The menopause is a natural event and hot flashes are the most common menopausal symptom. The intensity and frequency of hot flashes varies greatly from woman to woman. A hot flash is a feeling of warmth that spreads over the body, but is often most strongly felt in the head and neck regions. Hot flashes may be accompanied by perspiration or flushing. Hot flashes usually last from 30 seconds to several minutes. Although the exact cause of hot flashes is not fully understood, the most widely accepted theory is that hot flashes are caused by a deficiency in circulating estrogen as a result of declining ovarian function.

Hot Flushes

Area of incidence:

Hot flashes are considerably less common in non-Western countries such as Japan, Hong Kong, Pakistan, and Mexico, where studies show that 10% or less of menopausal women experience hot flashes. It has been postulated that the low incidence in Japanese women is due to their high-fiber, low-fat diets and high dietary intake of soy products. On the other hand, 85% of the women in the United States experience hot flashes of some kind as they approach menopause and for the first year or two after their periods stop. Between 20 and 50% of women continue to have them for many more years. As time goes on, the intensity decreases.

Characteristic Symptoms:

A typical hot flush lasts a few minutes and causes flushing of your face, neck, and chest. You may also perspire (sweat) during a hot flush. Some women become giddy, weak, faint, or feel sick during a hot flush. Sweats commonly occur when you are in bed at night. Other symptoms may develop such as headaches, tiredness, palpitations, being irritable, difficulty sleeping, depression, anxiety, aches and pains, loss of libido (sex drive), and feelings of not coping as well as before. All of the above described symptoms can be collectively called as short term menopausal symptoms.

There are some long term changes and problems occurs after menopause, which includes osteoporosis ('brittle bones') dried, thinner, and itchy skin, decrease the underarm and pubic hair, increase the facial hair, dried vagina, etc.

Treatment:

1. Prescription Medications

• Hormone Replacement Therapy (HRT) eg. Estrogen.
• Selective Serotonin Reuptake Inhibitors (SSRI's)
• Clonidine
• Gabapentin
• Magestrol Acetate
• Medroxyprogesterone

2. Nonprescription Medications/Alternative Treatments

a. Herbal/Natural

• Phytoestrogens(Bioflavonoids)
• Black Cohosh
• Combination of one or more plant drug (ginseng, licorice, evening primrose oil, dong quai, chasteberry, and wild yam)

 b. Synthetic drug

• Vitamin E
• Pantothenic acid (vitamin B-5)
• PABA

c. lifestyle

• Exercise
• Stress Reduction
• Sleeping Mode
• Avoiding of triggering Agent
• Beating the heat naturally

Due to several unwanted side effect & various adverse reaction of the prescription medicine, I prefer to encourage the nonprescription or alternative treatment though it is less effective than prescription medicine.

Phytoestrogens :

Isoflavones are chemical compounds found in soy and other plants (such as chick peas and lentils) that are phytoestrogens, or plant-derived estrogens. They have a chemical structure that is similar to the estrogens naturally produced by the body. Women who have had breast cancer and do not want to take hormone therapy (HT) with estrogen sometimes use soy products for relief of menopausal symptoms. Bioflavonoids (Isoflavones) have been shown to increase the effectively, particularly when they are taken with vitamin C. . Extensive research indicates that Vitamin C is considered an essential nutrient for optimal functioning of the adrenal glands, an important source of post-menopausal hormone production. However it is recommended that you get your soy from foods rather than from supplements. Foods that contain soy include tofu, tempeh, miso, soy milk, whole soybeans, texturized vegetable protein, and soy powder.

Black Cohosh:

Black cohosh is an herbal preparation that has been popular in Europe for the relief of hot flashes. This herb is becoming more and more popular in the U.S., and the North American Menopause Society does support the short-term use of black cohosh for treating menopausal symptoms, for a period of up to six months, because of its relatively low incidence of side effects when used over the short term. Black cohosh (20 mg to 60 mg 3 times daily) often provides effective relief of hot flashes, as well as other symptoms of menopause including headaches, heart palpitations, and anxiety.

