QUESTION: Although I am able to cope with most of the feelings that come on with my hot flashes, they have been going on for more than two years now, and I am beginning to wonder when this will all end.
I have tried to find information as to the reason that women are cursed like this, but have never found an explanation that makes much sense.
Is there a possibility you might include a simple answer for me in your column?
ANSWER: Like you, many women are forced to deal with one of the more distressing signs of menopause, the hot flash or flush.
While some of the secrets of the "why's" and "how's" of this most uncomfortable symptom are not clear, a great deal is known, and I will try to tell it to you.
Not all women have severe or annoying episodes; for many the event is mild and infrequent, lasting but a few moments.
They occur during day time hours and disappear after a year or two.
For others however, they can be most severe, lasting up to ten minutes and striking as often as six times an hour.
They may happen frequently at night, destroying sleep and provoking severe night sweats. Statistics show that as many as 25 percent to 50 percent of all sufferers with hot flashes may continue to have them for as long as five years.
The flash, skin flush and perspiration are a result of a temporary imbalance of the system in the body that regulates the body's temperature.
The hot flash attack begins in the hypothalamus, an organ lodged deep with in the brain that is responsible for the temperature control of the body, and also monitors the level of estrogen (female hormone) that circulates in the blood.
When estrogen levels are low, it sends a message to the anterior pituitary gland (using a chemical called gonadotropin releasing hormone).
In turn the anterior pituitary gland sends a chemical messenger (this time it's called follicular stimulating hormone) to the ovaries to produce more estrogen.
When the aging ovaries can not respond (or when the ovaries are missing because of surgery) the hypothalamus next releases a stimulant called free epinephrine, which spills over into the heat regulating area, and starts the reactions in both heart and skin that result in increased circulation and dilated blood vessels in the skin that create all the sensations of a hot flash, skin flushing and the perspiration that accompanies the reaction.
Even though the sensation may last for but a few minutes it takes about a half hour for the body systems to return to normal.
Over time the body and all of the mechanisms that control the body temperature readjust to the new lower levels of estrogen, and the attacks stop.
However other complications that occur with reduced estrogen production, such as osteoporosis, cardiovascular disease and vaginal atrophy and drying, continue to progress over time.
Since the attacks vary in frequency and intensity from woman to woman, the consideration of possible treatment must remain an individual decision.
Hormone replacement therapy can be used to diminish the symptoms, and will also be of considerable benefit in preventing or alleviating the other complications of menopause, but since such a therapy may be necessary for the life of the woman, all the pros and cons should be discussed with the physician.
Hormone therapy can produce other annoying symptoms such as weight gain, swelling, breakthrough bleeding, breast tenderness and abdominal bloating.
The presence of breasts or uterine cancer in the family history can also influence the decision to use hormone treatments.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
