Let’s Talk About Hot Flashes!
When people think about menopause, they usually think about hot flashes. This is because approximately 80% of women will experience hot flashes at some point in their menopausal transition.
Hot flashes or Hot Flushes, and night sweats are collectively known as vasomotor symptoms. These symptoms can vary greatly in terms of individual experience, but are generally characterized by an intense sensation of heat affecting the head, neck upper chest and arms. It can also be accompanied by symptoms such as sweating, chills, anxiety, heart palpitations, nausea, and irritation.
Sometimes women tell me that they feel like they are burning up from the inside.
Night sweat is simply a term used to describe a hot flash that happens at night and result in excessive sweating. These can often be a source of sleep disturbances.
Vasomotor symptoms of menopause continue to be trivialized and to this day and women are undertreated. This is because of the narrative that women are given that they have to be “unbearable” to deserve treatment. In addition, there continues to be confusion about menopause and proven treatments, not just among women themselves, but also among health care providers. This is not acceptable as these symptom can have a great effect on a woman’s quality of life.
Women need appropriate, evidenced-based, information about menopause!
So, here are some facts you should know about vasomotor symptoms (VMS) of menopause
- Underlying cause or mechanism remains unclear- it is likely that there multiple physiological processes happening at once.
- Smokers are 30% more likely to experience symptoms compared to those who never smoked.
- High fat diet, caffeine and alcohol are associated with worse VMS
- Women with high levels of anxiety are more likely to experience VMS
- Women who have had a hysterectomy have higher risk of hot flashes and night sweats that persist well over 10 years, whether or not their ovaries were removed.
- VMS have been linked to increased cardiovascular disease risk and poor bone health
- VMS can have a dramatic effect on a woman’s quality of life including her mental health, sleep and cognitive function.
- Women who know what to expect from menopause, and go into it with a better outlook tend to have less severe symptoms.
So what can be done??
If you have a health care provider who doesn’t want to discuss your VMS or brushes them off, you need to find a second opinion!
- Hormone Therapy is first-line treatment for VMS and is very effective. Estrogen + progesterone can reduce frequency by 75% and decrease severity.
- If hormone therapy is not for you, or is contraindicated for you there are other effective options.
- Paroxetine is an SSRI commonly used to manage depression is the only non-hormonal medication approved for the treatment of VMS.
- Gabapentin is something else that may be prescribed and has been shown to be effective, though it is not always well tolerated.
- Clonidine is a blood pressure medication that has also shown to work for some women, though less effective than other prescription options.
- Cognitive Behavioural Therapy has a range of benefits including improving quality of life, mood and overall functioning. It has also shown to be effective in improving VMS.
- Mindfulness based stress reduction and gentle yoga
- Soy isoflavones- these can be very effective for some women. The efficacy of soy all depends on a woman’s ability to convert soy in to equol. Approximately 2/3 woman can make this conversion and therefore there is a range of efficacy. However, soy has other benefits including a positive effect on heart health and protective against breast and prostate cancer.
- Acupuncture- Women often report a beneficial effect of acupuncture on their hot flashes. This can be a useful strategy for women who cannot take hormone therapy.
When treating women in menopause who are suffering with vasomotor symptoms, I find that a multimodal approach is most effective. Diet and lifestyle factors go hand in hand with the other strategies being used. These are the foundations that result in the best improvement for the longest period of time. If you are looking for a holistic approach to assessing and treating your menopausal symptoms, book your free Alignment Call HERE to find out how you can work with us.
Dr. Lisa Maddalena, ND
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