Vitamin E:

Some women report that vitamin E supplements can provide relief from mild hot flashes Taking 400 IU to 800 IU of Vitamin E daily significantly reduces the occurrence and severity of hot flashes and night sweats during menopause or perimenopause, and provides an additional benefit of strengthening the immune system and protecting the heart.

Pantothenic acid (vitamin B-5) & PABA:

Pantothenic acid (vitamin B-5) also plays an important role in the maintenance of normal adrenal gland function. Providing the adrenal glands with optimum nutrition may help ease the body's transition to alternate sites of hormone synthesis. Para-amino benzoic acid (PABA), another B-complex vitamin, has been shown to promote circulating levels of the body's own estrogens. It is considered a pro-estrogenic compound, capable of modifying the body's estrogen metabolism.

Complementary treatments:

Licorice, evening primrose oil, dong quai, chaste berry, and wild yam: There are many supplements and substances that have been advertised as "natural" treatments for symptoms of menopause, including ginseng, licorice, evening primrose oil, dong quai, chaste berry, and wild yam. Scientific studies to prove the safety and effectiveness of these products have not been performed. Red clover may be of benefit but different studies gave conflicting results. In addition, some species contain coumarin, which makes them unsuitable for women who take anticoagulants such as warfarin. Dong quai, evening primrose oil, vitamin E and ginseng are no better than placebo (dummy tablets). So, they are unlikely to help. herbology, in which many different herbs are cooked together to make a tea customized to your particular symptoms. Common to all Chinese herbal mixes is dong quai, thought to be a plant estrogen. More plant estrogens that women have found effective in treating hot flashes over the centuries can be found in ginseng, evening primrose oil, licorice root, red raspberry leaves, sarsaparilla, spearmint, damiana, motherwort, chaste berry (also known as Vitex), black cohosh, and wild yams. These herbal remedies, Chinese and other, may be effective at reducing hot flashes but, again, their relative safety in women who have had breast cancer is not known. Avoiding, or using plant estrogens with great caution, is best, and never try them without telling your doctor. Even leading Chinese medicine practitioners caution women not to self-treat with Chinese herbs.

Exercise:

Exercise at least 30 minutes every day. You can walk, run, ride a bicycle, or do another activity. Just don't exercise within 3 hours of going to bed to help prevent night sweats. Increasing your level of activity (for example, taking the stairs instead of the elevator) can reduce hot flashes and have a positive impact on just about every other symptom attributed to menopause and growing older, including: Insomnia, mood swings, eroded self-image, loss of libido fatigue & elevated cholesterol levels.

Stress Reduction :

Some examples of stress management techniques are meditation, yoga, prayer, exercise, spending time in nature, deep breathing, and muscle relaxation.

Sleeping Mode:

Lighter clothing & sleeping in a cooler room reduce the number of hot flushes. Get a bigger bed if you and your partner are on different heat planets but you still want to stay in close orbit. Take cool shower before bed. Where possible, lower the thermostat. Maybe it's time for a decent air conditioner or a ceiling fan. Or maybe you'd prefer one of those little hand-held battery-operated fans or the foldable kind you flutter in front of your face. You can find perfectly adequate paper fans for about a dollar.

Avoiding of triggering Agents:

Dietary triggers that can start a bout of hot flashes include alcohol, caffeine and cayenne or other spicy foods. If your hot flashes seem to be worse after consuming these foods, try eliminating the offenders and see if the hot flashes subside.

Beating the heat naturally: 

Hot flashes are often worse during hot weather. Wear all cotton clothes that allow your skin to breathe and keep a fan nearby during hot weather to reduce the number of hot flashes you experience. Other heat producing agents are diet pills, hot showers, hot beds & smoking. Keep ice water at hand that you can sip to cool down your insides.

Conclusion