Menopause is a natural transition during a woman’s lifetime when the ovaries stop producing estrogen and progesterone. Menopause often brings on fatigue, insomnia, weight gain, dry skin and brittle hair, etc. Every woman is unique and may experience menopause differently, but hot flashes are one of the main health issues that could develop during this period of life. Approximately 75% of perimenopausal women in Western nations experience hot flashes .
What are Hot Flashes?
Hot flashes are abrupt, random, and episodic feelings of warmth that typically affect the neck, chest, and face and are preceded by a sudden onset of excessive sweating. They are the most frequent cause of perimenopausal women seeking medical attention, particularly if the symptoms reduce the quality of life. Feelings of heart palpitations, dizziness, sweating, headaches, exhaustion, weakness, and anxiety can be associated with hot flashes. Warm settings, hot beverages, or emotional stress might cause them to manifest. The length, severity, and incidence of hot flashes can vary, but they usually peak about a year following the last menstrual cycle. Hot flashes can last a few seconds to several minutes and can occur multiple times per day .
Causes of Hot Flashes
The precise pathophysiology of hot flashes is still unknown, but one possible explanation is an aberrant regulation of hypothalamic thermoneutral zone which leads to an extreme vasodilatation of peripheral vasculature to lose heat. Women with hot flashes begin vasodilatory response with a much smaller rise in core body temperature than normal. The mechanisms of heat loss start once their core body temperature rises by 0.4°C, ultimately leading to excessive perspiration and a feeling of extreme heat.
Major body parts experience both an increase in blood flow and heat during hot flashes. The temperature may rise from the typical range of 20°C to 33°C in the fingers and toes, but the effects of hot flashes are most severe in the upper torso (head, neck, and upper chest). The peripheral vasodilation causes heat loss, a decrease in core body temperature, and the dissipation of flushing. The chills that come along with hot flashes are a compensatory mechanism to restore the body’s core temperature to normal .
Management and Treatment of Hot Flashes
The frequency and intensity of hot flashes serve as guidelines for managing them. Hot flashes can range in severity:
- Mild: causes no disruption to routine daily activities.
- Moderate: it can sometimes impair routine daily activities.
- Severe: unable to perform daily activities due to hot flashes
Some women choose to treat their symptoms with hormones, usually called Estrogen Replacement Therapy. Menopause hormone therapy is not for everyone. The severity of hot flashes, any contraindications to hormone replacement therapy, and the presence of other menopausal symptoms can influence the treatment recommendation. Commonly used prescription medications include:
- Estrogen is the most effective therapy for relieving hot flashes, but it can increase risk of blood clots, heart attacks, strokes, and breast cancer. According to the FDA (Food and Drug Administration), menopause hormone therapy should always be used at the lowest dose and the shortest time that you need it. You should not take hormone therapy for menopause if:
- you think you are pregnant
- you have problems with vaginal bleeding
- you have had certain kinds of cancers
- you have had a stroke or heart attack
- you have had blood clots
- you have liver disease
- Antidepressants may decrease hot flashes and help with mood instability.
- Clonidine is a blood pressure lowering medication that can also provide relief from hot flashes.
Management of Mild Hot Flashes
For the majority of women experiencing mild hot flashes, changing one’s regular routine may be sufficient. Use of fans, avoiding triggers like alcohol and spices, lowering the room temperature, and wearing clothing that is sweat- and heat-friendly are among the many strategies that can frequently prove useful. Low doses of vitamin E, weight loss, and cognitive behaviour therapy are other modalities that have been used with some success .
Management of Moderate to Severe Hot Flashes
Hormone replacement therapy (HRT) is the only FDA approved treatment for moderate-to-severe menopausal hot flashes, as long as the patient is under 60 years of age and does not have any contraindications to HRT such as coronary artery disease, a history of stroke, breast cancer, venous thromboembolism or active liver disease. Hormone replacement therapy can help hot flashes as well as other menopause symptoms such vaginal atrophy, mood swings, dyspareunia, joint aches, and sleep issues .
Complementary and Alternative Medicine (CAM)
Over the past 20 years, there has been much debate about the advantages and drawbacks of hormone replacement treatment. Due to worries about the increased risk of developing breast cancer and cardiovascular diseases, menopausal women as well as many medical professionals view HRT as a potentially harmful intervention. Therefore, many women have resorted to a variety of complementary and alternative medicine therapies, including dietary changes, herbal remedies, relaxation techniques like yoga and meditation, vitamins, and minerals.
Due to its low cost and accessibility, CAM’s popularity is steadily growing. Research has shown that approximately three out of every four menopausal women have used CAM to treat their hot flashes. According to a study, the rates of CAM use rose from 48.5% to 80% between 2002 and 2008. Among many different CAM modalities, many women favored consuming herbal supplements in particular to treat menopausal symptoms .
