Hot Flashes: Symptom or Power Surge?

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Hot flash! It comes on suddenly, a sensation of heat rising up through the chest, neck, and face, sometimes accompanied by profuse sweating, and lasting from a few seconds to a few minutes.

Women all over the world experience hot flashes before, during, and sometimes long after menopause. Whether you call them bouffées de chaleur, vampata di calore, or hitzewallung, hot flashes and the drenching night sweats that may accompany them, are among the primary signs of menopause, the natural end of a woman’s menstrual cycles. Yes, menopausal hot flashes are a normal life event, though they're often characterized as a hormonal deficiency requiring medical treatment. 

Depending on their severity, frequency, timing, and the social environment in which they occur, hot flashes can be annoying, embarrassing, disruptive, or even debilitating. Some women experience them rarely; others feel the burn hundreds of times each day for years.

Hot Flashes Causes

Medical researchers don't know for sure, but they hypothesize that the gradual decrease in production of reproductive hormones affects the temperature-regulating function of the brain’s hypothalamus, causing it to detect a rise in the body’s core temperature. This in turn, increases the heart rate and dilates the blood vessels, allowing heat to escape through the skin.

Certain drugs, surgeries, endocrine disorders, stress, and even allergies, can also bring on hot flashes.

Hot Flashes in Men

Because male hormones decline far more slowly than women’s and most men retain adequate amounts of testosterone to prevent hot flashes, most men don’t experience them (except vicariously and, we hope, sympathetically, if they have female partners).

However, there are exceptions, especially for men receiving androgen deprivation therapy for prostate cancer. Because these men will be under the care of a physician, they should ask their doctors about ways to help relieve especially debilitating flashes.

Hot Flashes Treatment

The usual suspects for many health problems: caffeine, alcohol, cigarette smoke, spicy food, stress, poor diet, and inactivity may also trigger or worsen hot flashes for some women.

Pharmaceudical approach

  • Research has confirmed hormone replacement therapy (HRT) as the gold standard for relieving severe or debilitating hot flashes, varying with a person’s age, health, choice of hormone(s), dose, and “delivery method” (oral, skin patch, topical preparation, implant, etc.) tailored to the individual.
  • Other prescription pharmaceuticals offered for debilitating hot flashes include antidepressants, anti-seizure medications, high-blood-pressure medications, and nitroglycerin.

Herbal and Botanical approach

But many women, wary of the potential side effects of hormone treatments and other pharmaceutical approaches, have turned to a wide variety of botanical preparations (especially phytoestrogens) to cool hot flashes, diminish night sweats, and smooth the mood swings that may also accompany menopause.  Many report they’ve found relief from herbs and plant foods.

Yet what little rigorous medical research is available on the safety and effectiveness of botanical approaches has yielded contradictory results. Because herbal supplements aren’t regulated in the same way as foods and prescription drugs, you may not know just what and how much of what your supplement contains.

The best paper I could find that summarizes the state of knowledge (as of 2008) on this topic is Toward Optimal Health: Menopause as a Rite of Passage, by Tieraona Low Dog, a medical doctor who also specializes in herbal medicine, and health writer/editor Jodi Godfrey.

If you’re using herbs, soy foods (or other phytoestrogenic products) to ease menopausal symptoms, make sure to inform your medical professional so she can make note of them in your medical record. I’d suggest printing copies of the labels or brining the actual containers so your clinician can add them to your medical record Some commercial products may cause allergies, have other side effects, or interact with prescription drugs.

Beyond Disease-mongering

Magazine and newspaper articles, medical literature and patient handouts often refer to symptoms, diagnosis, and treatments of menopause, describing “failing ovaries,” and “hormone deficiencies,” as if this natural process demands medical intervention.

There’s a long history of medicalizing the various stages of normal female sexual development.  As for the medicalization of menopause, one writer calls it the menopause industrial complex.

A book published in 1963 entitled Feminine Forever promoted the off-label use of synthetic female hormones to treat menopausal "hormone deficiencies." Its author, Dr. Robert A. Wilson, called postmenopausal women “castrates,” leading millions of women (and doctors) to believe that failing to seek treatment for these deficiencies risked falling prey to breast, endometrial, and ovarian cancers, stroke, blindness, and early death, not to mention wrinkles, sagging tissues, and the ultimate defeat--inability to hold onto their men. 

Although (HRT) is still prescribed as the most effective means of providing relief from severe and disabling hot flashes, experts now suggest starting the therapy early in menopause and administering the lowest dose for the shortest period.

Surge Ahead!

Most women pass through this natural transition without medical help. Here are some remedies to consciously weave into your everyday schedule.

  • Seek support from peers and other supportive groups.
  • Develop a mindfulness practice, such as yoga or meditation, breathing exercises, and/or visualization (imagining yourself cool).
  • Consider massage, accupressure, and other relaxation techniques.
  • Pay attention to eating well, avoiding alcohol and caffeine, and spicy foods.
  • Exercise daily, as activity has been proven to help. Keep yourself hydrated.
  • Get adequate sleep.

Even if it may not reduce the frequency or severity of hot flashes, all of these efforts will increase health, vitality, and a sense of new possibilities.

So, instead of symptom-seeking treatments, why not think of those hot flashes as power surges and explore ways to use that power for what lies ahead. 


About The Author

Margaret Boyles

Margaret Boyles is a longtime contributor to The Old Farmer’s Almanac. She wrote for UNH Cooperative Extension, managed NH Outside, and contributes to various media covering environmental and human health issues. Read More from Margaret Boyles

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