Hot flashes at menopause: what it is, symptoms

A hot wave covering the face and upper half of the body, profuse sweating, and rapid heartbeat are familiar to four out of five women who have celebrated their 50th birthday. These are hot flashes – a condition caused by hormonal changes in the female body, a kind of farewell to childbearing age. Their onset, duration, frequency of occurrence, and severity are very individual. For some, hot flashes begin before menopause, for others – after, stop quite quickly, or periodically recur for many years, causing discomfort not only of a physical but also psychological nature.

Causes menopausal hot flashes

The reasons for this phenomenon have not been fully clarified, it is assumed that it is caused by a low level of estrogens - sex steroid hormones. A low level of hormones of this group is also normal for girls during puberty, however, they do not have hot flashes. Probably, the answer to the question about the causes of hot flashes is more common, and it is too early to put an end to it.

In the fertile (childbearing) age, sex hormones are produced mainly by the woman's ovaries. In much smaller quantities, they are also produced by the adrenal glands, which after menopause remain the only producers of estrogens. This group of hormones includes estradiol, estriol and estrone, which is also produced during menopause. The body begins to rebuild itself in order to function in a state of estrogen deficiency. This provokes the development of a number of not very pleasant symptoms - hot flashes, increased nervousness, sudden mood swings.

The mechanism of hot flashes during menopause works as follows: estrogen deficiency causes an erroneous signal in the hypothalamus, responsible for thermoregulation, about the overheating of the body. In response, it reacts by releasing substances whose action is similar to adrenaline - the heart rate increases, blood rushes to the face and upper body through dilated vessels, and intense sweating begins. This condition is called "hot flashes", it is provoked by the fading function of the ovaries and, as a result, hormonal restructuring of the body.

According to experts, the course of climacteric syndrome is significantly influenced by a woman's lifestyle. Less intensively, and sometimes completely unnoticeably, the restructuring of the body occurs in women who lead an active lifestyle.

Some medications, emotional state, bad habits (smoking, drinking alcohol) can serve as a factor in intensifying hot flashes. Another attack can be provoked by high air temperature, hot food and drinks, spicy and salty dishes, caffeine.

Among the causes that aggravate the course of climacteric syndrome, frequent hot flashes and a long period of their periodic occurrence, early natural menopause, as well as those caused by surgery or drug therapy, are named.

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Symptoms menopausal hot flashes

Women, approaching the age of forty, often ask themselves: what are the hot flashes during menopause? This condition is well-known, and even visible - everyone has older friends, colleagues, mothers and grandmothers who have experienced the menopause in a very severe form. Therefore, this period is expected with a feeling of slight horror, and television advertising of drugs that reduce the symptoms of menopause does not add optimism either.

Some women, especially sensitive ones, feel the approach of a hot flash. However, in most cases, the hot flash begins suddenly: the entire upper part of the body - the face, neck, shoulders - simply glows with heat and turns red. The temperature during hot flashes rises,
the heartbeat quickens, its rhythm is disturbed, there is a lack of air. This condition lasts from 30 seconds to an hour (on average 2-3 minutes) and ends with profuse cold sweating, causing chills.

The attacks are characterized by varying degrees of severity, in some women they are not too intense, in others they are very pronounced. They can be accompanied by a feeling of increasing anxiety, increased irritability, dizziness with attacks of nausea, migraines up to fainting. Sometimes sweating is so strong that it is necessary to change clothes immediately. Hot flashes, especially intense and prolonged ones, and everything associated with them often cause confusion, anxiety, self-doubt in women, they have psychological problems.

Night hot flashes during menopause are called night sweats, since the hot flash remains unnoticed during sleep, but the woman wakes up cold and wet from the cold sweat that has appeared. The consequences of night hot flashes are the development of insomnia, which negatively affects memory, concentration, alertness and mood. Regular disruptions to night rest lead to stress, decreased immunity, weight gain, and an increased likelihood of pathologies of the nervous, cardiovascular and endocrine systems.

