Hot flash
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Hot flashes (also known as hot flushes, or night sweats if they happen at night) are a symptom of the changing hormone levels that are considered to be characteristic of menopause.^[1][2]

Description

Hot flashes, a common symptom of menopause and perimenopause, are typically experienced as a feeling of intense heat with sweating and rapid heartbeat, and may typically last from two to thirty minutes for each occurrence. The sensation of heat usually begins in the face or face and chest, although it may appear elsewhere such as the back of the neck, and it can spread throughout the whole body. Some women pass out if the effects are strong enough. In addition to being an internal sensation, the surface of the skin, especially on the face, becomes hot to the touch. This is the origin of the alternative term "hot flush," since the sensation of heat is often accompanied by visible reddening of the face. Excessive flushing can lead to rosacea^[3].

The hot-flash event may be repeated a few times each week or constantly throughout the day, with the frequency reducing over time. Hot flashes may begin to appear several years before menopause starts and last for years afterwards. Some women undergoing menopause never have hot flashes. Others have mild or infrequent flashes. The worst sufferers experience dozens of hot flashes each day. In addition, hot flashes are often more frequent and more intense during hot weather or in an overheated room, the surrounding heat apparently making the hot flashes themselves both more probable and more severe.

Severe hot flashes can make it difficult to get a full night's sleep (often characterized as insomnia), which in turn can affect mood, impair concentration, and cause other physical problems. When hot flashes occur at night, they are called "night sweats." As estrogen is typically lowest at night, some women get night sweats without having any hot flashes during the daytime.^[4]

Types of hot flashes

Some menopausal women may experience both standard hot flashes and a second type sometimes referred to as "slow hot flashes" or "ember flashes." The standard hot flash comes on rapidly, sometimes reaching maximum intensity in as little as a minute. It lasts at full intensity for only a few minutes before gradually fading.

Slow "ember" flashes appear almost as quickly but are less intense and last for around half an hour. Women who experience them may undergo them year-round, rather than primarily in the summer, and ember flashes may linger for years after the more intense hot flashes have passed.

In younger women

Younger women who are menstruating or expecting to menstruate soon (the premenstrual period typically lasts one week) may encounter hot and/or cold flashes. These episodes do not usually last long, with feelings of cold and heat alternating over the course of as short as a minute. Hot and cold flashes for younger women tend to occur only during times of menstruation or premenstruation (when estrogen is typically lowest). If they occur at other times in a young woman's menstrual cycle, then it might be a symptom of a problem with her pituitary gland; seeing a doctor is highly recommended.

In younger women who are surgically menopausal, hot flashes are generally more intense than in older women, and they may last until natural age at menopause.^[5]

Treatment

Hormone replacement therapy (HRT) may relieve many of the symptoms of menopause. However, HRT may increase the risk of breast cancer, stroke, and dementia and has other potentially serious short-term and long-term risks^[6][7].

The U.S. FDA and women's health advocates recommend that women who experience troublesome hot flashes try alternatives to hormonal therapies as the first line of treatment. If a woman chooses hormones, they suggest she take the lowest dose that alleviates her symptoms for as short a time as possible.

In addition to traditional hormone replacement therapies, there are other strategies and natural supplements available to try. A recent treatment, Femarelle (DT56a), has been shown to work as a novel [Selective Estrogen Receptor Modulator (SERM)]^[8]. As such, Femarelle works through the same mechanism as HRT, through the estrogen recepters, however the difference lies in its selective mechanism of action within the body, decreasing menopausal symptoms and increasing bone mineral density, without affecting the breast^[9] and uterus^[10][11]. Thereby Femarelle reduces the safety risks involved with HRT while maintaining its efficacy.

It is believed that dietary changes that include a higher consumption of phytoestrogens such as soy, red clover, black cohosh and yam may relieve hot flashes. Other dietary changes might also have a positive effect in relieving hot flashes. These include avoiding caffeine, hot drinks, chocolate, spicy or hot foods and alcohol.^[12] Certain herbs are also believed to help.^[13]

Other

It has been speculated that hot flashes are considerably less common among Asian women, possibly due to their soy rich diets ^[14][15].

Hot flashes in men could be a possible sign of low testosterone.^[16] Men who are castrated can also get hot flashes.^[17][18][19] Men with prostate cancer who are undergoing hormone therapy with antiandrogens, also known as androgen antagonists, which reduce testosterone to castrate levels, can have hot flashes as the most common side effect.^[20]

References