It must be the thermostat again, she thought. After all, it is an old apartment, and the temperature on the dial doesn’t always match the heating and cooling going on in the room. Maybe it kicked up a notch while I was sleeping.
After a change of clothes and a few towels on the bed sheets – and a quick check of the thermostat – Sarah went back to sleep. The next day, the incident was forgotten in her busy schedule of work and a dinner that night.
The problem would remain just one of those things if it was just that one time. But it wasn’t the thermostat’s fault, as Sarah would discover later in the month when it happened again. In fact, the severe sweating was the first announcement of hot flashes, the waves of warmth that mark perimenopause or the onset of actual menopause.
Hot flashes are very common but are embarrassing to discuss for many women. Menopause marks the permanent end of a woman’s menstrual periods. To many, it is a sign that old age has arrived. In our youth-oriented culture, that’s sometimes viewed as a stamp of obsolescence.
But perimenopause and menopause are perfectly natural conditions, and while hot flashes are disturbing, they are just a physical manifestation of this remarkable change of life.
What Are They?
The so-called hot flashes are waves of warmth in the body that arrive unexpectedly, often in the middle of the night. They typically start around the neck or head areas and radiate downwards, creating a feeling that the body temperature is raised. Profuse sweating often occurs because of this sudden rise in temperature. But after a period ranging from 30 seconds to several minutes, the flash is over, and the body returns to feeling normal.
The condition can manifest itself anywhere from perimenopause (the precursor to full menopause, which strikes some women in their mid-30s) to actual menopause.
To treat hot flashes and help with the challenges wrought by perimenopause and menopause symptoms, many doctors institute a regimen of hormone therapy, including estrogen doses. But some women can’t tolerate additional estrogen in their system, so some medical professionals offer other ways to help their patients deal with the consequences of the changes.
Symptoms of Menopause
Menopause is the result of decreased hormonal activity in the ovaries.
When the condition manifests, some women start to experience hot flashes, vaginal dryness that causes occasionally painful sexual intercourse and night sweats, which are hot flashes that occur in when the woman is in a deep sleep, as with Sarah’s episode.
There may also be confusion, memory issues, urinary incontinence, stiff joints, fatigue, mood swings, depression, anxiety, irritability and periods that may become irregular or missed entirely.
Keep in mind that some of these symptoms may be caused by medical issues other than menopause. A woman is not considered fully menopausal until she has not had a period for 12 consecutive months, which usually doesn’t occur until the early 50s in most normal circumstances (i.e., normal if there are no mitigating factors like surgery to remove the ovaries and/or uterus, chemotherapy or radiation treatments that bring an earlier onset).
While many women do not experience or even notice the hot flashes and other subtle changes related to perimenopause, the issues for some will gradually grow more obvious, including hot flashes that redden the skin and are extremely uncomfortable.
Sometimes doctors will use a combination of estrogen and progestin, a synthetic form of the estrogen-related hormone progesterone. These can be combined in women who still have a uterus. However, progestin will stop cell growth in the uterus, which may, in some women, lead to uterine cancer.
Problems with Hormones
While estrogen is an effective treatment, studies by the National Institutes of Health have noted problems with estrogen and other hormone therapy. There are increased risks of certain health problems, and those who are already frail or have an undetected underlying condition are particularly at risk.
A study done by the Women’s Health Institute looked at the use of estrogen plus progestin in women who still had a uterus, comparing its use in women who did not have a uterus. The groups were further divided into those receiving estrogen therapy and those who received a placebo.
The results were alarming. The hormone-medicated groups were found to have an increased risk of blood clots, heart attack, breast cancer and stroke compared to the placebo group, while the estrogen plus progestin medication also had an increased risk of breast cancer and heart attack.
While these results have resulted in cutting back on the use of estrogen therapy, the concerns raised by the study has also led to an increased focus on alternative and complementary medicines of the mind and body practices to help women through menopause.
Natural Remedies for Hot Flashes
Some women, believing natural is better than a prescription, often turn to supplements that have natural hormones or mimic the results of hormone therapy.
As with any natural, alternative or complementary treatment, a patient contemplating using herbal supplements should consult a medical professional, especially if the patient already takes medication. Some products, like herbs, may interfere with the function of other medicine or cause complications.
Keep in mind that not every supplementary product contains the same amount of whatever it claims to contain, and beware the marketing of some natural products, which can be a stretch when it comes to proclaiming potential results.
It’s also wise to pay attention to recommended doses of any supplement and to be aware that some so-called natural products may contain heavy metals and other harmful substances.
Finally, and most important, be aware that the United States Food and Drug Administration does not regulate the claims supplement manufacturers make. Thus, their purity is not assured, and research is lacking to support many contentions.
However, hot flashes are an issue that needs attention for some women, so here are some of the options often recommended:
- Black Cohosh – Extremely popular in Europe, black cohosh is an herbal extract used to offer some relief from hot flashes and other menopausal symptoms. Black cohosh should be used with caution and only for a short time because it may affect the liver and has consequences for women prone to breast cancer.
- Phytoestrogens – These are naturally occurring estrogens that are found in foods. They include isoflavones (found in soybeans and other legumes) and lignans (found in flaxseed, whole grains, and some vegetables and fruits). The hormones also may be found in soy or red clover. While some studies on phytoestrogens question their efficacy in reducing menopausal symptoms, some women swear by them. Be cautious when using them -- there are some reports that phytoestrogens could interfere with tamoxifen, used to combat breast cancer, and they may have other issues with medications or underlying conditions.
- Bioidentical hormones – These are products that are chemically identical to the hormones the body produces. They are not regulated by the United States Food and Drug Administration, and the over-the-counter versions may vary in strength and effectiveness in combatting hot flashes. There are bioidentical formulations available via prescription that may be more reliable than over-the-counter supplements.
- Dehydroepiandrosterone (DHEA) – This is a natural steroid that comes from the adrenal gland and is used as a dietary supplement by many to boost energy and deal with menopausal symptoms. To date, research has found no menopausal benefits from it, but some women have found that it does boost energy levels, which may help deal with mild symptoms in the perimenopausal stages.