Women frequently ask what symptoms they can anticipate during menopause. In reality, each woman experiences menopause differently. Some women have changes in several areas of their lives. It is not always possible to tell if these changes are related to aging, menopause or both.
While one woman is certain that insomnia is a menopause symptom for her, another feels joint aches are her primary menopause symptom.
Doctors find it difficult to communicate to their patients about menopause and what could be a host of uncomfortable symptoms.
For example, medical science cannot explain how declining hormone levels during menopause could cause joint pain.
Menopause is not an illness, but a natural transition when a woman’s reproductive ability ends. Yet many of the menopausal symptoms may mimic signs caused by diseases. When do women undergoing menopause need treatment in the first place?
The same pattern of hot flashes in two women can have a very different psychological impact. For one woman, they can greatly disturb her daily functioning, but for another, while another may hardly be bothered.
Whether it creeps up on you or you have forewarning, menopause is a fact of life for all women.
Two of the most common complaints about menopause are hot flashes and night sweats. This uncomfortable symptom affects approximately three-quarters of all women in perimenopause, or the time before actual menopause.
Once a woman has reached menopause, she may continue to have hot flashes for six months to five years, according to The North American Menopause Society (NAMS).
What Is a Hot Flash?
A hot flash is a feeling of intense heat, not caused by external sources. Hot flashes can appear suddenly, or you may feel them coming on. You may experience:
- tingling in your fingers
- your heart beating faster than usual
- your skin feeling warm, suddenly
- your face getting red or flushed
- sweating, especially in the upper body
What Causes Hot Flashes?
It’s not exactly clear what causes hot flashes. However, they’re most likely due to hormonal changes in the body. Some women barely notice hot flashes or consider them a minor annoyance.
For others, the intensity may affect their quality of life in a rather negative way.
Hot Flash Triggers
Each woman’s triggers for hot flashes may be a little different, but some common ones include:
- drinking alcohol
- consuming products with caffeine
- eating spicy foods
- being in a hot room
- feeling stressed or anxious
- wearing tight clothing
- smoking or being exposed to cigarette smoke
You may want to start keeping a journal about your symptoms. Write down what you were doing, eating, drinking, feeling, or wearing when each hot flash began.
After several weeks, you may begin to see a pattern that can help you avoid specific triggers.
Some women are able to manage their hot flashes with some simple tools or techniques. Here are some simple ways to find relief:
- dressing in layers, even on the coldest days, so you can adjust your clothing to how you’re feeling
- sipping ice water at the start of a hot flash
- wearing cotton night clothes and using cotton bed linens
- keeping an ice pack on your bedside table
How are hot flashes usually treated?
Traditionally, hot flashes have been treated with oral (by mouth) or transdermal (patch) forms of estrogen. Hormone therapy (HT), also referred to as hormone replacement therapy (HRT) or postmenopausal hormone therapy (PHT), consists of estrogens or a combination of estrogens and progesterone (progestin).
Oral and transdermal estrogen are available as estrogen alone or estrogen combined with progesterone.
Whether oral or transdermal, all available prescription estrogen replacement medications are effective in reducing hot flash frequency and severity.
However, long-term studies (NIH-sponsored Women’s Health Initiative, or WHI) of women receiving oral preparations of combined hormone therapy with both estrogen and progesterone were halted when it was discovered that these women had an increased risk for heart attack, stroke, and breast cancer when compared with women who did not receive HT.
Later studies of women taking estrogen therapy alone showed that estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer.
Estrogen therapy alone, however, is associated with an increased risk of developing endometrial cancer (cancer of the lining of the uterus) in postmenopausal women who have not had their uterus surgically removed.
The decision in regard to starting or continuing hormone therapy, therefore, is a very individual choice in which the patient and doctor must take into account the inherent risks and treatment benefits, plus each woman’s own medical history.
It is currently recommended that if hormone therapy is used, it should be used at the smallest effective dose for the shortest possible time.
Herb and Oil Relief
While medical studies haven’t backed up their effectiveness for reducing hot flashes, some women find certain herbal products to be helpful. These include:
- Black cohosh (Actaea racemosa, Cimicifuga racemosa): It should not be taken if you have a liver disorder.
- Red clover (Trifolium pratense): It could increase the chance of bleeding.
- Dong quai (Angelica sinensis): It interacts with the blood thinner, warfarin.
- Evening primrose oil (Oenothera biennis): It may affect blood thinners and some psychiatric medications.
- Soy: It can cause mild stomachaches, constipation, and diarrhea.
Please check with your doctor before taking any of these products.
Hormone Replacement Therapy (HRT)
The popularity of hormone replacement therapy (HRT) has waxed and waned over the years. Treatment with synthetic hormones may be an option for some women whose hot flashes are debilitating and greatly affect the quality of their life.
Estrogen supplements level out the amount of estrogen in your system, reducing the incidence and severity of hot flashes and night sweats.
Estrogen is usually taken with progestin to reduce the risk of developing endometrial cancer. It can be taken by pill, through a vaginal cream or gel, or a patch.
Other medications have been found to help women whose hot flashes and night sweats are difficult to manage. While they weren’t developed directly for this purpose, some women find them effective.
Gabapentin and pregabalin, usually given for nerve-mediated pain, offer relief for some women. Gabapentin is also prescribed for seizures.
Antidepressants venlafaxine (Effexor), fluoxetine (Prozac), and paroxetine (Paxil) have also been shown to be effective for treatment of hot flashes.
Acupuncture may be helpful, without the side effects of medication. A small study published in 2011 found that women who had acupuncture had significantly fewer menopausal symptoms, including hot flashes, than those who had sham treatments.
Sham acupuncture is shallow needling that doesn’t stimulate a true acupuncture point.
Meditation can also be very successful in helping manage stress levels. Stress is a common hot flash trigger for many women.
Lifestyle choices can make as much of an impact on your body as any medication or supplement you take.
Living a healthy lifestyle can reduce the incidence and/or severity of hot flashes and help reduce the risk of heart disease and osteoporosis. Be mindful of the following ways you can improve your health:
- eating a well-balanced diet, with portion-control
- exercising regularly
- stopping smoking, if you do
Don’t Get Discouraged
Just as no two women are alike, neither are the ways their bodies will react to hot flash treatments. If one method doesn’t seem to work for you, another might.
Talk to your doctor if none of the common hot flash management tools are helping.
As tough as it’s to imagine while in the midst of your own personal heat wave, this too shall pass. For more information on how to get the most out of your menopausal years, keep reading about menopause.