Definition Hot flushes are the sensation of sudden flushing and sweating. This condition is felt by 75% of women going through the change of life, known as menopause. It may also affect women who have had their ovaries removed.
What is going on in the body? Menopause occurs when the ovaries stop working. The ovaries stop producing eggs as well as oestrogen, one of the key female hormones. Menopause usually begins around the age of 50. Low oestrogen levels may cause many changes in a woman's body, including hot flushes.
Hot flushes are the most common symptom of the menopause. Of those women having hot flushes, 82% experience hot flushes for more than a year. From 25% up to 50% of these women have hot flushes for up to 5 years if they do not receive hormone replacement therapy.
What are the signs and symptoms of the condition? The hot flush can be short or last 10 minutes. The average time is 4 minutes. As a woman has less oestrogen, the number of hot flushes per day may increase. Symptoms of a hot flush include:
a feeling of pressure in the head that progresses into a flush
redness, warmth, and sweating on the face, neck, shoulders, and upper chest
a type of dizziness that may be worsened by movement and turning, called vertigo
panic attack, a feeling of overwhelming anxiety or fear
an abnormal sensation or aura, which may precede the onset of the hot flush
What are the causes and risks of the condition? The exact cause for hot flushes is not known. Studies suggest that changing hormone levels change the brain's "thermostat" that regulates temperature and blood vessel diameters. There are no known complications of hot flushes. Night sweats may cause chronic sleep loss, which can result in:
What can be done to prevent the condition? Menopause cannot be prevented but symptoms may be treated. A woman may feel better by:
avoiding smoking, caffeine, and excessive alcohol. These chemicals increase irritability and make hot flushes worse. Also, smoking can cause a woman to enter menopause at least 2 years earlier than the average non-smoking woman.
limiting intake of red wine, aged cheeses, and chocolate. These foods contain a chemical that may trigger hot flushes.
using lightweight blankets at night
avoiding going from a hot to cold environment, as this may bring on a hot flush
wearing clothing made of cotton in loose layers to absorb excess moisture
increasing intake of soy products, as this appears to decrease the number of hot flushes
Herbal supplements have not been proven to prevent hot flushes. Certain products such as oil of primrose or dong quai may be helpful.
How is the condition diagnosed? A complete history and physical should be done to rule out other reasons for hot flushes. Other conditions like hyperthyroidism, which is an over-active thyroid gland, diabetes, tuberculosis, rare tumours of the adrenal glands, anxiety, and other chronic infections can cause hot flushes.
What are the long-term effects of the condition? Hot flushes generally cause no long-term effects. If a woman who is still having periods begins to have hot flushes, she may be starting menopause and should consult a doctor.
What are the risks to others? There are no risks to others, as hot flushes are not contagious.
What are the treatments for the condition? Not all women want treatment for mild hot flushes. Using a fan, sipping cool water, or imagining a cool spot may help. If hot flushes are severe or frequent or are disturbing sleep patterns, a doctor should be consulted. He or she may suggest hormone replacement therapy.
What are the side effects of the treatments? Side effects of hormone replacement therapy may include:
nausea
headaches
weight gain
increased appetite
abdominal bloating
irregular vaginal bleeding
breast tenderness
These symptoms are usually of a short-term nature and disappear after 1 to 2 months.
Use of hormone replacement therapy is possibly associated with an increased risk of breast cancer and cancer of the uterus. This increased risk should be discussed with a doctor before therapy is started.
What happens after treatment for the condition? With the proper dosage of medication, hot flushes should become less severe and frequent. This will allow normal daily activity as well as healthy sleep patterns.
How is the condition monitored? A woman can monitor her symptoms and report them to her doctor.
Author: Eva Martin, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 15/032005 Contributors Potential conflict of interest information for reviewers available on request
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