At about the age of 40 years, levels of estrogen and progesterone start to fall in females, and perimenopause — the transition to menopause — begins. As this transition progresses, a female may experience vasomotor symptoms.
Vasomotor symptoms are those that occur due to the constriction or dilation of blood vessels.
They include hot flashes, night sweats, heart palpitations, and changes in blood pressure. The most likely reason why these symptoms can occur during menopause is that hormonal fluctuations affect the mechanisms that control blood pressure and temperature control.
According to the North American Menopause Society, up to 75% of females in the United States experience hot flashes around menopause. Hot flashes usually occur over a period lasting from 6 months to 2 years, but a person can experience them for up to 10 years.
In the U.S., menopause usually begins between the ages of 45 and 58 years. The average age for menopause is 52 years. A person enters menopause 12 months after their last period.
Hot flashes and other symptoms can start during perimenopause, while menstruation is still occurring, or they may begin after a person’s periods end. Not everyone has these symptoms, and they can vary in severity among individuals.
Some people start menopause earlier in life. In some cases, this may happen naturally, but in others, it may be due to surgery, a health condition, or certain types of medical treatment.
Menopause is not a health condition. It is a normal transition that most females will go through during their life. However, the hormonal changes that it involves can lead to specific symptoms.
Hormones play a role in how the cardiovascular system works. As their levels fluctuate, they can affect the circulatory system. They can also interfere with how the nervous system controls body temperature.
Hot flashes are the primary vasomotor symptom. During a hot flash, a sudden sensation of heat affects the chest, neck, and face. The skin in these areas may become red.
Alongside hot flashes, a person may experience:
- sweating, including night sweats
- sleep disturbances
- heart palpitations
If menopause starts as a result of treatment, such as chemotherapy, the person may find that the associated symptoms stop, and menstruation begins again once the treatment finishes. However, this is not true for everyone.Is it a hot flash or something else?
Click here to find out how a hot flash feels.
The causes of hot flashes are likely to be neurovascular, which means that they happen when changes occur in the part of the nervous system that affects circulation.
Experts believe that hot flashes result from changes in the part of the brain that regulates body temperature. Sudden drops in estrogen levels may trigger them, but it is unclear exactly what role this hormone plays.
There is evidence that taking supplementary estrogen helps relieve symptoms, but scientists have not found a correlation between circulating hormone levels and the severity of symptoms.
Possible triggers for hot flashes include:
- eating spicy foods
- drinking coffee or alcohol
- wearing clothing that is too warm for the environment
- having a high temperature
- some medical treatments and drugs
- some health conditions, such as diabetes, tuberculosis, or an overactive thyroid
However, they can also occur without any apparent trigger.
Some types of cancer treatment can also lead to hot flashes, regardless of a person’s age or sex.
Vasomotor symptoms are common during menopause, but not everyone experiences them.
Hot flashes may occur over a longer period in African American and Hispanic females than in white or Asian Americans, according to the National Institute on Aging.
Hot flashes and sweating are not usually harmful, but they can lead to discomfort, and some people can feel embarrassed by the visibility of the symptoms.
In some cases, hot flashes may not relate to menopause but
People should see their doctor if:
- hot flashes interfere with their daily life
- they have other symptoms, such as diarrhea, fatigue, unexplained weight loss, or a general feeling of being unwell
- they are at risk of another health condition, such as diabetes or thyroid problems
Seeing a doctor can help a person get treatment to improve their comfort levels and reduce anxiety. Doctors may also identify other underlying causes of vasomotor symptoms, should these be present.
How long do menopause symptoms last? Find out here.
A doctor may recommend medication to help people manage hot flashes.
Hormone therapy aims to balance hormone levels in the body. It can help relieve hot flashes and other symptoms, but it is not suitable for everyone, as it can lead to side effects.
A doctor may not recommend hormone therapy for people with a history or high risk of particular conditions, including cardiovascular disease, stroke, breast cancer, uterine cancer, and liver disease.
Antidepressants,such as paroxetine (Paxil), may help. A doctor will usually prescribe a lower dosage for menopause symptoms than for depression. Possible adverse effects include headaches, nausea, and drowsiness.
Many people have mild symptoms during menopause and do not use medications. An individual should discuss with their doctor the benefits and drawbacks of using medications.
Some lifestyle practices may help a person manage hot flashes during menopause.
- avoiding known triggers, such as spicy foods, alcohol, and caffeine
- quitting smoking, if applicable, or avoiding secondhand smoke
- dressing in layers so that it is easy to remove a layer if a hot flash occurs
- carrying a water bottle containing ice water to sip if a hot flash starts
- keeping a portable fan nearby
- keeping the bedroom cool at night
- avoiding exercise immediately before bedtime
- practicing deep breathing and relaxation exercises
- following a healthful diet and getting regular exercise
- reaching or maintaining a moderate weight
Some people use alternative treatments, such as black cohosh, dehydroepiandrosterone
(DHEA), or soy isoflavones, for hot flashes. However, according to the National Institute on Aging, there is no evidence that these will help, and their long-term effects are unclear.
It is advisable to speak to a doctor before using any herbal treatments, supplements, or other types of medication for menopause.
Vasomotor symptoms, especially hot flashes, are a common feature of menopause. Not everyone experiences them, and they can affect people differently.
Anyone who finds that vasomotor symptoms affect their daily life significantly should speak to a doctor, who may recommend treatments or lifestyle changes that can help.
Learn more here about what to expect during menopause.