Symptoms of Menopause: The Hot Flash

Menopause marks a time in a woman's life where her strengths and focus begin to shift. Throughout her twenties, thirties and into her forties, a woman's primary concerns are finding a mate, childbearing and raising a family, and/or pursuing an education and building a career to secure the future.

As she approaches mid-life these concerns become less urgent, and many find a period of self-discovery unlike anything they have previously experienced. Women in their forties and fifties are going back to school for a long-delayed degree or pursuing creative interests. There is wisdom, and a sense of empowerment.

But for many women the physical symptoms of menopause can make this stage of life anywhere from mildly uncomfortable to downright unbearable. Hot flashes, mood swings, weight gain, decreased sex drive…the list goes on! How is it possible to enjoy this amazing time of life while faced with these physical obstacles?

Take heart ladies--there is help! In my practice the complaint I get most from menopausal and perimenopausal women are hot flashes. They can begin occurring several years before other symptoms of menopause, and will gradually decline in frequency and intensity. The majority of women who do experience hot flashes have them for 2 years or less, while a small percentage have them for more than 5 years.

The hot flash was once thought to be psychosomatic, the emotional reaction of a woman facing mid-life. But it is now known to be a very real physiological event. What is it like? Most women will experience it as an increasingly intense sensation of heat that begins in the mid-section, rising to the upper body, neck and head, often followed by a sudden outbreak of sweating, and sometimes accompanied by increased heart rate, thirst, irritability, anxiety, or even nausea. Sounds like fun, right? This may occur a couple of times a week, or for some unlucky women many times during the day and at night. For some it is merely a mild annoyance, but for others hot flashes can be so severe as to disrupt everyday life.

The exact cause of hot flashes isn't known, but medical experts think that the body’s thermostat, the hypothalamus, is involved. This is an area at the base of the brain which is responsible for maintaining the “balance” within the body known as homeostasis. Functions such as blood pressure, heart rate, digestion and other basic processes are controlled by the actions of the hypothalamus. It also regulates body temperature. It is thought that the natural reduction of estrogen as a woman ages triggers the secretion of luteinizing hormone (LH). The function of LH is to stimulate egg follicles in the ovaries to produce estrogen in response to perceived decreased levels. This surge of LH in turn tricks the hypothalamus into thinking the body is overheated and it quickly attempts to cool the body down, thus the intense release of heat known as a hot flash.

Until recently hormone replacement therapy, or HRT, was the treatment of choice for hot flashes and other symptoms of menopause. But in recent years studies have linked some kinds of HRT therapy to an increased cancer risk, especially breast cancer. So what are the alternatives?

First, know that there are things that can trigger hot flashes. Spicy foods, alcohol, smoking, hot drinks and caffeine are all common triggers. Other triggers include hot showers, being in a warm or stuffy room, wearing synthetic or wool fabrics, fatigue, and emotions such as anger, irritability and stress. Avoiding triggers whenever possible is the first step to reducing hot flashes.

Then take it one step further and try to integrate some relaxation techniques such as meditation, breathing exercises or yoga into your everyday schedule. In my opinion, this is key to controlling your hot flashes. Stress, negative thoughts and anger are powerful triggers. Try the following exercise when you begin to feel one coming on:

Take a deep slow breath in, and release slowly. Do this several times keeping your focus on your breath. Then close your eyes and breathe normally. Bring your attention to your physical self. If you feel your heart race, focus on that until it begins to slow. You can also focus on the sensation of heat as it begins to dissipate. Shifting your attention in this way will probably not stop the episode, but can lessen the intensity and duration. It will also help to relax you and lessen your anxiety.

There are a number of natural remedies to treat many of the symptoms of menopause. For hot flashes specifically, black cohosh, dang quai, licorice root, red clover, and chasteberry (also known as vitex), wild yam, and evening primrose oil have all been found to be helpful. Black cohosh has been the most studied herb for controlling hot flashes, but results are inconclusive. However, many women claim that it does provide relief. For the best results, consult with an experienced herbalist.

Many have also found significant relief from hot flashes with acupuncture and Chinese medicine. By inserting thin needles into specific points on the body, acupuncture helps to balance the body and promote healing. It does this by stimulating the nervous system to release chemicals that influence the body’s own natural healing abilities. Acupuncture has long been used to treat women’s health issues. Be sure to work with a licensed acupuncturist and if you choose to take Chinese herbs, someone who has been trained in Chinese herbology.