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Hot Flashes

Alternate Names

  • hot flushes
  • vasomotor flushes

Definition

Hot flashes are the sensation of sudden flushing and sweating. This condition is felt by 3 out of every 4 women who go through the change of life, which is also known as menopause. It may also affect women who have had their ovaries surgically removed.

What is going on in the body?

Menopause occurs when the ovaries stop producing estrogen, one of the key female hormones and is defined as having twelve consecutive months without a menstrual period.
Menopause usually begins around the age of 50. Low estrogen levels may cause many changes in a woman's body, including hot flashes.
After the cessation of menses, hot flashes are the most common symptom of menopause. Of those women having hot flashes, 8 out of 10 have hot flashes for more than a year. From 25% up to 50% of these women may have hot flashes for up to 5 years.

Risks

What are the causes and risks of the condition?

The exact cause for hot flashes is not known. Effects on the autonomic nervous system can result in flushing and sweats that are augmented when the estrogen levels are diminished.
Studies suggest that changing hormone levels change the brain's "thermostat" that regulates temperature and blood vessel diameters. There are no known complications of hot flashes.
Night sweats may cause chronic sleep loss, which can result in:
  • depression
  • chronic fatigue

Prevention

What can be done to prevent the condition?

Menopause cannot be prevented but symptoms may be treated. A woman may feel better by:
  • avoiding smoking, caffeine, and excessive alcohol. These chemicals increase irritability and make hot flashes worse. Also, smoking can cause a woman to enter menopause at least 2 years earlier than the average non-smoking woman.
  • limiting intake of red wine, aged cheeses, and chocolate. These foods contain a chemical that may trigger hot flashes.
  • using lightweight blankets at night
  • avoiding going from a hot to cold environment, as this may bring on a hot flash
  • wearing clothing made of cotton in loose layers to absorb excess moisture
  • exercise may decrease the number or intensity of the hot flashes
  • talking to a healthcare professional regarding medicines that may include hormone replacement therapy if your symptoms are severe

Diagnosed

How is the condition diagnosed?

A complete history and physical should be done to rule out other reasons for hot flashes. Other conditions like hyperthyroidism, which is an over-active thyroid gland, diabetes, tuberculosis, rare tumors of the adrenal glands, and other chronic infections can cause hot flashes.

Long Term Effects

What are the long-term effects of the condition?

Hot flashes generally cause no long-term effects. If a woman who is still having periods begins to have hot flashes, she may be starting menopause and should consult a healthcare professional.

Other Risks

What are the risks to others?

There are no risks to others, as hot flashes are not contagious.

Treatments

What are the treatments for the condition?

Not all women want treatment for mild hot flashes. Using a fan, sipping cool water, or imagining a cool spot may help.
If hot flashes are severe or frequent or are disturbing sleep patterns, a health care professional should be consulted. He or she may suggest treatments such as hormone therapy (HT). Estrogen therapy is the most effective treatment for hot flashes, yet does have potential risks. Therefore, the risks and benefits of HT should be thoroughly discussed with your health care provider.
Because of concerns about hormone therapy, many women utilize natural medicines (herbs, vitamins or supplements) for hot flashes.
The Natural Medications Comprehensive Database (NMCD) concludes that soy has the most evidence for effectiveness and may be worth trying. Soy foods are preferred over soy supplements which have concentrated isoflavones.
The NMCD also concludes that the use of black cohosh has less evidence than soy, but might help some women. They also report there is not enough safety or efficacy data to recommend unopposed transdermal progesterone, bioidentical hormone therapy, or testosterone.
Furthermore, the NMCD concludes that there not enough safety or efficacy data to recommend red clover, DHEA, flaxseed, chasteberry, kudzu, alfalfa, hops, licorice, evening primrose, Panax ginseng, wild yam, or vitamin E for hotflashes and that dong quai should not be used due to safety concerns.
The North American Menopause Society does not recommend dong quai, evening primrose oil, ginseng, licorice, Chinese herb mixtures, acupuncture, or magnet therapy for hot flash relief due to a lack of evidence supporting their use.

Side Effects

What are the side effects of the treatments?

Side effects of hormone therapy may include:
  • nausea
  • headaches
  • weight gain
  • increased appetite
  • abdominal bloating
  • irregular vaginal bleeding
  • breast tenderness
These symptoms are usually of a short-term nature and disappear after 1 to 2 months. Use of hormone replacement therapy has been associated with an increased risk of heart disease (if women 60 years old or older) blood clots, breast cancer (if estrogen and progesterone are taken together) and cancer of the uterus. This increased risk should be discussed with a healthcare professional before therapy is started.
If you decide to use alternative therapies, the American College of Obstetricians and Gynecologists (ACOG) reminds you to be sure to tell your physician.
ACOG says that some natural medicines have the potential to cause drug interactions with other medications you are using.
Remember, too, that dietary supplements, including herbal products, are not as strictly regulated by the federal government as are prescription and over-the-counter drugs. As a result, potency may vary from product to product, or even from batch to batch of the same product.
Bear in mind that just because alternative therapies are referred to as ‘natural' remedies doesn't mean they're without risks or side effects. For this reason, you should take the same care when using alternative supplements or products as you would when using any over-the-counter or prescription medication.

After Treatment

What happens after treatment for the condition?

If untreated, hot flashes can persist anywhere from 6 months to 5 or more years before disappearing. Any treatment is aimed at decreasing the frequency and/or the severity of the hot flashes.

Monitor

How is the condition monitored?

A woman can monitor her symptoms and report them to her healthcare provider.

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