Hot flashes – intense feelings of warmth, often sudden, that characteristically begin from the neck, face, or chest. Routinely, they are associated with perspiration and anxiety.
Women at or near menopause develop hot flashes. They typically commence 1 or 2 years before menopause and cease after two years. But, in a few proportions of women, hot flashes may trouble them for an astounding 15-year period. It is noteworthy that up to three-quarters of women experience hot flashes after their menstruation winds up.
We believe that the reduction in oestrogen as menstruation ceases leads to hot flashes. Menopause is a natural phenomenon in all women. However, it may occur early following the removal of ovaries. Tamoxifen halts normal ovarian function – it can then lead to hot flashes. They may also be due to hormonal therapy during prostate cancer management. Nicotinic acid (niacin), a vitamin that we find in foods like milk, meat, and wheat, may cause them.
As noted earlier, an abrupt feeling of intense warmth is the hallmark of hot flashes. Excessive sweating and shivering ensue.
In the general sense, the symptoms are insubstantial; however, they can be severe enough to affect sleep quality or activities of daily living. They can be as brief as 30seconds or last for about 5 minutes. Up to 33% of women report as high as ten episodes daily.
These symptoms that may follow are worth noting: palpitations, tachycardia (increased heart rate), transient rise in body temperature, and brisk reflexes.
Because several conditions present with symptoms in close similitude with hot flashes, when you report them to the doctor, they will order tests to rule them out. Such investigations may include thyroid function tests, hormone profiles that include follicle situating hormone, luteinising hormone, and oestrogen. The aim is to ascertain that you do not have hyperthyroidism, lymphoma, anxiety, among other mimics.
Treating hot flashes remains a tricky endeavour to date. Replacing oestrogen to curb the condition remains the gold standard. However, several studies have shown that women who take oestrogen replacement drugs potentiate their risk of breast and uterine cancer, blood clots, myocardial infarction (heart attack), and stroke. Many women have tried herbal products but, we lack evidence to substantiate their efficacy. Besides, some of them contain a ridiculous concentration of oestrogen that may increase the probability of blood clots.
In selected instances, certain drugs – fluoxetine, paroxetine, gabapentin, soy proteins, and vitamin E may confer some relief; however, evidence is limited to ascertain their efficacy.
Since oestrogen replacement remains the ‘only’ feasible choice, the aim is to take the lowest dose that abates the symptoms. Do not self-medicate.
It is prudent to acknowledge the importance of non-conventional therapies – cold water, air conditioning, use of fans, dietary changes, exercise. It is imperative that you see a doctor immediately if you experience abdominal pain, nausea, vomiting, fever, diarrhoea, or chills. The hot flashes may be a harbinger of more sinister disease. At all times, involve your doctor if you are batting menopause such that they lay a management plan for you. It is never about drugs.
For more information about hot flashes, read this article.