Women go through menopause during their forties and fifties. About 75 percent of them experience hot flashes during this time. Why does this happen? What makes a woman’s body suddenly become a living walking steam room?
At puberty a girl’s ovaries will begin to produce the female hormones, estrogen and progesterone. Estrogen, the primary female hormone, will then be produced every day until she has gone through menopause. Progesterone is produced for twelve to fourteen days each month just after she ovulates (releases an egg).
As a women approaches menopause her ovaries gradually lose their ability to produce estrogen. Her ovaries produce less and less estrogen. And by the time she is through menopause (usually late forties or early fifties), her estrogen production will have stopped.
The pituitary gland, located at the base of the brain, regulates hormone production. It monitors the estrogen level in a woman’s blood stream. Whenever estrogen levels are too low, the pituitary sends out an ovarian stimulating hormone, FSH. As menopause approaches, the ovaries gradually lose their ability to produce adequate estrogen, and the pituitary compensates by sending out more and more FSH to try and correct the deficiency.
The hypothalamus, located next door to the pituitary gland in the brain, contains the thermoregulatory center, which controls the body’s temperature. This delicate neural mechanism gets disturbed by the increased activity of its neighbor, the pituitary. The thermoregulatory center responds by narrowing its thermoneutral zone.
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Imagine a building which has an HVAC system with too narrow a thermoneutral zone. With the minutest increase in temp the air conditioner goes on. This cools down the building, but then with the slightest drop in temperature the heat goes on.
In menopause a woman’s body does the same thing. With the slightest increase in temperature, her cooling system goes on. The capillaries just under her skin dilate so that her blood can dump its heat by radiating it out through her skin. Thus her skin gets red and hot. The dilated blood vessels cause her blood pressure to drop a bit and she may get lightheaded and have palpitations. She sweats and its evaporation cools her body further. But now her body has cooled to the point that her thermoregultory system triggers the body’s heating system and she begins to shiver. Rapid contractions of the skeletal muscles produce heat.
Can a woman’s faulty HVAC system be repaired? Well, not really. But it will eventually self-correct. And there are several ways that she can make it through this challenging time in her life.
Many women just put up with hot flashes. They learn to lower the temperature in the house and especially the bedroom. They dress in layers so that they can adjust quickly to temperature changes. Other measures that are known to help are avoidance of alcohol, cigarettes, and excess weight. Stress management such as yoga, meditation, and exercise can also be very helpful.
The most effective medication for hot flashes is estrogen. But taking estrogen has risks, which will need to be discussed with her doctor.
There are also hormone free medications such as antidepressants, from the SSRI group. Another is gabapentin, which was designed to treat seizures and chronic pain. The hormone free meds have their pros and cons, of course, and need to be discussed with her doctor.
And there are herbal and nutritional remedies that may help.
What can we men do to help? In a word, lots.
Don’t tease her. Chances are it’s not funny to her.
Be compassionate. Communicate your concern. Let her know that you are there for her.
Let her control the heat in the house, the bedroom, and the car.
You may find yourself dressing in layers so that you can adjust to her changing the thermostat and opening and closing windows. You may feel like you are camping out at night, so have your sweats and wool socks ready.