Hot Flashes
Hot flashes are a primary and often disruptive symptom of the menopausal transition, characterized by a sudden, intense sensation of heat predominantly felt in the upper body (face, neck, chest). This feeling results from fluctuating estrogen levels impacting the brain's temperature control center (hypothalamus), making it overly sensitive to slight changes in core body temperature. The heat sensation is often accompanied by profuse sweating as the body attempts to cool down, visible skin flushing, and sometimes heart palpitations or feelings of anxiety. Following the heat, a person might experience chills. Episodes typically last from 30 seconds to five minutes, but their frequency and intensity vary greatly among individuals, ranging from occasional mild warmth to multiple severe episodes per hour, day and night (termed 'night sweats'). Common triggers include stress, warm environments, caffeine, alcohol, and spicy foods, though individual triggers vary. Identifying and managing triggers, alongside lifestyle adjustments like dressing in layers and maintaining a cool environment, can provide some relief. While strongly linked to menopause, it's advisable to discuss persistent or bothersome hot flashes with a healthcare provider to confirm the cause and explore effective management strategies, which may include hormonal or non-hormonal therapies.
Management Strategies
- Dressing in layers
- Maintaining cool ambient temperature (fans, A/C)
- Sipping cold water
- Avoiding known triggers
- Maintaining healthy weight
- Regular exercise (avoid intense workouts near bedtime)
- Stress management techniques (paced breathing, meditation, yoga, mindfulness)
- Quitting smoking
- Estrogen Therapy (ET - for women without a uterus)
- Estrogen plus Progestogen Therapy (EPT - for women with a uterus)
- Cognitive Behavioral Therapy (CBT)
- Clinical Hypnosis
- Acupuncture (evidence varies)
- SSRIs (e.g., Paroxetine - FDA approved)
- SNRIs (e.g., Venlafaxine)
- Gabapentin
- Pregabalin
- Clonidine
- Fezolinetant (Neurokinin 3 receptor antagonist - FDA approved)
Diagnostic Considerations
Primarily diagnosed based on characteristic symptoms in the context of perimenopause/menopause. Rule out other causes (e.g., thyroid issues, carcinoid syndrome, medication side effects, infections) if presentation is atypical.