Quite often, hot flashes occur in the evenings after the end of the working day, so women suffering from this pathology are advised to rest more and not overwork themselves.

The severity of climacteric symptoms determines the frequency and duration of hot flashes. It has been observed that the slower the level of estrogens in the body falls, the easier and more imperceptible the restructuring is. In the vast majority of women, the body adapts to working in a deficit mode in a year or two, sometimes up to three years. In about a fifth of women, this period lasts up to five or ten years, and in a very small number - for the rest of their lives.

Hot flashes and night sweats are the first signs of the body's restructuring associated with the fading of reproductive function and are far from the most threatening to health. The consequences and complications of a decrease in estrogen levels can be much more serious. The importance of female sex hormones in the functioning of almost all organs is difficult to overestimate:

• they prevent the deposition of cholesterol plaques on the walls of blood vessels, protecting them from the development of atherosclerosis, which provokes pathologies of the blood vessels of the brain and heart, from which the majority of the elderly population dies;
• ensure the normalization of calcium metabolism, its absorption by bone tissue and the prevention of its embrittlement (women over 50 often suffer from osteoporosis, dangerous habitual fractures and poor bone fusion);
• provide natural hydration of the skin and mucous membranes of all organs (with the onset of postmenopause, more and more women feel their dryness, which contributes to the introduction of pathogenic microorganisms and the development of inflammatory processes);
• In addition to physical changes in the genitourinary system, libido usually decreases, which negatively affects the psychological state of the woman.

In fact, everything is not so scary; modern drugs allow you to slow down the rate of decline of estrogens in the blood and adapt the female body to existence in new conditions as painlessly as possible.

Diagnostics menopausal hot flashes

If hot flashes do not cause any particular inconvenience, women rarely consult a doctor about this problem. However, pathological menopause, accompanied by frequent intense hot flashes, is a reason to seek medical help from a gynecologist. Diagnosis is usually based on complaints of patients whose age is approaching the standard age for the onset of menopause. During this period, concomitant pathologies usually worsen, overlapping with the clinical picture, which complicates diagnosis. Therefore, a woman usually requires consultations with other specialists - an endocrinologist, rheumatologist, cardiologist, psychotherapist and other specialists as needed.

For objective diagnostics, the necessary tests are performed to determine the blood estradiol content, the estradiol to estrone ratio, the level of follicle-stimulating, luteinizing and other hormones, histology of the endometrial scraping, and cytology of vaginal smears. In addition to tests confirming the presence of age-related hormonal changes, a clinical and biochemical blood test is prescribed. A test may be prescribed to determine the blood glucose level or the level of thyroid hormones.

Depending on the presence of concomitant diseases, the doctor prescribes appropriate examinations. Instrumental diagnostics may include ultrasound examination, including transvaginal, mammography, electrocardiogram, rheoencephalography, electroencephalography.

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Differential diagnosis

Based on the results of examinations, differential diagnostics allows us to exclude pathologies of the ovaries and mammary glands, thyroid and pancreas, adrenal glands, and pituitary gland.

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Treatment menopausal hot flashes

The condition of the female body during the fading of reproductive function can hardly be called a disease, since no woman can avoid it, although not all can be considered healthy during this period. Hormonal treatment (hormone replacement) is considered the most effective method of treating estrogen deficiency, since by replenishing it and eliminating hot flashes, it improves the quality of life of a woman. Replacement of sex hormones is indicated in case of pronounced climacteric disorders - hot flashes, night sweats, heart rhythm disturbances, insomnia, signs of depression, increased fatigue, atrophy of the urogenital organs.

Drug hormone replacement therapy is carried out in three main modes: monotherapy with estrogens or gestagens; complex therapy with estrogens and progestogens; complex therapy with estrogens in combination with androgens. Hormonal treatment is carried out only as prescribed by a doctor. The treatment regimen and scheme are selected individually taking into account the benefit/risk ratio, minimal dosages of the drug are used to achieve the optimal level of hormones, ensuring simultaneous improvement of the condition and the absence of side effects. The patient's endometrial thickness and the condition of the mammary glands are monitored annually.

