Hot flashes are the harbinger symptom of menopause. About 75 percent of women will suffer from them as they go through menopause between ages forty and sixty.
Men reading this may ask: What’s the big deal? So a woman gets hot once in a while. What’s the problem?
Let’s pause for a moment and consider what it would be like if you or I, as a man, were to suddenly begin having hot flashes.
Imagine that you are at work or hanging out having a drink with your friends. Out of the blue you get a hot feeling in your face and upper chest. The heat is intense and quickly spreads to the rest of your body. But your skin stays cool.
After what seems like an eternity, the hot feeling inside begins to let up. But now your skin turns red and hot. You start to sweat. You don’t sweat a little; you sweat a lot!
Then you feel light headed and you feel your heart pounding in your chest. You wonder if you are having a heart attack, but you think: “I’m too young!” You look around for a place to drop.
You don’t want anybody to think that you aren’t tough. You try to act like everything is normal. But you get concerned looks from your friends. You shrug, “I guess I must be coming down with a bug.”
You feel better in a few minutes, but now you’re soaking wet. You fake it through this one, but as the weeks go by these weird heat attacks come more and more often, usually with no warning.
At times your face or legs or feet get so hot that you have to use a damp cloth to cool them off. You have learned to take a change of clothes with you wherever you go. And you dress in layers to allow for stripping down when you are hot and starting to sweat.
Now sleeping has become a problem. Most nights you wake up hot and soaking with sweat. You throw off the covers but then you get cold and start to shiver. The sheets are wet so you have to awaken your wife and change them. This is not the first time and she’s getting cranky about being disturbed. “Honey, are you getting old?” she says.
We men don’t have hot flashes. Thank God! Women do though, so what can be done about them?
As a woman’s reaches the age of forty and beyond, her ovaries gradually lose their capacity to produce estrogen, the female hormone. Hot flashes are the most common of the symptoms that result from the falling estrogen levels in her body.
The obvious answer would be to replace the missing estrogen. Many women do this very thing by taking estrogen in the form of a pill or skin patch or vaginal cream. And they usually realize gratifying relief from the hot flashes and other menopausal symptoms. Unfortunately, estrogen replacement is associated with certain risks such as blood clots and breast cancer. These complications are highly unlikely, but they need to be considered.
Other remedies, which do not involve the use of estrogen, include certain drugs from the SSRI group of antidepressants. These medications are less effective at reducing hot flashes and other menopausal symptoms and they have their own side effects and risks. But they are less risky than estrogen and they can also help the moodiness and problems sleeping that some menopausal women get.
Gabapentin, a drug designed to treat seizures and chronic pain, has also been shown to reduce the likelihood of hot flashes. It also is less effective than estrogen and has it’s own side effects and risks.
And there are herbal remedies for menopausal symptoms. Their effectiveness at reducing hot flashes is uncertain but they are available without a prescription. Some women find them to be helpful.
In future blogs I’ll talk lots more about how falling estrogen levels cause changes in a woman’s body, and I’ll discuss remedies for menopausal symptoms in more detail.