Leela is halfway through a presentation at work. Her words exude her confidence, the audience engagement is great, and the team is appreciating her efforts. And then suddenly, her face turns red, her heart starts pounding and beads of sweat start forming on her face. She is embarrassed and tries to continue with her presentation, hoping nobody notices what is happening. But the damage is done, and she is now distracted and fumbling.
Shalini is at her cousin’s wedding. She is dressed in her raw silk saree with a beautiful matching blouse and fine jewelry. In the middle of a conversation with a relative who she is meeting after a long time, suddenly, she feels a wave of heat come over her. She breaks out into a sweat on her forehead and nose and feels her heart flutter. Her embarrassment builds as those around her notice and ask her if she feels okay. She dismisses them saying she ate something spicy, but her evening is ruined and she just wants to be back home in her PJs.
Both these situations represent the unfortunate, and often embarrassing, reality of hot flashes. They can be attributed to hormonal changes, especially the decline in estrogen. They are so common that more than 55% women in perimenopause and more than 80% of women in menopause experience them.
Hot flashes cause a sudden surge of heat, with sweating and an increased heart rate. They often arrive without any warning and throw the person completely off control. They tend to be disruptive and unnerving, and can’t be avoided. But understanding them can help you manage them better. When they occur at night, they are also commonly referred to as night sweats.
Who is more prone to hot flashes?
Anyone can experience hot flashes, but there is an increased occurrence in women with obesity, of African descent, lower socioeconomic status, occurrence of premenstrual syndrome, sedentary lifestyle, and smoking.
What happens during hot flashes?
Most of the time it involves a feeling of intense heat, almost like burning up, especially in the face, neck and chest region. There can also be profuse sweating and an increase in heart rate. Some women additionally experience dizziness or lightheadedness, anxiety, palpitations, and chills once the hot flash is over.
How long does it last?
A single episode can last anywhere from 1 to 5 minutes. Many women experience episodes of hot flashes daily, sometimes more than once a day too, while some don’t experience them at all. These episodes can recur for years - throughout perimenopause and menopause.
What causes these episodes?
Scientific data aren’t very clear on the causes, but certain triggers that set off a hot flash have been identified. These include hot weather, heat (due to intense exercise, being near a hot stove, etc.), smoking, caffeine, alcohol, spicy foods, tight or synthetic clothing and stress.
How can I cope with them?
While you may not be able to stop them from occurring, you can definitely manage their impact with the following modifications to your lifestyle:
Dress in Layers: This allows you to easily adjust to temperature changes and layer up or down depending on whether or not you are experiencing a hot flash.
Choose Your Fabrics Wisely: Synthetic fabrics may aggravate the feeling, especially in hot, humid weather. Natural materials like cotton are preferred.
Keep Stress at Bay: While the stressors may be beyond your control, you can manage them effectively with guided meditation, yoga, or deep breathing techniques.
Watch What You Eat: Alcohol, spicy foods, hot foods and caffeine can aggravate the condition. Some studies suggest that phytoestrogens found in soybeans and other soy products like tofu might be beneficial in reducing the frequency of hot flashes during menopause. A balanced diet rich in fruits, vegetables, whole grains and lean protein can be beneficial, but data on this remains inconclusive.
Control The Ambient Temperature: Use fans or air conditioning as needed. Keep a cool water spray handy for when you are outdoors.
Create A Comfortable Sleep Environment: Create a cool, quiet sleep environment. Use comfortable, natural clothing for your nightwear, pillow covers, bedsheets and blankets. Keep a bottle of cool water and a hand towel nearby for when night sweats occur.
Exercise: Over-exercising or performing high intensity workouts can increase the severity of hot flashes (how bad they get), but not the occurrence (how often you get them). However, resistance training workouts have been shown to be beneficial.
Does medical treatment help?
Yes and no. It entirely depends on the type of medical treatment you opt for.
Cognitive behavioral therapy (CBT) has shown maximum promise in the management of hot flashes and night sweats, especially when delivered in small-group or self-help formats. CBT programs specifically designed for menopausal women have shown beneficial results, including improved sleep and overall quality of life, even at 6-month follow-ups.
Other non-hormonal therapies using antidepressants, isoflavones, evening primrose oil, melatonin, vitamin E, acupuncture and others have been tested but the results have been conflicting and unconvincing.
Many healthcare practitioners and menopausal women are apprehensive about hormone replacement therapy (HRT), but the latest studies suggest it as a safe and effective option in treating hot flashes and night sweats in women under the age of 60. The development of bioidentical hormones, delivered at measured doses, in transdermal or other non-oral modes of delivery have resulted in a form of HRT in which the benefits outweigh the risks.
Long-term implications of hot flashes on cardiac health
Hot flashes have long been linked to high blood pressure; however, their relationship (what causes the other) is unclear.
A more recent long-term (15-year) study of around 2000 women aged 18-30 (in the beginning of the study) clearly shows a 1.5 times greater risk of developing heart disease in women who regularly experience both early adulthood migraines and persistent/ frequent hot flashes during the menopausal transition.
Therefore, despite being the most common menopause symptom, severe hot flashes should be addressed and managed (medically if required) for better long-term health.
Summary
Every woman experiences menopause differently for different periods of time. And, every woman is affected differently by this transition. What works for one may not work for another. Understanding how you can effectively manage your symptoms and when to seek medical help can smoothen your menopausal journey and prevent you from feeling frustrated, helpless and depressed.
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About the author
Kanchana is a Lifestyle Consultant & Weight Management Specialist. After a Masters degree in Molecular Biology from the USA, she ventured into the field of Nutrition and is certified in General Nutrition, Sports Nutrition, and Weight Management. Her own successful weight loss journey inspired her to help people of all age groups and health conditions via Calorie Culture, which she founded in 2012. She is also an avid dancer, mini marathoner, and sports enthusiast. She strongly advocates sustainable lifestyle changes as a means to long-term health benefits and optimal weight.
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