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         originated September 2006

         Updated December 2008

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A Powerful Sensation

Hot flashes often occur as a result of decreased estrogen.

They are preceded by prodromes (early warning) and

occur as a burst of heat accompanied by a sweat. 

A mild or strong tingling sensation in the hands, feet,

and legs is also common.

 

For some women a feeling of  anxiety, panic, or irritation

can occur with the hot flash.

 

Hot flashes are often accompanied by cardiovascular alterations;

they begin with an increase in heart rate and in blood flow 

which is maintained for the duration of the flash but rapidly

decrease thereafter.

 

A probable cause of hot flashes is a change in hypothalamic
(brain) function in response to an alteration in ovarian feedback,

resulting in a sharp decrease in the central thermostat of the

hypothalamic thermoregulation centers.

 

Source:

Obstetrics & Gynecology 2000;95:804-809
Hormone Replacement Therapy for Oxidative Stress

in Postmenopausal Women With Hot Flushes
MARIANO LEAL, MD, JULIAN DÍAZ, PhD

 

 

 

 

According to

the American College

of Obstetricians & Gynecologists

the average time

a woman uses

hormone therapy

to relieve

menopausal symptoms

is four years.

Understanding

and Hot Flashes and Night Sweats

 

  As estrogen levels diminish or fluctuate, blood vessels may expand rapidly allowing for increased blood flow. The increase in blood flow generates warmth causing skin temperature to rise slightly. Perspiration often occurs to cool down the body. During a hot flash a sensation of warmth and perspiration  moves upward from the chest to the shoulders, neck and head. A hot flash may also start at the legs and move upward throught the body. Additionally, during a hot flash the face might look flushed, and red blotches may appear on the chest, neck and arms.


  A hot flash can last from 30 seconds to several minutes. The frequency, as well as the duration, of hot flashes varies for each woman. A hot flash may occur once an hour, in clusters (bursts) every few minutes or only occasionally. They can occur  day or night. Those occurring during sleep are referred to as night sweats.

 

  In addition to hot flashes and perspiration (diaphoresis), vasomotor symptoms may also include heart palpitations, anxiety and tingling of the skin, hands and feet.

 

  Estrogen levels gradually decline during the menopausal transition. Below is an average serum concentration decline of estrogen (estradiol) during the menopausal transition. This gradual reduction in estrogen often generates vasomotor menopausal symptoms such as hot flashes. 


Age 48 140-130 pg/ml
Age 52 less than 40 pg/ml
Postmenopausal less than 20 pg/ml


Note: pg/ml = picograms per milliliter

 

Plenty of Options . . . to ease and balance hormones


Prescription hormone replacement and prescription bio-identical hormone replacement B-HRT are very effective for the treatment of vasomotor symptoms (hot flashes and night sweats). Low dose oral contraceptives, estrogen replacement or hormone replacement provide a steady level of hormones. Balanced, regulated hormone levels are less likely to cause menopausal symptoms. Low dose oral contraceptives or hormone replacement (prescription HRT, or B-HRT) often results in relief of vasomotor symptoms within one to two weeks in 80% of women. Many, many women achieve results within days.

 

Helpful options to reduce hot flashes are overviewed in the next sections.


Source:
Current Role of Hormone Replacement Therapy for Management of Menopause. American Association of Clinical Endocrinologists Menopause Guideline Revision Task Force
Rhoda H. Cobin MD
Endocrine Practice 2006; 12(13): 315-337

 

                                      Hot Flashes Can Also

                     Be Managed . . . Naturally

 

   Many women can self manage hot flashes and other menopausal symptoms by using a combination of phytoestrogen creams and supplements, natural progesterone cream derived from mexican wild yam root and dietary/herbal supplements (nutraceuticals). Keep in mind, dietary supplements, herbal supplements and phyto-estrogen and natural progesterone stimulate biological effects. Such therapies can be potent, and when used incorrectly or in excess can stress body tissues and organs.

 

  The menopausal transition occurs naturally/gradually over a period of years. Some nutraceuticals therapies are more specific to perimenopause symptoms, some more specific to menopause and some are more specific to postmenopause. Additionally, there are wide variations in the manufacturing and quality of nutraceuticals. Please, research before you purchase.


Relief for hot flashes . . .

soy isoflavones, flaxseed and pycnogenol.

 

  Estrogen receptor B agonists and specific nutraceuticals that hush the sympathetic nervous system are effective in reducing hot flashes. Estrogen receptor beta affects the ovaries, vascular endothelium, smooth muscle and the central and peripheral nervous system. As such, hot flashes (vasomotor symptoms) respond well to nutraceuticals that bind to estrogen receptor B.


