall Street Journal, April 12, 2006 & January 11, 2007

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