Hot Flushes - Hot Flashes
Hot Flushes - Hot Flashes


Causes of hot flushes and night sweats and their treatment

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What are hot flashes?

A hot flash is a sudden temporary feeling of heat experienced by the majority of women around the time of their menopause.

Hot flashes (flushes) and night sweats are the most common symptoms associated with the menopause. Hot flashes affect 80% of women. Many women have problems with hot flushes and night sweats for just a few months, but these troublesome symptoms can persist for a number of years.

Hot flushes are not caused by a lack of estrogen, but by a sudden drop in estrogen. This is why hot flashes usually stop once the level of estrogen stabilises.

Hot flushes may be initiated by blankets, hot-water bottles, coffee, tea and spicy foods... Hot flashes can involve the neck and face, upper arms, or the entire body. They may last a few seconds only or a few minutes and they can be mild or strong. Increased blood flow to the area raises the skin temperature and this creates a flush - red and blotchy skin. Sweating is the body's natural way of trying to cool down.

The cause of hot flashes  seems to be a response to estrogen deficiency on the blood vessels in the skin which dilate resulting in increased local blood flow. Hot flushes and night sweats generally respond well to hormone replacement therapy.

Treatment of Hot Flashes and night sweats

Hot flashes and night sweats are the amongst the most common gynaecological symptoms requiring medical advice at the menopause.

There are many options for treating hot flashes ranging from lifestyle changes to prescription medications.

For mild hot flashes: Start with diet and lifestyle changes

  • Keep yourself cool. Dress in layers so that you can remove clothing when you feel too warm. Open a window or use a fan or air conditioner to keep air flowing.
  • Watch what you eat and drink. Hot and spicy foods, caffeinated beverages and alcohol can trigger hot flashes. Learn to recognize your personal triggers and avoid them.
  • Stop smoking. Smoking is linked to increased hot flashes.

What about dietary supplements?

  • Black cohosh. Black cohosh has been used widely in Europe for treating hot flashes and is becoming increasingly popular among women with menopausal symptoms in the United States. While its safety record has been good, scientific appraisal has not confirmed its efficacy for hot flashes or night sweat relief.0801

Prescription medication options

If you continue to have troublesome hot flashes your doctor may recommend hormone therapy.

Hormone Replacement Therapy and Hot flashes

Estrogen replacement therapy is the most effective treatment for hot flashes.

Antidepressants. Low doses of certain antidepressants may decrease hot flashes. Antidepressants from classes of medications known as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) have been found to relieve hot flashes in some clinical trials. These include venlafaxine (Effexor), paroxetine (Paxil), fluoxetine (Prozac), citalopram and (Celexa).

Many doctors now consider these antidepressants the treatment of choice if you have troublesome hot flashes and can't — or choose not to — take hormone therapy. However, these medications aren't as effective as hormone therapy for severe hot flashes and may cause unwanted side effects, such as nausea, dizziness, weight gain or sexual dysfunction. Talk with your doctor about whether the benefits outweigh the potential side effects for you.

Clonidine, a pill or patch used to treat high blood pressure, may provide some relief from hot flashes. Side effects such as dizziness, drowsiness, dry mouth and constipation can occur.

 

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London.

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Hot Flushes - Hot Flashes