  Soy isoflavones, with high genistein content bind to estrogen receptor B and can significantly reduce menopausal hot flashes. Isoflavones/genistein positively effect, regulate blood vessels which helps diminish hot flashes. Health food stores offer phytoestrogen dietary supplements that are primarily dervied from soy. A non genetic modified phytoestrogen dietary supplement that contains about 40 mg total isoflavones (fermented soy) will be helpful. Take as directed on the supplement. Certain soy milks have 70 mg of isoflavones in one cup of soy milk. Enjoying organic soymilk through out the day will be helpful. Red clover also contains isoflavones.

 

  Flax seed is a omega 3 essential fatty acid that also has a positive effect on blood vessels. In addition to soy isoflavones, adding one/two tablespoons of milled flax seed (powder) to the daily diet reduces the frequency/intensity of hot flashes for most women. One tablespoon of milled flax seed contains 1300 mg of omega 3 oils. Milled flax seed can be sprinkled in soy yogurt, fresh salad and over cereal. As an added bonus flax seed also nourshes the skin and hair. At menopause (no menstrual cycles) women loose thirty percent of skin elasticity due to diminished estrogen, and continue to loose 1-2% of skin elasticity annually during the postmenopausal years.


  The Mayo Clinic conducted a six week study regarding flaxseed and hot flashes. The women in this study found their frequency of hot flashes decreased 50 percent over six weeks, and their overall hot flash score decreased an average 57 percent. Participants also reported improvements in mood, joint or muscle pain, chills and sweating, which significantly improved their health-related quality of life. Flaxseed therapy, consisted of 40 grams of crushed flaxseed taken daily. Keep in mind, you can purchase milled flaxseed (already ground to a fine powder at the food store). Milled flaxseed can be sprinkled on hot or cold cereal etc.

 

  Pycnogenol is a natural plant extract originating from the bark of the maritime pine that grows along the coast of southwest France. Pycnogenol is available as a dietary supplement. Health benefits associated with pycnogenol include cognitive function, skin elasticity, nitric oxide stimulation, free radical scavenging and enhanced antioxidant activity. Nitric oxide is a key molecule that regulates blood vessel function. Pycnogenol helps ease hot flashes by enhancing nitric oxide levels. In more physiological terms: pycnogenol stimulates constitutive endothelial NOS (eNOS) activity to increase nitric oxide levels, which is thought to counteract the vasoconstrictor effects of norepinephrine.

 

  A study published in the Scandinavian Journal of Obstetrics and Gynaecology (2007) validates the use of pycnogenol to ease menopausal symptoms. The study which included 155 women between the ages of 45 - 55, found 100 mg pycnogenol twice a day reduced hot flashes, depression, panic attacks, cholesterol and other symptoms associated with women entering menopause transition.

 

  Soy isoflavones, flax seed and pycnogenol work in synergy to reduce symptoms of hot flashes that occur due to diminished estrogen.

  

 

   

Natural Estrogen Cream for Hot Flash Relief

 

 

        

 

 

       

 

 

 

    

   Natural estrogen cream (estriol) is a very effective option to help relieve menopausal (no menstrual period) hot flashes. Estrogen cream is rubbed on the skin and contains low dose phytoestrogens. These plant based estrogens slightly upregulate estrogen receptors or bind to estrogen receptors. This helps modulate estrogen sensitive tissue which reduces hot flashes. Please note: women who are peri-menopausal, still get a menstrual period can most often reduce symptoms with a natural progesterone cream.

  A good quality estrogen cream should primarily have only natural ingredients. Estrogen cream can be purchased online or at health food stores. Although you do not need a prescription for over the counter estrogen cream or gel, keep in mind the cream is biologically potent. When used incorrrectly or in excess estrogen cream can stress body tissues and organs.

 

  Prescription bio-identical estrogen cream or gel is somewhat more potent than the estrogen cream offered at the health food store. Bio-identical Hormone Replacement (B-HRT) is natural estrogen or progesterone (or both) blended by a specialized compounding pharmacy. Bio-identical hormones are identical to the hormones produced by the ovaries.

 

Sources:
Endothelium-dependent vascular effects of pycnogenol
Fitzpatrick D. F. Bing B. Rohdewald P.
Journal of Cardiovascular Pharmacology
1998, vol. 32, no4, pp. 509-515

Flaxseed Shows Potential to Reduce Hot Flashes
Sandhya Pruthi, M.D.
Mayo Clinic Rochester, Minn. August 29, 2007

   
 

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Information is provided for educational purposes to help individuals form an understanding of biological processes as they effect health. This information is not intended for medical diagnosis or treatment.