Contraindications to hormone replacement therapy: malignant neoplasms of the mammary glands or female genital organs (current or previous), endometrial hyperplasia, bleeding of unknown origin, venous (arterial) thrombosis, severe arterial hypertension, acute liver pathologies, porphyria, sensitization to the components of the drug. Hormone therapy is not primarily prescribed to women over 65 years of age. It is recommended to begin treatment of hot flashes with hormones during the period preceding menopause and early postmenopause.

Side effects of hormone replacement therapy: with prolonged (five years or more) use of hormonal drugs, the risk of malignant neoplasms of the mammary gland increases. To prevent this risk when taking estrogens orally, progestogens are prescribed intravaginally or intrauterinely.

With a tendency to thrombosis, thromboembolism is likely to develop, which is typical for the first year of therapy. Women from this risk group are prescribed parenteral drugs: estrogen patches, gels and intrauterine (vaginal) administration of progestogens.

The positive effect of hormone replacement therapy is expressed in a decrease in the intensity and frequency of hot flashes in more than 90% of women, which is also accompanied by an improvement in mental state, appearance (skin, hair), a decrease in urogenital symptoms, and an improvement in the absorption of calcium by bone tissue.

A very extensive list of drugs is used for hormone replacement therapy, for example:

• tablet forms Femoston, Divina, Klimonorm, Klinorette, Klimen-combi, Triaklim - complex drugs containing estradiol valeriate and a progestogen component (dydrogesterone, norethisterone, medroxyprogesterone);
• local hormonal drugs: Divigel, Estrogel gels; Estrocad suppositories, Estradiol gel and patch.

However, even in cases where a woman has no contraindications to hormone replacement therapy, it is better to first use hormone-free treatment. Pharmacies offer herbal preparations containing plant substances similar in structure and action to the main sex hormone of a mature woman – 17-beta-estradiol. Phytoestrogens, which include isoflavones, coumestans and lignans, as well as mycoestrogens produced by parasitic fungi, mitigate the effects of estrogen deficiency, reducing the intensity and frequency of hot flashes.

At the end of the last century, as a result of various comparative studies of the incidence of different peoples depending on their lifestyle and diet, it was suggested that Asian women practically do not experience hot flashes, since phytoestrogens predominate in their diet. The hypothesis that they can have a “balancing” effect on both the deficiency and excess of sex hormones is still being studied. Their side effects have not yet been thoroughly studied. However, there is no doubt that they affect the hormonal background. There is no specific answer yet to what extent phytoestrogens are useful and whether they can replace hormone replacement therapy. Positive results of a number of studies have given impetus to the production of herbal preparations to alleviate climacteric symptoms. In particular, the frequency of hot flashes is reduced by 45%. True, the same study explains about 70% of the positive results by the placebo effect. At the same time, this is not bad at all, because the placebo effect certainly does not threaten side effects.

There is evidence that isoflavones, like estrogens, reduce the likelihood of cardiovascular pathologies and the development of osteoporosis, and also bind free radicals. Their effect is still being studied, and new abilities are constantly being discovered, most of which have not yet been interpreted. In particular, some studies note that a number of phytoestrogens reduce the likelihood of occurrence and inhibit the growth of malignant neoplasms.

To eliminate or alleviate climacteric symptoms: hot flashes, night sweats, insomnia, neuroses accompanied by increased excitability or depressed mental state, drugs containing phytoestrogens are used. These drugs are sold in pharmacies without a doctor's prescription, however, it is advisable to get a doctor's consultation before using them.

