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Hot flashes and menopause: everything you need to know

- 9 min read
written by Shield Connect

What is a hot flash? A feeling of intense heat that may appear suddenly or one that may seem like it is coming on gradually is called a hot flash. It is not caused by any external sources. In an episode of hot flash, you may experience 1: Tingling in your fingers Faster heart beat … Continue reading “Hot flashes and menopause: everything you need to know”

What is a hot flash?
A feeling of intense heat that may appear suddenly or one that may seem like it is coming on gradually is called a hot flash. It is not caused by any external sources. In an episode of hot flash, you may experience 1:

    • Tingling in your fingers
    • Faster heart beat than usual
    • Sudden warm feeling in the skin
    • Flushing or face getting red
    • Sweating, particularly in the upper body

Hot flashes are reported by up to 85% of menopausal women and in about 55% of women even before the onset of the menstrual irregularity. This, thus, defines entry into the menopausal transition. The incidence and severity of hot flashes increases as women go through the menopause, peaking in the late transition and tapering off within the next several years.2

How long do hot flashes last?
Often, hot flashes occur suddenly, but how long a single episode of hot flash persists will vary from person-to-person. Some hot flashes pass after a few seconds, while some stay longer for more than 10 minutes. On an average, hot flashes last for about four minutes.1

Hot flashes also vary in its pattern of occurrence. Some women experience only a few hot flashes in a week, while others may have several in the span of an hour. The pattern also depends on where you are in your perimenopausal stage.1

What causes hot flash?
It’s not exactly clear what causes hot flashes and there are multiple studies being conducted to understand the exact cause. However, there is clear evidence that hot flashes result from hormonal changes in the body. Their connection to other health problems, such as diabetes, is also being studied.1

Obesity and metabolic syndrome may increase the incidence of hot flashes. For some women it is barely a minor annoyance, while for others, the intensity may affect their quality of life in a rather negative way.1

The most comprehensible theory implicates that there is a resetting and narrowing of the thermoregulatory system in connection with variations seen in or loss of estrogen production. In the past, hot flashes were associated exclusively to the withdrawal of estrogen; however, there has been no acute change observed in serum estradiol levels during a hot flash.2

Hot flashes have also been related to variability in both estradiol and follicle-stimulating hormone (FSH) levels. It is believed that decreased estrogen levels may reduce serotonin levels and thus upregulate the serotonin (5-hydroxytryptamine [5-HT2A]) receptor in the hypothalamus. Due to the upregulation, additional serotonin is released, which can cause activation of the 5-HT2A receptor. This activation changes the set point temperature and results in hot flashes.2

Triggers for hot flash
Some of the common triggers include1:

    • Consuming alcohol
    • Consuming products containing caffeine
    • Eating spicy foods
    • Being in a hot room
    • Feeling stressed or anxious
    • Wearing tight clothing
    • Smoking or being exposed to cigarette smoke
    • Bending over

To understand your trigger better, keeping a journal about your symptoms would be helpful. Writing down what you were doing, eating, drinking, feeling, or wearing when each hot flash began, would build a pattern that can help you avoid specific triggers.1

Quick relief methods
Some simple ways to find relief are1:

    • Dressing in layers, so you can adjust your clothing depending on how you’re feeling
    • Sipping ice water at the start of a hot flash
    • Wearing cotton nightclothes
    • Using cotton bed linens
    • Keeping a cold pack on your bedside table

Treatment methods
The frequency and severity of the hot flashes guides its treatment. The severity of hot flashes can be graded as3:

    • Mild – when hot flashes does not interfere with your usual daily activities
    • Moderate – when hot flashes interferes with usual daily activities to some extent
    • Severe – when hot flashes interfere with your usual daily activities to the extent that it cannot be performed

Management of mild hot flashes
Lifestyle modification would be helpful for women experiencing mild hot flashes. The various ways of modification include using fans; lowering the room temperature, avoiding triggers, and using clothes that are heat and sweat-friendly. Other options include Vitamin E in low doses, weight loss, and cognitive behavior therapy, however it is suggested to consult your doctor first.3

Management of moderate to severe hot flashes
Regardless of the exact cause of the hot flash, both hormone therapy and nonhormonal regimens can help to relieve vasomotor symptoms.2

Hormonal replacement therapy
Hormonal replacement therapy (HRT) with estrogen is the most effective treatment for hot flashes.3

Treatment with synthetic hormones may be an option for some women who experience severe hot flashes that are debilitating and greatly affect the quality of their life.1

Estrogen supplements balances out the amount of estrogen in your system, reducing the occurrence and severity of hot flashes and night sweats. Estrogen is usually taken with a progestin to reduce the risk of developing severe side effects, such as endometrial cancer.1

Estrogen can be taken in the form of a pill, through a vaginal cream or gel, or a patch. Your doctor would prescribe you with HRT only after examining your history and current medical condition.1

The Women’s Health Initiative (WHI) study, however, showed an increased risk of breast cancer by 26%, heart disease by 29% and stroke by 41%, in participants who took HRT for the relief of menopausal symptoms.4

Nonhormonal drug treatment
As an alternative to HRT, botanical dietary supplements have been reported to be safer. EstroG-100 is a botanical dietary supplement in tablet form is an established treatment for menopause. Numerous studies have confirmed the safety and efficacy of Tablet EstroG-100. EstroG-100 is a herbal product, containing a mixture of standardized extracts of Cynanchum wilfordii, Phlomis umbrosa and Angelica gigas, on menopausal symptoms; without any side effects.4

In a randomized, double-blind, placebo-controlled study conducted by Change et al., it was observed that EstroG-100 significantly improved the vasomotor symptoms as compared to placebo in pre-, peri- and postmenopausal women without weight gain and any serious side effects.4

Several other non-hormonal medications, such as some antidepressants, some drugs commonly prescribed for nerve pain, and some high blood pressure medications also help in relieving hot flashes. Again, your doctor would decide this after a complete examination.5

Alternative therapies
Acupuncture may be helpful, without the side effects of medication. Stress is a common hot flash trigger for many women. Hence, meditation can be very successful in helping manage stress levels. Taking stress management training might provide numerous benefits in your health and quality of life.1

References: 1. Understanding and Dealing with Hot Flashes [Internet]. Available at: https://www.healthline.com/health/menopause/understanding-hot-flashes. Accessed on Feb 2, 2021.
2. Santoro N, Epperson CN, Mathews SB. Menopausal symptoms and their management. Endocrinol Metab Clin North Am. 2015 Sep;44(3):497-515.
3. Bansal R, Aggarwal N. Menopausal hot flashes: A concise review. J Midlife Health. 2019 Jan–Mar;10(1):6–13.
4. Chang A, Kwak BY, Yi K, Kim JS. The effect of herbal extract (EstroG-100) on pre-, peri- and post-menopausal women: a randomized double-blind, placebo-controlled study. Phytother Res. 2012 Apr;26(4):510-6.
5. Menopause-related hot flashes and night sweats can last for years [Internet]. Available at: https://www.health.harvard.edu/blog/menopause-related-hot-flashes-night-sweats-can-last-years-201502237745. Accessed on Feb 2, 2021

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