What are hot flushes?

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

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

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

Hot flushes may be initiated by blankets, hot-water bottles, coffee, tea and spicy foods... Hot flushes 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 flushes  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.

What causes night sweats (sleep hyperhidrosis)?

  • Night sweats is the occurrence of excessive sweating (hyperhidrosis) during sleep.
  • NIght sweats may occur at any age, but is most commonly seen in early adulthood.
  • Night sweats can be even more upsetting than daytime flushes because they disrupt sleep leading to daytime fatigue, poor memory and tension.
  • They can be hereditary and may be relatively harmless.
  • The most common causes of night sweats in women over 40 is the hormonal changes related to menopause and perimenopause. This is a very common occurrence around the menopause years. It is not dangerous or a sign of underlying disease. Some women experience night sweats during pregnancy.
  • While most causes of night sweats may be relatively harmless, others may not and can be a sign of a serious underlying disease such as infections, endocarditis, hyperthyroidism, HIV, TB and non-Hodgkins Lymphomas. True night sweats with medical causes should be properly investigated by a medical physician.

Treatment of Hot Flushes and night sweats

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

If there are night sweats, symptoms should not automatically be attributed to the menopause without consideration of other causes.

There are many options for treating hot flushes and night sweatsranging from lifestyle changes to prescription medications.

For mild hot flushes: 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 flushes. Learn to recognize your personal triggers and avoid them.
  • Stop smoking. Smoking is linked to increased hot flushes.

What about dietary supplements?

  • Black cohosh. Black cohosh has been used widely in Europe for treating hot flushes 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 flushes or night sweat relief.0801

Prescription medication options

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

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

Antidepressants. Low doses of certain antidepressants may decrease hot flushes. 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 flushes 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 flushes and can't — or choose not to — take hormone therapy. However, these medications aren't as effective as hormone therapy for severe hot flushes 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 flushes. Side effects such as dizziness, drowsiness, dry mouth and constipation can occur.


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