Hot flushes are sudden or mild waves of heat on the upper part of the body that last from 30 seconds to a few minutes, caused by a decreased estrogen production during menopause. Hot flushes are typically experienced as a feeling of intense heat with sweating and rapid heartbeat, and may last from two to ten minutes for each occurrence. The sensation of heat usually begins in the face or face and chest, although it may appear elsewhere such as the back of the neck, and it can spread throughout the whole body. In addition to being an internal sensation, the surface of the skin, especially on the face, becomes hot to the touch. The sensation of heat is often accompanied by visible reddening of the face.

The hot flush event may be repeated a few times each week or constantly throughout the day, with the frequency reducing over time. Some women undergoing menopause never have hot flushes. Others have mild or infrequent flushes. The worst sufferers experience dozens of hot flushes each day. In addition, hot flushes are often more frequent and more intense during hot weather or in an overheated room. Hot flashes may be accompanied by perspiration and shivering, increased heart rate and/or feelings of irritation, anxiety, or panic.

Will all women going through menopause get hot flashes/flushes?

What are night sweats?

Night sweats, medically termed "sleep hyperhidrosis," are episodes of nighttime sweating, which can range from mild to profuse. They usually accompany hot flashes, and thus the usual accompaniments of hot flashes,viz: nausea, chills, headache, etc may accompany episodes of night sweats.

Will women who suffer from hot flashes and night sweats begin to suffer immediately after menopause?

Hot flashes can begin during the late premenopausal or early perimenopausal years, but

they become more frequent and severe during the late perimenopausal and early postmenopausal

years^.(3)  Hot flashes can last from a few seconds to more than an hour and persist for 1 year in 95%

of affected women and up to 5 years in 65% of affected women.⁽⁴⁾ Hot flashes are not confined

to the menopause transition associated with natural age-related decline of estrogen and progesterone.

What are the factors that trigger hot flashes or night sweats?

What is the treatment for hot flashes?

In mild cases, physical measures like avoiding synthetic clothes, spicy food, too much caffeine or alcohol, keeping a cool environment, avoiding layered clothing, etc, may help. Meditations, deep breathing exercises, and measures to reduce stress can all help.

However, in severe cases, medications called oestrogens, will be required. Treatment with oestrogen, is called hormone replacement therapy. Non-hormonal treatment like isoflavone tablets may suffice for milder symptoms. There are many other medications also available for treatment of hot flashes, for women who are not fit candidates for oestrogen treatment.

How long will a woman suffering from hot flashes have to take hormone drugs, if at all they are prescribed?

Usually hot flashes last only for 3-5 years, and drugs will be needed only for that period. However, each individual is a different person, and the duration of therapy has to be tailored as per the requirements of that person, by the doctors prescribing the medication.

Is oestrogen available in food?

Ostrogens made by plants, called phytooestrogens are available inlarge amounts in food products like soy products, and sesame seeds(til). Smaller amounts are available in chickpeas(Bengal gram, channa), garlic, Mung bean sprouts, dried apricots, dried dates, sunflowerseeds, almonds, green bean and peanuts.

They are not as potent as the oestrogens made by the human body, but they have much less side effects compared to human oestrogen. Japanese and other Asian communities who consume a lot of soy products in their diet, have fewer episodes of hot flashes.

Questions and Answers compiled by:

Dr.Shobhana Mohandas. MD.DGO.FICOG.

Consultant Gynaecologist,Sun Medical centre, Thrissur, Kerala.

Email: shobhanamohandas@yahoo.co.in.

References:

1. R. E. Williams, L. Kalilani et al, Frequency and severity of vasomotor symptoms among peri- and

postmenopausal women in the United States.: CLIMACTERIC 2008;11:32–43.

2. LL.Sievert et al., Determinants of hot flashes and night sweats: Annals of Human Biology, January–February 2006; 33(1): 4–16

3.Ratka et.al, Menopausal Vasomotor Symptoms (MVS) Survey for Assessment of Hot Flashes: fJ.Women’s Health, Volume 15, Number 1, 2006© Mary Ann Liebert, Inc.

4.Keefer.L,Blanchard EB., Hot Flash, Hot Topic: Conceptualizing Menopausal Symptoms From a Cognitive-Behavioral Perspective: Applied Psychophysiology and Biofeedback, Vol. 30, No. 1, March 2005.