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You're a woman, 40-plus. You're sitting in your office, and suddenly you notice the room temperature feels just a bit too toasty. You find yourself saying, "Is it hot in here or is it just me?"
If you haven't yet reached menopause but are approaching it, one of the things you may dread experiencing is hot flashes - that butt of jokes about women's change of life. Yet it's no laughing matter for women who experience them.
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Signs of perimenopause
- Hot flashes/night sweats
- Insomnia/fatigue
- Changes in menstrual cycle
- Mood swings/forgetfulness
- Vaginal dryness/less interest in sex
- Headaches
- Urinary problems
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Hot flashes herald the approach of menopause for more than 60 percent of women. Another common sign is very irregular menstrual periods, which may last longer or shorter or even come closer together or farther apart, depending on the woman.
"Some women don't experience any changes at all. Their period just stops, boom," says Pamela Boggs, director of education for the North American Menopause Society (NAMS). "But some women have a difficult time during perimenopause."
Perimenopause is the time leading up to menopause. Menopause is when your periods stop, and your ovaries stop making estrogen. The average age of reaching menopause in the western world is 51, but some women can reach it in their 30s and some in their 60s, according to Boggs.
"Reaching menopause is a wonderful signal that it's time to see your health care provider, take a look at all the signs you are having and also take a look at what risks you have for disease later on," Boggs says.
What is a hot flash?
Hot flashes are a result of a "thermo-regulatory glitch," Boggs says. As estrogen levels fluctuate, the body's internal thermostat called the hypothalamus sends heat surges through the body. Your face and neck may become flushed and red, and blotches may appear on your chest, back and arms. Sweating is very common.
"For some women, it's awful," says Boggs. "They'll be drenched (with sweat). Everyone has a different experience. In the worst cases, women get hot very, very quickly in just a few seconds and sweat profusely. Then immediately afterward, they get chilled, and they can do this many times a day."
Hot flashes may also relate to other signs of perimenopause. If you have hot flashes at night, you may not be getting a good sleep, and that can lead to being tired and irritable.
A hot flash can last a few moments or as much as 30 minutes. Eighty percent of women with hot flashes report that they have them for two years or less, but some women report having them for more than five years.
Hormone treatment
If you do get hot flashes, you don't just have to grin and bear it. There are many options, including hormone therapy (HT). However, HT is not for every woman. The results of the Women's Health Initiative (WHI), a 15-year research program, showed taking HT for a long time increases the risk for cardiovascular disease, blood clots and breast cancer. The Food and Drug Administration approves of hormone therapy (estrogen alone or estrogen plus progestin) only for the relief of menopausal symptoms at the lowest effective dose for the shortest period of time.
Although the WHI studies showed some benefit in terms of bone strength and fewer fractures, HT is generally not considered a good choice for treating the brittle bone disease called osteoporosis.
You and your doctor should review your HT treatment six months after you start it.
Ways to keep cool
If a woman cannot or does not wish to be on HT, she has other choices. The National Institute on Aging and the NAMS offer the following tips for coping with hot flashes:
- Exercise. Aerobic (heart-pumping) and weight-bearing exercises are a powerful remedy for many menopause complaints, including hot flashes, joint pain, irritability and sleep disturbances. Exercise also can reduce the risk of heart disease, osteoporosis and weight gain. Be sure to check with your doctor before you start.
- Avoid triggers. For some women, hot flashes are triggered by stress, caffeine, alcohol, spicy foods, or drinking or eating something very hot, such as soup.
- Reduce stress. Try deep, slow abdominal breathing, meditation, yoga, massage or a leisurely bath. Researchers have found deep, slow breathing can reduce the effects of hot flashes in half, probably by calming the central nervous system.
- Don't get overheated. Dress in layers so you can remove them at the first sign of a flash.
- Drink a glass of cold water or juice at the onset of a flash.
- Use cotton sheets, lingerie and clothing that allow your skin to "breathe."
- Talk to your health care provider about prescription drugs or "alternative" remedies.
Eating a soy-rich diet has been discussed because soy products contain estrogen-like substances. Talk with your doctor first.
For news about menopause or consumer information, call the North American Menopause Society at 1-800-774-5342.
This article was reviewed and updated June 2007.
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