Klimadinon is available in tablets and drops for oral administration. The active ingredient is the extract of the rhizome of black cohosh, a stimulator of the estrogen receptors of the hypothalamus. Reduces the effect of estrogen deficiency in the period preceding menopause and later, reducing the frequency and intensity of hot flashes, normalizing the emotional background and the vegetative-vascular system, metabolic processes in bone tissue, and promotes the restoration of the vaginal epithelium.
The active component of the drug does not stimulate the growth and reproduction of endometrial cells and estrogen-dependent malignant tumors of the mammary glands, which is different from hormonal drugs.

Contraindicated in case of sensitization to the ingredients and in estrogen-dependent diseases. Extremely rarely causes side effects in the form of a feeling of tension in the mammary glands, pain in the abdomen, vaginal discharge.

Recommended dosages of tablet forms Klimadinon Uno (one unit per day before bedtime), Klimadinon (one unit in the morning and evening). Swallow with plenty of water. Drops are not diluted, take 30 drops in the morning and evening, can be swallowed or dripped onto a piece of sugar. The effect of the drug becomes noticeable after two weeks from the start of therapy, the duration of administration is individual. Without medical recommendations, you can take no more than three months.

The drug Simidona Forte (Simidona Uno) with a similar active ingredient reduces or eliminates climacteric symptoms.

Tazalok drops for menopause are of plant origin. Their active ingredient is a mixture containing fresh roots of curly parsley, celery and meadowsweet, yellow porridge grass, wild flax and calendula flowers. It has a normalizing effect on the production of natural gonadotropic hormones, the ratio of estrogens and gestagens. It has a positive effect on the cells of the mammary glands, uterus and ovaries, prevents dysplastic changes in these tissues. It has a relaxing, mild analgesic effect, regulates hormonal levels, which has a beneficial effect on the condition of patients suffering from climacteric syndrome. Not prescribed if there is intolerance to the components. Take orally, three times a day, diluting 30-40 drops in half a glass of water. The duration of admission is not less than three months.

In addition to drugs that regulate hormonal levels during hot flashes, the doctor may prescribe antihypertensive drugs, since hot flashes are often caused by hypertension.

Sedatives are prescribed to relieve agitation, anxiety, and insomnia. Their effect on the body reduces the intensity and frequency of hot flashes.

Low-dose antidepressants are prescribed for hot flashes complicated by depressive disorders, tearfulness, and anxiety.

For hot flashes accompanied by climacteric neurosis, novocaine (2%) is used. When it enters the blood, it is broken down by blood plasma and tissues, resulting in the formation of para-aminobenzoic acid, which stimulates the reproductive system, thyroid gland, and other endocrine glands.

Injections are made with a freshly prepared solution of novocaine (2% in 5% glucose solution), starting with 3-5 ml every other day. Each time the dose is increased by 1 mg, bringing it to 10 mg. The course of therapy includes 12 injections, taking a break for ten days, it can be repeated, if necessary, two or three more times. Some specialists note that novocaine therapy reduces the number of hot flashes and their intensity.

Active vitamin therapy with ascorbic acid, B vitamins, retinol and tocopherol can have a good effect.

However, it is important to remember that medications for the treatment of hot flashes must be prescribed by the attending physician, taking into account their severity and concomitant diseases.

Physiotherapeutic treatment (hydrotherapy, d'Arsenval current treatment, franklinization, ultraviolet irradiation, X-ray therapy) can give good results in the treatment of hot flashes, while eliminating headaches, irritability, and normalizing sleep.

Physiotherapy exercises that tone the entire body system can be prescribed for climacteric disorders in the absence of special contraindications for a woman.

Alternative Treatment for Hot Flashes During Menopause

Folk remedies are widely used for climacteric disorders. The simplest recommendation is to raise your arms at the very beginning of the hot flash, and if possible, lower your feet into hot water.

In case of night sweats, it is recommended to take a pine bath or a lavender bath before going to bed, they have a sedative effect, normalize sleep, which has a positive effect on the intensity and frequency of hot flashes. You can add ready-made essential oils to the bath.

