Hot Flashes and Hot Flushes

The most common symptom of the perimenopausal period is an upset in the body's thermostat that results in episodes of warmth and flushing. Although the hot flash or flush can cause discomfort, it does not in and of itself, present a health hazard and does not indicate disease.

Your first hot flash can be a startling experience. It may begin like a headache, with a pressure in the head, or as a sudden sensation of intense warmth. The "flash" increases in intensity until a feeling of heat or burning occurs in the face, neck, and chest. Your skin may redden and increase in temperature by as much as seven degrees. You may feel an urgent need to remove a sweater, jacket, or nightgown, and cool yourself by grabbing for a fan, throwing off covers, or standing by an open window. An outbreak of sweating, particularly affecting the upper body, may immediately follow the hot flash. Sweating cools down the skin temperature, causing the shivers. Less common symptoms which may accompany a hot flash include palpitations, weakness, fatigue, faintness, and vertigo.

Hot flashes vary in frequency, intensity, and duration. The average length of a hot flash is 4 minutes, though it can last from a moment to as long as 10 minutes. Frequency varies from 1 to 2 an hour to 1 to 2 a week.

Hot flashes trouble three-fourths of women experiencing natural or surgical menopause. However, only 10 to 15 percent of women find them debilitating. Eight out of 10 women who experience hot flashes get them for more than a year, but only 25 percent get them for more than 5 years. Hot flashes can occur as early as age 42. Heavier women tend to experience hot flashes less often, perhaps due to the estrogen produced in fatty tissue.

For some women, a hot flash is not unbearable and they easily go on with their daily routine. For others, it can be an intolerable disruption to their lives. The greatest problem the hot flash brings about is disturbed sleep patterns. A women experiencing regular hot flashes may wake several times, or even hourly, during the night. Some women wake up sweating profusely, in a phenomenon known as night sweats, and need to change the sheets or their night clothes.

Sleep deprivation affects people differently. A profound sleep disturbance may cause memory disorders or make concentration difficult. Some women feel anxiety, or suffer from fatigue or muscle aches. Lack of sleep can also cause a woman to cry easily and feel mentally and physically exhausted.

Coping with Hot Flashes

For the majority of women, hot-flash symptoms begin to subside within four to six years after their last menstrual period. Studies have shown that women who exercise are less likely to experience hot flashes. Among smokers, however, the incidence rises, probably due to the effect smoking has on the hormonal output of the ovaries.

Though there is no way to eliminate hot flashes short of drug therapy, many women develop ways to cope that help them get through the experience gracefully. For example, they learn not to wear turtlenecks or they switch from wool to cotton sweaters. Dressing in layers that can be quickly removed when feeling warm is also a good idea.

Embarrassment and concerns about what others are thinking is a common reaction. To allay your worries, you might ask a friend, or your spouse, to give you an accurate picture of how you look when experiencing a hot flash. As intense as it feels to you, close observers may not even realize that you appear slightly flushed and moist. If this is the case, ignoring the experience during a business meeting or other public event may be the best course.

On the other hand, if you perspire so profusely that it is obvious to others, you may want to plan what you will do if a hot flash strikes at an inconvenient time. It may be best to excuse yourself and head for the ladies' room, or to be prepared with a brief joke or explanation to ease yourself through the moment. With over 40 million American women set to experience menopause in the next 2 decades, public understanding of hot flashes is likely to expand. Though you may not be able to predict when the next one will occur, you can be prepared to react. Confidence, patience, self-assurance and a sense of humor will help ease the frustration.

Hot flashes lead more women to seek professional medical assistance than any other symptom of menopause. Estrogen therapy is the principal treatment eliminating hot flashes quickly and completely. Beneficial results include an end to the symptoms and thus relief from the constant awakening that can end in chronic sleep deprivation. Restored sleep patterns bring measurable improvements to memory, as well as decreased anxiety and irritability.

Other medications, such as clonidine (Catapres TTS) also have been studied for effectiveness against hot flashes. If you cannot or do not wish to take hormone replacement therapy, ask your doctor about alternative medications. But be aware, that like all drugs, these can cause side-effects about which you should be informed.