Hot flashes are the most common menopausal symptom. Anywhere from 50 to 85 percent of women experience hot flashes and night sweats at some point during perimenopause. For some women hot flashes lead to loss of productivity and a decreased quality of life.
Mainstream medicine considers hot flashes to be a result of declining estrogen levels. But while hot flashes are seen in women with low estrogen, women with high estrogen levels or fluctuating estrogen levels also experience hot flashes. It is not uncommon for women to experience hot flashes during pregnancy, and also premenstrually.
What are Hot Flashes?
Hot flashes, or vasomotor flushes, are sudden rushes of heat that affect the face, neck and chest. Many women flush, sweat and then become chilled afterward.
Depending on the intensity of a hot flash, some women may experience accompanying headaches or feel dizzy, tired, weak, or lose sleep. Others experience heart palpitations or erratic heartbeats.
Hot flashes often occur just before or during the menstrual period in perimenopausal women. While hot flashes tend to go away a year or two after menopause, many women experience hot flashes post-menopausally.
Night sweats are on a continuum with hot flashes. In Traditional Chinese Medicine 3:00–4:00 A.M. is the most common time for night sweats, which may cause you to awaken drenched with sweat. Solutions are the same as for hot flashes.
What Causes Hot Flashes?
Hot flashes occur when blood vessels in the skin open more widely than usual. This causes more blood to shift into the area creating heat and redness. Researchers believe that this vascular shift is due to changes in neurotransmitter activity that are not fully understood but occur in response to erratic hormone levels.
Women with low progesterone but normal estrogen levels may experience hot flashes and night sweats. Other hormones may also play a role in causing hot flashes. Hot flashes also occur with low testosterone levels (even in men!), high follicle stimulating hormone (FSH), surges of luteinizing hormone (LH), increased cortisol, increased stress hormones and low beta–endorphin levels. Even low levels of antioxidants in the body can contribute to hot flashes, which is another reason why a hormone-balancing diet rich in nutrients and low in refined carbohydrates is important to support the body during menopause.
Certain illnesses, such as anorexia nervosa can cause hot flashes. Over-the-counter sinus and allergy medications can have an adrenaline-like effect that can trigger hot flashes. Prior to menopause, I experienced hot flashes while taking GnRH to shrink my fibroid before having it surgically removed.
It’s Not Always Your Hormones.
Hot flashes are most common in Western cultures. Women from non-western cultures, such as Japan, Hong Kong, Pakistan and Mexico report fewer menopausal symptoms, including fewer hot flashes. While a diet high in soy foods may be part of the equation in some non-western cultures, this is only part of the picture.
In our culture 70 to 85 percent of women suffer from hot flashes, sometimes severely. I believe that this is, in part, because we have been led to believe that issues that arise premenstrually and perimenopausally are just hormonal, or that they exist in a universe that is completely separate from the rest of our lives.
This is simply not true. By reducing our bodies’ signals to physical symptoms, we are “buying in” to the belief system that pervades Western medicine. While I am not discounting the direct physical effect of changing hormones, it is important to understand that uncomfortable symptoms, such as hot flashes, will be magnified and prolonged if a woman is carrying heavy emotional baggage. In general, women with a history of anxiety, panic attacks or depression are more troubled by hot flashes than women without these experiences.
10 Common Hot Flash Triggers to Avoid
Every woman can learn to stay cool by paying attention to her own individual triggers. In fact, learning your triggers may be all you need to control your hot flashes.
Here are 10 common hot flash triggers that you may want to avoid:
1. Spicy food. Many women find that spicy food aggravates or even triggers hot flashes. However, some researchers now believe that hot peppers can be great for combating hot flashes, as women in South American and Mexico rarely experience them.
2. Hot drinks. Warm beverages can heat you up just enough to trigger a hot flash. If this is true for you, stick with cold or room-temperature drinks.
3. Caffeine. Eliminate all caffeine (even decaffeinated drinks) for one week to see if caffeine is a trigger for you.
4. Alcohol. Alcohol is a refined carbohydrate that acts like sugar in the body. It can cause an epinephrine release, which can trigger a hot flash. Red wine is particularly potent.
5. Sugar. Sugar has also caused heart palpitations in some of my patients.
6. Stress. Stress causes a hormonal chain reaction in the body that has been linked to increased number and severity of hot flashes. See Solutions for ways to combat stress.
7. Hot weather. You can’t control the weather, but you can set your thermostat at a comfortable level; 70 degrees during the day and 65 at night may help keep you cool.
8. Hot tubs and saunas. Hot tubs and saunas can cause your body temperature to rise and trigger a hot flash. It’s best to avoid these if you’re sensitive.
9. Tobacco. Studies show that smoking is associated with increased frequency risk of hot flashes. This may be due to altered hormone levels in smokers. While quitting smoking may lessen the risk of hot flashes, there are plenty of other reasons not to smoke.
10. Unexpressed anger. Keeping feelings of anger and shame bottled up can lead to a whole host of health problems. Identify the root of your anger and express it openly. You may want to keep a journal to help you uncover patterns.
7 More Hot Flash Solutions
If you are keeping track of your triggers and are still hot and bothered by hot flashes, here are 7 more ways you can control the severity and frequency of your hot flashes.
1. Try estrogen replacement. Estrogen replacement is highly effective in cooling hot flashes and is considered the “gold standard.” I recommend only bioidentical estrogen at individualized doses. You may want to have your hormone levels tested before you begin using estrogen.
2. Try natural progesterone cream. 2 percent bioidentical progesterone cream has been shown to decrease hot flashes in many women at a dose of 1/4 teaspoon per day on skin. I recommend 1/4 teaspoon once or twice per day, at least 3 weeks per month, or daily if periods have stopped. Remember, bioidentical progesterone is entirely different from the synthetic progesterone found in most conventional hormone replacement regimens and in birth control pills. It has far fewer side effects compared to the synthetic varieties.
3. Learn stress reduction techniques. Dr. Herbert Benson, author of The Relaxation Response and founder of The Mind/Body Medical Institute (now The Benson-Henry Institute for Mind Body Medicine) successfully taught women relaxation techniques and cognitive behavioral skills to help them ease the transition to menopause. His studies show that relaxation-based techniques help cool hot flashes in 90 percent of women without any hormonal therapy at all.
4. Improve your diet. Many women also find relief when they improve their diets. The Menopause Food Plan that I lay out in The Wisdom of Menopause is a great place to start!
5. Try herbal therapies. There are a wide variety of herbs that can help ease hot flashes, including Angelica (Dong Quoi), burdock, chasteberry, motherwort, and licorice. Pueraria mirifica found in my Amata Life products can also help immensely.
6. Check your emotional baggage. Determine what your hot flashes mean to you. Tapping into your body’s wisdom can help ease your symptoms significantly. Many women experience hot flashes when they are angry, especially if they don’t let their anger out. Author Vicki Noble suggests that hot flashes are the body’s way of naturally cleansing what it no longer needs. If you have any doubts about your emotions, one of the best ways to figure out just how you feel about things is through keeping a journal.
7. Establish a peer support network. Studies show that women benefit both mentally and physically from mutual support. Talking with other women about your experience can help alleviate some of the anxiety often associated with menopausal symptoms.
Do you suffer from hot flashes? What have you done to alleviate this symptom?
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