Again, know these blogs are just me being a girl, standing in front of other girls who are all going through our new and exciting journey of womanhood. And as I was researching all of this for myself (my OB did not give me much guidance, and colleagues were all over the place in their recommendations), I decided I would share what I found with you, to hopefully save you from some of the struggle. I totally believe in the collective experience and solidarity of women. I don’t get why talking about menopause and all these changes is so secret.
When you suddenly feel hot (and not in that I’m-20-and-look-awesome kind of hot way), it is terrible. I remember I had a plastic surgery scrub tech going through menopause who would sweat so much she had to scrub out of surgery. I didn’t understand it like I do now.
What is it?
- A wave of heat in the upper body
- Sweating, redness, anxiety, and HEAT. You sweat and your blood vessels dilate (which makes you flush) to get rid of the heat.
- It has to do with estrogen being in the brain, and then it is taken away. The faster the removal/bigger the change, the more symptomatic you are.
- They last 2-4 minutes.
- They disrupt sleep.
- They can be followed with chills and shivering
- Some women get these 20-30 times a day and it on average lasts 7 YEARS.
- There may be an association with cardiac disease/stroke in those with severe hot flashes
How long?
There are 4 equally occurring patterns:
- start early in menopause transition and stop after the final period,
- later onset with most symptoms around the last period and slowly declining for 4 years,
- few or none, or
- “super flashers” (sounds naughty, but is really just tragic) for those who go from the transition up to 10 years out.
Risk factors:
- GENETICS. Longest are seen in African American woman (11 yrs), Asian women (5-6 yrs), Hispanic and Caucasian in between
- SOCIO: lower education, poverty, and stressful childhood
- SMOKING. (yup. smoking doesn’t do anything good for your body)
- Stress/depression
- CAFFEINE
- ANXIETY
- HEAVY DRINKING
- AFTERNOONS
- HOT WEATHER/HUMIDITY can trigger
Treatment
- Wear layered clothing and stay cooler so you don’t trigger a hot flash
- Unclear if any “cooling” clothing works, though it is good to have vents to aerate
- Behavior therapy. meditate. think “this is only going to last a few minutes.” Breathe. Slow your heart rate.
- Hormone replacement, with the lowest dose that fixes the symptoms. It takes 6 weeks to see the effect.
- Antidepressants (Paxil 10 mg, Celexa 10 mg, Lexapro1 10 mg, Effexor 75 mg) Takes 6-12 weeks to see effect
- Antiepilepsy medications like gabapentin (300 mg at night) or lyrica
- NEW one? fezolinetant, which causes the nerves to stop overreacting. No estrogen given.
What doesn’t work: phytoestrogens, magnets, exercise, acupuncture. (*this was stated as not effective by the book I am reading which cites the research)
And what is not proven? Herbals. **NOTE All herbals are not monitored as true medications are. Please read my blogs on herbals HERE. Think Black cohosh, evening primrose oil, and phytoestrogens