Hot flashes are the most common symptom of menopause and in Western societies. They occur in about 75% of perimenopausal and postmenopausal women. The symptoms can be sweating on the face, neck, and chest, as well as flushing and the feeling of heat. They can come and go in a flash going from hot to cold, hence the name hot flashes.
When it comes to hot flashes, women immediately think it is because of low estrogen and menopause. However, there are many other things that contribute to hot flashes and they may not be due to low estrogen or menopause! Studies show that levels of estrogen do not differ between women with or without symptoms.
Thermoneutral Zone: The Key to Hot Flashes
The thermoneutral zone is defined as the range of ambient temperatures where the body can maintain its core temperature solely through regulating dry heat loss, i.e., skin blood flow. A living body can only maintain its core temperature when heat production and heat loss are balanced.
If any heat that is generated in or outside of the body, your body will respond by releasing heat through sweat and dilation of blood vessels. The wider the zone of temperature regulation the less likely these pesky hot flashes will occur and the narrower the zone, the more likely hot flashes will occur. Women with hot flashes don’t have a thermoneutral zone or may have a very narrow one so small temperature elevations will trigger a hot flash.
Regulating the Thermoneutral Zone
The sympathetic response can activate hot flashes by narrowing the thermoneutral zone. The sympathetic nervous system otherwise known as the fight or flight nervous system will generate heat and dilate blood vessels to fight or flee. Activating the sympathetic nervous system (stress, anxiety, worry, lack of sleep, pain, nutritional excesses or deficiencies, allergic reaction or any distress the body is feeling), is a recipe for a hot flash in women who have a very narrow or low thermoneutral zone. Clonidine is a medication that stops this sympathetic activation and can reduce or eliminate hot flashes by widening the thermoneutral zone.
Other things that can raise body temperature or dilate blood vessels such as intense exercise or alcohol can raise body temperature, narrow the zone, and produce a hot flash.
Breathe Flashes Away
Deep slow breathing that lowers the sympathetic nervous system and activates the parasympathetic nervous system, has been shown in at least 3 controlled investigations to significantly reduce hot flashes by about 50%. Deep, slow breathing is safe, free, effective and has no adverse effects. It has a lot of positive effects and can enhance relaxation, reduce anxiety, aid digestion and absorption, balance hormones, and allow the body to repair and rejuvenate. Activating the parasympathetic nervous system otherwise known as the relaxation response through simple breathing techniques is an effect way to reduce hot flashes.
Studies have shown that people with anxiety were 3 to 5 times more likely to have hot flashes. Researchers also looked at 2 different types of anxiety.
- Somatic Anxiety has physical symptoms such as dizziness, increased heart rate, stomach upset, or headache. People with somatic anxiety were more likely to have hot flashes during menopause.
- Emotional Anxiety was related to worry and this type of anxiety was not associated with hot flashes during menopause.
This study showed a strong predictive association of somatic anxiety with the risk of menopausal hot flashes. The presence of somatic anxiety predicts the risk of menopausal hot flashes and may be a potential target in clinical management of perimenopausal women.
Hot flashes commonly occur in perimenopause before observable menstrual irregularities and are associated with both hormonal and behavioral factors.
Significant predictors of hot flashes are:
- Higher follicle-stimulating hormone (FSH) levels
- Obesity – Body Mass Index BMI >30
- Smoking either currently or in the past
- Alcohol use
If you are suffering from hot flashes and not sure of the reason why you are having them, get an evaluation from a functional medicine doctor who has experience with hormone balance. They will not only measure your hormones but will also address the lifestyle factors that contribute to them.
If you are looking for someone, look no further, Dr. Lorraine Maita, MD has helped thousands of women and would be delighted to serve you.