So, You DON'T want a hot flash!

Goes without saying, doesn't it?


Despite the fact that 80% of menopausal women experience them, we really don't know what causes hot flashes.  We know that typically they are like a blast furnace door that suddenly opened (so you could be engulfed in intense heat) and then two minutes later closed so you could be cold, but I don't have to tell you that.  They may happen once a day or once an hour, but I don't have to tell you that.  They may go on for several months or in a few, for years, but I don't have to tell you that.  In the Study of Women's Health Across the Nation (SWAN) 20% of premenopausal women reported hot flashes.


Physiologic studies point to thermoregulatory dysfunction.  Well, yes.  Note that we use big words to restate the issue when we don't know much about it.  What we do know is that core body temperature is normal at the beginning of a hot flash and falls below normal afterwards.  We know there is abnormal peripheral vasodilatation and increased blood flow in the skin.  We also know that the thermoneutral zone (range of temperatures that you "feel" ok) narrows at menopause.  We know about physiological changes, but not what causes them.


We also know that hot flashes are associated with:

• decreased endogenous estrogen levels
• a pulse of luteinizing hormone
• increased follicle stimulating hormone (FSH)
• different sleep stage (REM suppresses hot flashes)
• decrease in normal heart rate variability 
• decreased endogenous brain opioid activity

We know that vasomotor symptoms (hot flashes) are worse for:

• obese women (despite higher endogenous estrone)
• smokers
• sedentary women
• women who are hyperthyroid

And may be triggered by:

• hot drinks
• alcohol
• anxiety
• many drugs, particularly SSRIs
• rare diseases, such as carcinoid

So many observations, but no true cause and effect found, but we can help.

Studies have shown decrease in number, duration or magnitude of hot flashes in women treated with everything from estrogen replacement to breathing "right".

Studies of women with hot flashes show that estrogen replacement is the most effective treatment, orally or transdermal.  Find out more at http://www.endo-society.org/journals/scientificstatements/upload/jc-2009-2509v1.pdf from the Endocrine Society Scientific Statement.  We have previously blogged about the risks of estrogen replacement from deep vein thrombosis to increased breast cancer.  There are almost too many studies for other attempted hot flash treatments to mention (from SSRIs and SNRIs to Vitamin E); almost as many options as those with hot flashes!  No drug or supplement has been shown to be overwhelmingly effective, but there is help.

Imagine the medicine that could treat hot flashes, increase bone density and not cause any bad side effects like breast cancer or maybe even prevent cancer.

Yes, you are right, that medicine is already available: 

• BE LEAN
• BE ACTIVE
• REGULARLY EXERCISE
• LIMIT ALCOHOL

Together we can prevent 75,000 cases of breast cancer each year!