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URMC / Patients & Families / Health Matters / February 2015 / Cool It: What’s Behind that Hot Flash?

Cool It: What’s Behind that Hot Flash?

It’s 3 a.m. and you’re jolted awake by a burst of heat that radiates from your face, neck and torso—until you’re drenched in sweat.
woman having a hot flash
Sound familiar? It may if you’re a woman in her late 30s and beyond.
Those often joked about (but sometimes unbearable) hot flashes affect up to 75 percent of women during menopause, and 10 percent for a lifetime. UR Medicine menopause specialist Dr. James Woods offers information and tips on how to cope.
What’s Happening?
In her later childbearing years, a woman’s estrogen level typically starts to decline. Hot flashes are the most common symptom of this change in the presence of this important reproductive hormone. They come without warning and can range anywhere from mild to disruptive, often depending on when they strike. For many women, they’re a cause of sleep disruption, discomfort and irritability.
In the Zone
Scientists have found that, during her reproductive years, a woman’s body adjusts fairly easily to temperature changes in her environment. In most cases, she’ll adapt to fluctuations of 0.4 degrees without her body signaling the brain’s thermostat, the hypothalamus. This is called the thermoneutral zone.
In her menopausal years, as her estrogen level drops, this thermoneutral zone disappears. As a result, any small rise in temperature sets the hypothalamus in action as it works to lower the body’s temperature. Her heart rate increases, as does blood flow to her skin, creating that warm, flushed feeling. This is followed by a release of moisture through the sweat glands, a drop in temperature, and chills.
What to Do
While you can’t halt this natural change as you mature, there are steps you can take to help you cope with hot flashes and other symptoms of menopause. 
  • Mind-body interventions such as yoga, hypnosis, or acupuncture won’t stop hot flashes but may improve your response to the stress, sleep disorders and depression they may trigger. 
  • Exercise, healthy eating and maintaining a healthy weight may reduce the discomfort of temperature changes.
  • Medications may help.
    • Hormone replacement therapy using estrogen is the gold standard medication for managing hot flashes, usually reducing their incidence and severity. Though it’s not for everyone, short-term use is helpful to many women.
    • Other medications such as some antidepressants known as SSRIs, or the anti-seizure prescription gabapentin, have been shown to reduce hot flashes in 20 to 50 percent of women.
It’s important to partner with your health care provider to create a plan that will work best for you.
James Woods, MD
James Woods, M.D., professor of Obstetrics and Gynecology at UR Medicine, specializes in caring for women during and beyond menopause at the Hess/Woods Gynecology Practice. He is editor of the blog menoPAUSE.


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