Herbal treatment is very effective. The high content of flavonoids in the herb of sage makes it indispensable in cases of intense and frequent hot flashes, night sweats, nervousness, irritability, in addition, it stimulates the immune system, improves memory, attention and promotes skin rejuvenation. In the morning, you can drink sage tea: brew one sprig of the herb or a teaspoon of dry crushed raw materials with a glass of boiling water. Drink the tea three times a day for two weeks, then take a break for two weeks and repeat the course again.

You can brew tea from equal parts of sage and linden. This tea has a pleasant taste and aroma, and linden contains flavonoid glycosides, ascorbic acid, carotene, has a mild sedative, analgesic, and pronounced anti-inflammatory effect.

Herbal tea brewed from a mixture of herbs can be effective: peppermint and valerian root (30 g each) mixed with two tablespoons of chamomile. Take two tablespoons of the mixture, pour into a thermos and brew with boiling water (500 ml). After three hours, strain and drink a glass a quarter of an hour before breakfast and dinner.

Horsetail also contains flavonoids, and is also rich in vitamins and microelements. You can brew tea with it or drink its decoction. Drink horsetail drinks 15 minutes after eating. You can also take baths with it, which will relieve excessive sweating.

Horsetail can be used as part of a collection in equal parts with sage and valerian. A decoction from such a collection is drunk several times a day depending on the frequency of hot flashes.

A calming effect is provided by the use of teas with mint or lemon balm, it is better to sweeten them with honey. Teas with oregano and St. John's wort can be used as an antidepressant.

Homeopathy can be of great help in treating climacteric syndrome with hot flashes of varying severity. Pharmacies offer complex homeopathic preparations for the treatment of pre- and menopausal disorders.

Klimaktoplan contains homeopathic dilutions of extracts of black cohosh (normalizes the nervous system, reduces the frequency and intensity of hot flashes), sepia (stabilizes the synthesis of hormones by the adrenal glands, pituitary gland and ovaries), ignatia (reduces sweating, fatigue, headache), sanguinaria (stops hot flashes, hyperemia, tachycardia, migraines). Contraindicated in case of sensitization to the components of the drug. Tablets are taken sublingually one or two half an hour before meals or an hour after. Can be combined with other drugs. Overdose has not been recorded.

Remens is available in tablets and drops, has a normalizing hormonal balance effect on the hypothalamus-pituitary-ovarian system. Eliminates hot flashes, night sweats, sleep disorders, irritation, anxiety, depression, as well as inflammatory processes in the pelvic organs, hypertensive and other cardiovascular disorders. Contraindicated in case of sensitization to the ingredients, very rarely can cause increased salivation. Recommended dosage: on the first or second day, take one tablet or 10 drops eight times a day, then switch to three times a day, with therapeutic improvement, you can take this dose twice a day. Drops should be taken undiluted or slightly diluted, before swallowing - hold in the mouth. Compatible with any medications.

Classical homeopathy for the treatment of hot flashes suggests using more than forty preparations, the main ones being: Lachesis, Glonoinum, Sanguinaria, Sepia. These preparations are also used in combination pharmacy products recommended for climacteric disorders. To receive individual prescriptions that will be most effective for a particular woman, you need to see a homeopathic doctor.

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Ayurveda for menopause and hot flashes

The ancient medical system of Ayurveda correlates the years of old age with wind (Vata). Irritability, anxiety, insomnia, and depressive mood correspond to this period of life. Treatment of the transition to old age consists of reducing the influence of Vata. Herbal products that tonic the sexual sphere are recommended:

• aloe juice, containing a vitamin-mineral complex, organic acids, flavonoids, enzymes, which have a beneficial effect on the body and support its defenses;
• Asparagus racemosus or shatavari - has the ability to maintain a normal balance of female sex hormones, heal and rejuvenate the skin, as well as almost all organs and tissues;
• crocus stigmas or saffron – a unique remedy that purifies the blood and promotes the production of serotonin (the hormone of joy);
• Ashwagandha – slows down the aging process, activates energy metabolism, promotes cellular tissue renewal, has a positive effect on memory, the nervous system, and sexual function.

