Women may begin to experience menstrual cycle changes as early as their late 30s, yet for most of us, the challenging symptoms of perimenopause begin in our 40s. In fact, the average age of perimenopause for a woman in the UK is 45, with menopause coming at 51.
READ MORE What is the difference between perimenopause and menopause?
One of the earliest signs that menopause is on its way is the development of flushes, (or flashes). So what causes hot flushes – and why do they always strike at the most inconvenient times? Flashes/flushes of heat are caused by the changes in hormone production that accompany menopause, the time when your ovaries are producing less estrogen and progesterone in the body.
What happens during a hot flash?
Up to 80% of women will experience a hot flush in their perimenopause and menopause years.
Any woman who has endured a hot flush knows how uncomfortable it can be. The sudden onset of heat can overtake whatever else you were trying to do – a work meeting for instance – and demand your full attention. A sensation of warmth begins to spread over the upper body, usually more intense in the neck and face. You may even notice your skin turning red, like a sunburn, while this is happening.
READ MORE HRT, is it safe? Everything you need to know.
When you lose body heat in this way, you might experience excessive sweating when you have a hot flush, which may lead you to feeling a chill once it passes. When these flushes happen during the night, you will often find yourself waking up until the episode is over. This can, of course, cause major issues with the amount of restorative sleep you are getting.
How often and how intensely each woman experiences flashes of heat varies. Other symptoms, like rapid heartbeat and sudden anxiety, are also unique to each woman. They can occur at any time throughout the day and night and may happen more several times a day. These hot flushes can happen for a decade or more during the years preceeding menopause, until several years after.
How can I stop hot flushes?
The good news is that there are ways to manage hot flushes, and take back some control over your everyday routine.
For most women, HRT will help with hot flushes. Our medical advisor Dr Stephanie Goodwin always recommends giving HRT three months to make a difference. Your flushes may not disappear overnight, but give the treatment time, and you will see an improvement.
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HRT has other benefits too. As well as helping with symptoms like hot flushes, insomnia and anxiety, it protects against future possible health issues, like osteoporosis and heart disease.
Are there other ways to treat hot flashes?
According to the North American Menopause Society, there are many natural ways to get relief from hot flashes. Black Cohosh has been scientifically studied for the effect it may have on hot flushes, yet the results have been mixed. Many women have claimed to experience a decrease in the frequency of their flashes, while others claim no difference. The good thing is that despite an earlier worry that Black Cohosh acted like estrogen inside the body, this is not the case, and therefore this herb has a strong safety profile, making it a good option to try in case you’re one of the women who do experience a benefit.
Does acupuncture work for menopause?
Another natural remedy for these flashes is the use of acupuncture. Symptoms of menopause were reduced for some women after acupuncture treatment was performed, over women who did nothing to treat their symptoms. Flashes and night sweats were reduced by over a third in women treated and the relief lasted for six months. This is a promising non-drug remedy.
Wake Forest Baptist Medical Center in North Carolina published their results in the medical journal Menopause. The lead author of this study, Nancy Avis, said that while it did not work for every woman, on average “acupuncture effectively reduced the frequency of hot flashes and results were maintained for six months after the treatments stopped”.
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This Traditional Chinese Medicine practice is a technique that stimulates certain parts of the body through the insertion of thin needles through the skin. The subjects of this particular study were women between the ages of 45-60 who had been having roughly four flashes per day for the two weeks prior to the study. They had up to 20 treatments while recording their symptoms as the study progressed. After six months, there was a 36.7% decrease in frequency and severity of flashes, as opposed to a 6% increase in the subjects of the control group, who had no treatment at all. This is a promising development for women who need relief without the risk of side effects from medication or other potentially dangerous options.
Natural alternatives to HRT
There are other herbal remedies to help with menopause symptoms, but they won’t necessarily work to ease hot flushes. These include Red Clover and Dong Quai.
Ginseng has been found to be highly beneficial for menopausal symptoms like sleep disruptions and mood swings, yet not effective for flashes. Kava has been shown to be effective for the treatment of anxiety, yet offers no relief from hot flushes. If taken too often or in too high of a dosage, Kava has the potential to cause liver damage, according to the FDA (Food and Drug Administration).
READ MORE Does HRT and menopause cause weight gain?
Evening Primrose Oil has also been touted as a solution to the problem of flushes, yet a study of over 50 women showed no benefit over a placebo. This supplement was also linked to side effects like nausea, intestinal upset, as well as problems with blood clotting and inflammation. It’s also not recommended that Evening Primrose Oil be used in anyone taking antipsychotic medications, as it may possibly induce a seizure.
What causes hot flushes other than menopause?
It’s important to eliminate the possibility that your flushes are caused by conditions other than menopause. Women and men can occasionally experience these sensations as a result of other issues. While for women after 40 menopause is the first thing usually considered, take a look at other potential causes to rule them out. Have you started any new medication? Prescription side effects can be the culprit for some hot flash episodes, especially drugs in the opioid class, starting or changing your antidepressant medication, as well as drugs prescribed for conditions like osteoarthritis.
Steroids taken to reduce inflammation and swelling also are known to occasionally cause a flush. Most of the time, side effects like this decrease the longer you take a medication as your body adapts. However, if you experience severe discomfort, always speak to your health care provider about potentially changing your dose or trying something else. Never stop your medication suddenly without first checking with your doctor.
READ MORE HRT, alcohol and menopause.
What causes hot flushes can also be your own health and wellbeing. Those who carry extra weight are also more likely to experience flushes, due to the effect weight has on metabolism. This is especially true for women who gain weight later in their lives. For most, these flushes can be managed by changing the diet and increasing consumption of healthier foods, increasing moderate exercise during the day, as well as limiting or eliminating alcohol, caffeine and sulfite additives in food.
Checking for food allergies if a flush occurs after consuming specific foods can also help. And remember, as well, that eating foods that are inherently spicy can cause vasodilation of the blood vessels, causing them to expand, and thus can create feelings of heat leading to a flash episode.
Undiagnosed anxiety disorder is another potential culprit. If your hot flush is accompanied by the feeling of a racing, or fast beating, heart, as well as nervous movements, fidgeting, or feeling like you are breathing faster at the same time, chances are you’re having an issue with anxiety. Try calming down by taking a deep, cleaning breath, releasing it slowly, and pay attention to your body.
Many times by consciously relaxing your body, you will feel your heart beat slow down, and your breathing will become steady and normal. It takes practice but this exercise should help you gain control. If your anxiety is unmanageable, is becoming more frequent, or you can’t seem to get your body to relax, it may be time to approach your health care provider about possible solutions.
What other symptoms occur with menopause?
The first sign most women recognise, aside from the flashes, are menstrual changes. Most women will notice that they are having periods that are heavier or lighter than usual. They may not last for as many days as they used to, or you may begin to skip periods altogether as early as your mid-40s.
It’s important to keep in mind that as long as a period is present, it is still technically possible to get pregnant, therefore contraception is still needed if you do not want to conceive.
Other symptoms that indicate possible menopause include vaginal dryness, changes in libido, mood swings similar to PMS (though usually more extreme), trouble with sleep, difficulty concentrating, and possible hair loss. Always have a medical professional review your symptoms to best decide a course of action to handle symptoms that interfere with your enjoyment of life.
Always talk to your GP before taking any medication.