Hot Flushes and Night Sweats
The actual physiological process that causes a hot flush (in America known as hot flashes) or night sweat remains little understood, but clearly involves the Hypothalamus.
Flushes start in the Hypothalamus where low levels of oestrogen stimulate the production of gonadotropin releasing hormone (GnRH). Subsequently the GnRH stimulates the pituitary to increase levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH).
At the Ovaries, FSH and LH try to stimulate oestrogen production. With no eggs, the ovaries are unable to respond. Receiving feed-back that the level of oestrogens remains low, the hypothalamus again produces GnRH.
This cycle continues until Catecholamine sensitive neurons in the autonomic nervous system become activated by the increased level of GnRH and subsequently, substances that cause dilation of peripheral blood vessels are secreted and the hot flush begins.
However caused, hot flushes or night sweats represent the most common and often most distressing symptom of the menopause, typically lasting between a few seconds and a few minutes, and they can be felt for a period of up to 15 years from the onset of the peri-menopause.
Flushes and sweats tend to peak within 2 to 3 years after the menopause, and lessen thereafter, but the range of patterns among those experiencing menopausal is quite diverse. Experienced by more than 75% of perimenopausal women, flushes and sweats vary in frequency from an occasional flush to up to 20 a day or more.
The severity of hot flushes also varies: Some may just feel a sensation of heat flooding from breast to head. For others, the hot flush may begin with a feeling of nausea or a headache, then turning bright red, they perspire profusely, afterwards feeling cold and shivery. During a flush, other symptoms, such as palpitations, giddiness, weakness, skin prickliness, or feeling suffocated, may occur.
Night sweats are severe hot flushes, and can cause sufferers to wake, often drenched in sweat. In some cases, this leads to several get-ups during the night to wash and change. By impairing the dream-time sleep (REM phases), a sufferer is always left feeling tired and worn out in the morning. Night sweats can also cause serious stress in a relationship, if a partner also suffers from disturbed sleep.
Lifestyle changes that can help
There are several ways of helping to relieve this menopausal symptom. The number of night sweats can be reduced by dropping the evening bedroom temperature a few degrees cooler and avoiding food, alcohol, or caffeine within 3 hours of going to bed.
Those experiencing hot flushes should avoid caffeine, alcohol, cayenne, occlusive clothing, and heat. Wearing clothing made of natural (i.e., cotton) materials and if possible taking exercise each day for 30 plus minutes (not within 3 hours of bedtime) is also recommended, as is the use of long-term herbal deodorants.
Many prescription drugs such as anti-hypertensives and mood altering drugs such as anti-depressants can also cause hot flushes. Over-the-counter medications and supplements should also be examined for their side effects at this time of life.
Other considerations
Hot flushes and night sweats are often mistakenly accepted as the only major problem caused by the menopause, not a symptom of the more significant health issues brought about by living in an oestrogen-deficient state for up to a third of a lifespan. Due to this, many women go through the menopause without taking adequate measures to reduce the risk of problems later in life, such as heart disease and osteoporosis.
To more fully manage hot flushes and night sweats, a woman has to manage her reduced ability to produce oestrogen. Hence oestrogen maintenance is vital for any women looking to ensure a good quality of life, now, and in the future.
Further Information
For oestrogen maintenance and menopausal symptom control, please refer to Natural HRT, Phytoestrogens, Red Clover, and Conventional HRT.