There are ready-made Ayurvedic medicine preparations aimed at women suffering from hot flashes and other unpleasant climacteric disorders, for example, the composition of "Shatavari".

To eliminate or alleviate climacteric syndrome, it is recommended to take fresh aloe juice three times a day - one tablespoon at a time.

At night, it is recommended to take calcium (1.2 g), magnesium (0.6 g), zinc (0.06 g), which will not only reduce the intensity of hot flashes, but also prevent calcium deficiency.

When a woman feels the approach of a hot flash, she should drink a cup of pomegranate juice with a teaspoon of natural sugar (candy powder) and ten drops of lime juice dissolved in it. This drink can be drunk several times a day.

A mixture of shatavari and wild yam has an effective effect. Mix half a teaspoon of powder of these herbs and swallow twice a day (after lunch and dinner), washing down with warm water, or even better - aloe juice.

Diet

The main part of the diet should be vegetables, including raw ones - in the form of salads. It has been established that fans of vegetarianism practically do not suffer from hot flashes. Probably, phytosterols contained in plant foods help to cope with age-related hormonal changes.

It is advisable to replace morning coffee with green tea. Coffee has a stimulating effect on the nervous system, green tea has a softer effect, it helps to get rid of toxins, free radicals, contains vitamins, minerals.

In pre- and postmenopausal periods, the reserves of vitamins, microelements, especially calcium, magnesium, potassium are seriously depleted. Therefore, the diet should include products containing them: fresh vegetables and fruits, whole grain bread, dairy products, fish, lean meat. You should not consume hot drinks and food, alcoholic drinks, spicy dishes. All this can provoke hot flashes.

To restore psychological and emotional balance, it is recommended to promote the production of serotonin with the help of mood-lifting products such as chocolate, dates, dried apricots, bananas, oatmeal, and red bell peppers.

However, you should not overdo it, especially if you have extra kilos. You need to monitor the calorie content of your menu, avoid fried foods, reduce the amount of food in a serving, and eat more caloric dishes in the first half of the day. Lovers of salty foods should limit the amount of salt.

It is advisable to include soy products in your diet – meat, milk, tofu cheese.

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Prevention

You can reduce the frequency and intensity of hot flashes, and sometimes even eliminate them, by following some simple rules:

• First of all, avoid stuffy rooms; it is advisable to sleep with the window open;

• you should not reduce your usual physical activity, you can even increase it a little, for example, by starting to attend yoga or swimming classes, or go for walks, which can help overcome feelings of anxiety, restlessness, nervousness, and increase stress resistance;
• lead a healthy lifestyle and follow a diet - limit meat products, eat more fruits and vegetables, drink at least 1.5 liters of water daily, which compensates for moisture loss due to increased sweating and helps reduce the frequency and intensity of hot flashes;
• after consulting with your doctor, choose a suitable vitamin and mineral complex;
• exclude items made of synthetic materials from your wardrobe, do not wear sweaters with a closed neck, it is better to wear several items in cold weather, tie a scarf or shawl around your neck so that you can remove the top layer of clothing when the tide approaches;
• take a shower regularly, use antibacterial soap, deodorants, antiperspirants;
• do not overwork yourself, get quality rest, avoid stressful situations; when you feel the tide approaching, try to close your eyes and take several deep breaths in and out;
• Always carry a bottle of water with you, a few sips of cool water can help avoid a hot flash;
• If hot flashes significantly worsen the quality of life, despite all recommendations, you need to seek medical help; modern medications and treatment methods can significantly improve the condition, reducing climacteric symptoms.

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Forecast

Hot flashes are temporary inconveniences that will stop after a short period of time. After all, this is not even a disease, but simply the body's adaptation to new conditions of existence. And it needs help with this - just make some effort: change your lifestyle, diet, leave bad habits in the past. And most importantly, a life-affirming perception of the new stage, an attentive attitude to the state of your soul and body will help you quickly overcome the transition period.