Hi. I’m Dr. Daniel McDyer of Florida Woman Care of Jacksonville and I would like to take a few minutes to discuss an interesting and frustrating problem from which many women suffer around the time of menopause: hot flashes.
Approximately 85% of women experience hot flashes in the few years prior to menopause or after menopause. They can be quite disruptive to normal daily activities or to sleeping patterns as many women frequently experience them at night.
The exact cause of hot flashes is uncertain, but it appears that the lower estrogen levels experienced in pre-menopause and menopause may alter the body’s temperature control mechanisms in an area of the brain called the hypothalamus resulting in increases in the core body temperature. When the core temperature increases, the blood vessels at the skin surface dilate open to allow more blood to flow to the skin in order to expel body heat. This is why many women have extremely red skin during the hot flash and it results in the heat sensation which is frequently accompanied by profuse sweating. The heat sensation typically begins in the face or chest and it may spread throughout the entire body. It typically lasts between 2 to 30 minutes. A rapid heart rate may also accompany these symptoms. They may occur a few times per week or multiple times throughout the day. Occasionally, they may create adverse consequences if they disrupt the sleeping pattern which may result in alterations of mood and impaired concentration. Fortunately, their intensity and frequency usually diminish as time passes.
The most effective treatment for hot flashes is estrogen replacement or hormone replacement therapy. It seems that providing estrogen normalizes the body temperature control mechanisms alleviating the hot flashes for the vast majority of women. Other medications that may help include antidepressant selective serotonin reuptake inhibitors, like Paxil, and a blood pressure medication called Catapres. Herbal remedies that may help include plant-based estrogens called phytoestrogens and isoflavones in ginseng and flaxseed oil. The weak estrogens in these substances may also beneficially affect the body’s temperature control mechanism. Extracts from black cohosh root have been shown to help, too.
Additionally, certain lifestyle changes may help relieve hot flashes. These include avoiding caffeine, hot drinks, chocolate, spicy or hot foods and alcohol.
Some treatments are more effective than others and some have side effects that certain women may want to avoid. If you suffer from hot flashes, please discuss this with your doctor so that he or she can help you determine a personalized treatment plan that is right for you.