“Who turned up the heat?” you snarl, as the sudden sweat on the back of your neck battles the red heat creeping onto your chest. “Wait. It’s cooling off again. I must be crazy.”
Sound familiar? Hot flashes, or vasomotor symptoms, affect approximately 80% of menopausal women and are one of the tell-tale signs of menopause.
Hot flashes are the sudden intense sensations of heat for no apparent reason. They are often accompanied by a red face and chest, a fast heartbeat, and sweating. Though the episodes may last just a few minutes, they can be quite disruptive to a woman’s lifestyle and work.
Chills may follow the hot flash, attributing to more temperature instability. Some women can even experience an uncomfortable sensation just before the hot flash starts, while others describe an intense thirst that accompanies the episode.
Hot flashes at night are called night sweats and may result in frequent awakenings and, therefore, poor sleep. Women may need to change their pajamas or even sheets due to the sweating. It is possible that severe vasomotor symptoms at night can lead to poorer functioning during the day, further contributing to the emotional instability and brain fog that sometimes accompany menopause.
Frequency and when will they end?
The frequency of hot flashes can vary, even going away for a period of time, and then returning. One study of women ages 54-65 revealed that 90% had previously had hot flashes or night sweats, and despite being on average 10 years postmenopausal, 54% still had at least 30 hot flashes per week. While some women only have a few episodes a few times, others will experience uncomfortable temperature swings from early in perimenopause until many years after menopause.
Vasomotor symptoms do not strike all women equally. It is known that both smoking and obesity contribute to the increased frequency of hot flashes. Also, Black and Hispanic women report more hot flashes than women of other ethnicities.
Hot Flash Lifestyle Hacks
So, what can be done? Some lifestyle tips include:
- Try to take note of potential triggers. Do you have more hot flashes when you eat spicy food, drink wine, have coffee, stay up late at night?
- Dress in layers that can be easily removed at the start of a hot flash.
- Carry a small battery operated or hand fan.
- If you smoke, even a little bit, try to quit.
- Try to maintain a healthy weight.
- Consider learning some simple meditation techniques.
- Turn down the temperature in the bedroom, and sleep in lightweight pajamas.
- Keep a cool glass of water with you, day and night.
If the above hacks aren’t enough, talk to your healthcare provider about medications that are approved to help with vasomotor symptoms. While paroxetine is the only anti-depressant FDA-approved for hot flashes, some other anti-depressants, seizure medications, or even blood pressure pills may provide some benefit.
Other women with more severe symptoms may need hormone therapy to get them through. Hormone therapy is a personalized choice, and talking with your provider can help you decide if this is right for you.
Finally, a new non-hormonal oral medication for hot flashes was recently approved. Fezolinetant, marketed as Veozah, can help to restore the brain’s regulation of body temperature, resulting in fewer vasomotor symptoms.
Finally, some women turn to alternative therapies such as plant estrogens, black cohosh, flax seed, wild yams, ginseng, and vitamins to turn down the heat. Studies on these substances are mixed, and none are FDA approved. And, as with any medication, even “natural” supplements have potential risks and interactions, so always discuss these with your provider.
Don’t despair, your menopausal “hot mess” won’t last forever, and there are steps you can take to improve your quality of life.
If you would like help taking back control of your personal thermostat, make an appointment with a Women’s Health provider at 507-646-1478.