Thursday, January 9, 2014

Understanding hot flashes

Hot flushes (aka "hot flashes") are one of the most commonly reported symptom from women who are "going through menopause". The word menopause means "the end of monthly cycles" and typically begins in the middle ages of a woman's life (late 40's to early 50's). While there are other symptoms associated with menopause such as insomnia, irritability, irregular periods, painful intercourse, etc. hot flashes are probably the most common complaint from women in this age group. According to the American College of Obstetrics and Gynecology up to 75% of menopausal women in the US will experience hot flashes.

So, what are hot flashes? To answer this I have to first explain what causes menopause in the first place. As menopause nears, the ovaries start to produce less estrogen. The lack of estrogen causes a spike in a several other hormones which, in turn, cause the symptoms of a hot flash (sudden feeling of heat that rushes to the upper body and face lasting a few seconds to several minutes). Hot flashes occur when blood vessels in the skin of the head and neck open more widely than usual, allowing more blood to shift into the area, creating heat and redness. Researchers believe that this vascular shift is due to changes in neurotransmitter activity that are not fully understood, occurring in response to rapidly changing hormone levels.
The good news, there are several options for the treatement of hot flashes! Hormonal therapy includes etrogen plus or minus progesterone (depending on whether you still have a uterus). In addition to treatment of hot flashes, estrogen therapy is also beneficial for vaginal dryness, urinary tract problems, prevention of bone loss and reducing the risk of colon cancer. There are potential risks associated with hormone therapy and should be discussed before starting these medications. Specific to hot flashes and mood changes associated with menopause, there was speculation that that a class of medications called SSRI's may help. These medications theoretically stabalize the thermo-regulatory centers of the brain. There is a new medication in this class marketed and approved specifically for menopausal women. There are also certain blood pressure medicines that can relieve symptoms of hot flashes.

Ask your doctor for more information on treatment options available for menopausal symptoms.

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