Herbal Supplements for Hot Flashes:
Because of their alleged capacity to alleviate menopausal problems, nutraceuticals including phytoestrogens as well as herbal derivatives have grown in favor in recent times . Many different herbal formulas have been used to manage menopausal symptoms. Most popular products are made of soy isoflavones (Equelle, Amberen) black cohosh (Estroven), red clover, vitamins/minerals (Relizen) and over the counter (OTC) hormones including DHEA, topical progesterone, and melatonin. These treatments are very popular among women because they are thought to be ‘natural’ and better alternatives to estrogen therapy.
According to epidemiological studies, there may be a correlation between soy consumption and reduced hot flashes. Consumption of soy is four to nine times higher in Asian nations like Japan, Korea, China, Taiwan, and Indonesia than in Western nations such as the United States. Soy contains isoflavones which are phytoestrogens. This may be the reason why the women from Asian countries have reported fewer hot flashes (10–25%) than women in Western countries (60–90%).
Many menopause supplements in the market are soy-based products. They contain isoflavones which are plant-based estrogens (phytoestrogens). There is weak evidence that these products may reduce the frequency of hot flashes. Black cohosh (Cimifuga racemose) based products have been used worldwide for female hormonal imbalance. Presently, there is no conclusive scientific evidence that existing supplements are effective in menopause. They either lack scientific validation (black cohosh) or raise breast cancer concerns (hormones and isoflavones).
Evening Primrose Oil:
Phytoestrogens are estrogen-like substances that are present in plant materials. One of the most significant plant phytoestrogens is evening primrose oil. Symptomatic alleviation for psoriasis, premenstrual syndrome, and the prevention of platelet aggregation are some of the effects of this plant, which is a member of the Onagraceae family. There are some research reports showing that the evening primrose can be useful to treat menopausal vasomotor symptoms .
A medication with phytoestrogenic characteristics may work as an estrogen agonist by binding to the estrogen receptor, but its exact mechanism for reducing hot flashes as well as night sweats is unknown. Several large drug companies manufacture menopausal supplements using plants with phytoestrogens.
Actaea racemosa has been reported to be useful in treating menopause symptoms like hot flashes, sleeplessness, irritability, as well as musculoskeletal discomfort. Unlike phytoestrogens, Actea racemosa, Ginkgo biloba, and Valerian officinal are examples of herbal derivatives that work through estrogen-independent mechanisms to reduce menopausal symptoms.
A variety of other herbal substances are used to relieve the symptoms of menopause, including red clover, rhapontic rhubarb (Rheum rhaponticum), ginseng (Panax ginseng), dong quai (Angelica sinensis), kava (Piper methysticum), maca (Lepidium meyenii) and chaste tree (Vitex agnus castus). As a growing number of women are affected by unpleasant symptoms of menopause, there is an unmet medical need in this field with formidable opportunity for a safe and effective product.
Lifestyle Changes for Management of Hot Flashes- What Can I Do?
- Dress in layers that you can take off when a hot flash starts.
- Steer clear of coffee, alcohol, and hot foods. These may exacerbate menopausal symptoms.
- Achieve a healthy weight if possible. Obese or overweight women may get more frequent and intense hot flashes
- Try to stop smoking, not just to prevent hot flashes but also for your general health.
- Carry a little fan so you can cool off if a hot flash occurs.
- Explore mind-body techniques. Hypnotherapy, meditation, and yoga have been shown to aid in the management of hot flashes in some research studies.
ReiSHE™ and Hot Flashes:
ReiSHE™ is a complete anti-aging supplement for mature women. ReiSHE™ was created by Dr. Young Joo Lee, who currently is the Medical Director of Breast and Integrative Oncology at Anne Arundel Medical Center in Annapolis, Maryland. ReiSHE™ has shown many health benefits in women, most strikingly almost all users have experienced immediate relief from hot flashes, night sweats and insomnia. It contains the highest quality Ganoderma lucidum extract along with 4 other adaptogenic herbs that have numerous health benefits in menopause symptom control.
ReiSHE™ is made with carefully selected raw herbs without pesticides or heavy metal contamination. ReiSHE™ is manufactured at a GMP certified facility in the US. ReiSHE™ is the culmination of her medical knowledge and clinical experience, backed by her lifelong reputation as an ethical, caring and compassionate physician.
You can order ReiSHE™ at reisheherbal.com. Dr. Lee takes ReiSHE™ every day and wants to share her high quality, safe and effective formula with other women so that they can also experience many health benefits of this remarkable product.
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