Up to 80% of women experience hot flashes during perimenopause but every experience can be different. It may (or may not) involve:
- Sweating
- Blotchy or red skin
- Heart palpitations (awareness of heart/ feelings of ‘racing heart’)
- Can happen a few times a week up to 10 times per day (!)
- Can last 30 seconds up to 10 minutes
- May be accompanies by chills or night sweats
Why does it happen?
While exact mechanisms are still uncertain, it is clear that declining estrogen plays a major part. As estrogen levels reduce, the hypothalamus (the part of the brain the regulates body temperature) can become hypersensitive to slight changes in temperature…. It thinks the body is too warm and kicks into action to cool it down. The result: blood vessel near the skin surface relax, the heart rate increases and sweat glands are activated making you feel (and look) like you just ran a race even though you might just be sitting in a meeting.
This description of hot flashes doesn’t convey the extreme impact they can have on quality of life and functioning. Whilst they are common, they do not have to be endured.
Management Options:
- Menopause Hormone therapy (MHT) is the most effective for hot flashes, with and has been shown to reduce symptoms by up 90%.
- Non-hormonal medications such as fezolinetant , gabapentin and antidepressants may be considered, particularly (for the few) women for who MHT is contraindicated
- Lifestyle modifications can help reduce the occurrence or severity of hot flashes for some women. This include avoiding triggers (eg. spicy food, hot beverages caffeine, alcohol), dressing in layer and using cooling devices (fans, AC etc).
- There is evidence that cognitive behavioural techniques can reduce the severity of hot flashes when the occur.
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