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Turn Down the Heat on Hot Flashes
Hot flashes are an uncomfortable sign of perimenopause. Learn how you can reduce their occurrence.

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Picture of older woman Turn Down the Heat on Hot Flashes

You're a woman, 40-plus. You're sitting in your home, and suddenly you notice the room temperature feels just a bit too toasty. You ask yourself, "Is it hot in here or is it just me?"

Hot flashes may be the butt of jokes about women's change of life, but they are no laughing matter for women who have them.

Hot flashes and other perimenopausal changes usually start during a woman's forties. Perimenopause is the time leading up to menopause. Menopause occurs 1 year after your last menstrual period.

Signs of perimenopause
The signs of perimenopause are:

  • Hot flashes, night sweats
  • Insomnia, fatigue
  • Changes in menstrual cycle
  • Mood swings, forgetfulness
  • Vaginal dryness, less interest in sex
  • Headaches
  • Urinary problems

Hot flashes and irregular menstrual periods are common signs of perimenopause. Periods may last longer or shorter or even come closer together or farther apart. Talk to your doctor if your periods have become irregular, heavier, or more frequent.

What is a hot flash?
Hot flashes are usually caused by fluctuating hormone levels. Your face and neck may become flushed and red, and blotches may appear on your chest, back, and arms. Sweating is very common.

Hot flashes may also relate to other signs of perimenopause. If you have hot flashes at night, you may not be getting a good night's sleep, which can lead to being tired and irritable.

A hot flash can last for a few moments or up to 30 minutes. Most women have them for 3 to 5 years before they lessen. And though some women never have a hot flash or have only a few of them, others can have them into their sixties. Each woman is different.

Hormone treatment
If you do get hot flashes that get in the way of your everyday activities, you don't just have to grin and bear it. There are many options, including hormone therapy (HT). However, it is not for every woman. The Women's Health Initiative (WHI) studied HT for 15 years. This research program showed that taking hormone therapy for a long time raises the risk for cardiovascular disease, blood clots, and breast cancer. The Food and Drug Administration approves of hormone therapy (estrogen alone or estrogen plus progestin) only for the relief of menopausal symptoms at the lowest effective dose for the shortest period of time.

The WHI studies showed some benefit in terms of bone strength and fewer fractures. However, hormone therapy is generally not considered a good choice for treating the brittle bone disease called osteoporosis.

Remember to review your hormone treatment with your doctor at least every 6 months after you start it.

Ways to keep cool
The National Institute on Aging and the North American Menopause Society offer the following tips for coping with the symptoms of menopause:

  • Exercise. Aerobic (heart-pumping) and weight-bearing exercises are a strong remedy for many menopause complaints, including irritability, and sleep disturbances. Exercise also can lower the risk of diabetes, heart disease, osteoporosis, and weight gain. Be sure you check with your doctor before you start.
  • Avoid triggers. For some women, hot flashes are triggered by stress, caffeine, alcohol, spicy foods, or drinking or eating something very hot, such as soup.
  • Reduce stress. Try deep, slow abdominal breathing, meditation, yoga, massage, or a leisurely bath. Some researchers have found deep, slow breathing can cut the effects of hot flashes in half, probably by calming the central nervous system.
  • Don't get overheated. Dress in layers so you can remove them at the first sign of a flash.
  • Drink a glass of cold water or juice at the onset of a flash.
  • Use cotton sheets, lingerie, and clothing that allow your skin to "breathe."
  • Talk to your doctor about other treatments that may help.
By Nancy Reid, Staff Writer
Created on 09/14/2000
Updated on 09/06/2011
  • U.S. Food and Drug Administration. Estrogen and estrogen with progestin therapies for postmenopausal women.
  • National Institute on Aging. Menopause.
  • North American Menopause Society. The changing body.
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