By Cindy Moy Carr, founder of mySysters

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If there’s any symptom of perimenopause that should be the moniker of a superhero, it’s hot flashes.

It should come with a superhero costume made of special fabric that adjusts to body temperature, soothing when one feels prickly, cooling the skin when it feels like it’s on fire and cozy during an especially chilly aftermath.

PERIMENOPAUSE

Perimenopause, of course, is NOT a disease.

Perimenopause is the transition phase leading up to menopause, which marks 12 months without a menstrual cycle.

Culturally, perimenopause and menopause are used interchangeably and will be within this article.

We refer to hot flashes and other perimenopausal experiences as ‘symptoms’ in accordance with World Health Organization standards because hot flashes, migraines, joint pain and other symptoms can affect quality of life.

While most of us will experience vasomotor symptoms (hot flashes or night sweats) over the years, we all experience them differently.

For me, I get hot one day and stay hot and sweaty and miserable and cranky for several weeks.

Then suddenly I’m fine until the next hot flash which may be several months or even years later.

My friend Jean, however, had several intense hot flashes a DAY, every day, for months.

These hot flashes triggered dizziness, nausea and often even vomiting, which she tried to do quietly in the shared bathrooms at her work.

Jean didn’t tell anyone what she was going through until I started telling my friends I was thinking about creating a resource for women in perimenopause so they wouldn’t have to go through what I did when trying to get help.

It was then that Jean broke down crying and told me about her hot flashes.

“You need to make that,” she said. “I don’t know what to do.”

I didn’t know what to do either, or what this vague idea of a resource would look like, but I knew I had to do SOMETHING–for Jean and our younger sisters and our daughters and all of our friends who must be going through this too.

mySysters really was created for sisters, and Jean remains one of its cheerleaders nearly a decade later.

Jean is a superhero for many reasons, including those hot flashes she endured. They stopped by the way. Her hot flashes stopped.

Read on to learn more about hot flashes:

• the hot,
• the sweaty,
• the options for treatment and
• possible ways to avoid them.

But first, here’s your cape, Superhero!

EVERYTHING YOU NEED TO KNOW ABOUT HOT FLASHES

Hot flashes are one of the most common symptoms of menopause.

They can be uncomfortable and disruptive, but there are ways to manage them.

In this article, we’ll discuss what hot flashes are, how they affect you during menopause, and some tips on how to manage them.

We’ll also explore the hormonal changes that occur during menopause that can cause hot flashes and night sweats.

With this information in hand, you’ll have a better understanding of how to cope with these symptoms so you can go through menopause with more ease.

Or at least less sweat.

WHAT ARE HOT FLASHES?

Hot flashes, or hot flushes, as they’re known in some parts of the world, are a common symptom of menopause and perimenopause, experienced by up to 75% of women.

Hot flashes are sudden, intense waves of body heat that can cause flushing, sweating, and a rapid heartbeat.

They can last anywhere from 30 seconds to 10 minutes or more.

Menopausal hot flashes can occur at any time of day or night and can be disruptive to everyday life.

It is important to understand the symptoms and causes of hot flashes so you can seek relief from the discomfort.

Hot flashes often cause your body to feel warm for a limited period of time, though each individual may experience them slightly differently.

You could get flushed and begin to perspire when you experience a hot flash.

You might feel chilled after the heat.

Each person’s experience with hot flashes is unique, and they can continue for a variety of times and be of varying intensity.

One person’s brief irritation may be another person’s extreme heat.

Everyone’s experience is ‘normal.’

UNDERSTANDING THE CAUSES OF HOT FLASHES

Hot flashes are caused by the hormonal changes that take place during perimenopause.

As hormones become imbalanced, they can cause the body to heat up, leading to hot flashes and night sweats.

The most frequent cause of hot flashes is a change in hormone levels prior to, during, and after menopause.

How exactly hormonal changes result in hot flashes is unknown.

However, the majority of evidence points to the hypothalamus, your body’s thermostat, as the likely source of hot flashes since it becomes more sensitive to even minute variations in body temperature when estrogen levels are low.

A hot flash is a series of actions that the hypothalamus starts when it perceives that your body is becoming too warm.

The hot flash is the chain of events meant to cool you down.

Hot flashes and night sweats are almost never brought on by anything other than menopause.

However, other potential causes include

• adverse drug reactions,
• thyroid issues,
• some cancers, and
• the side effects of cancer therapy.

LIFESTYLE CHOICES

By making simple changes to your lifestyle, you can help alleviate the discomfort caused by hot flashes.

Hot flashes can be managed in modest ways by

• layering your clothing,
• lowering the temperature in your home,
• using a fan, and
• drinking cold beverages.

Hot flashes are also more common in smokers and users of tobacco products.

The elevated cardiovascular risks of postmenopausal women are exacerbated by smoking.

Another lifestyle modification that frequently benefits menopausal women is exercise.

In addition to helping you maintain a healthy weight, it has been found that those who lead sedentary lifestyles tend to have more hot flashes.

Just keep in mind to keep an eye on the temperature when exercising.

It’s important to attempt to exercise in a cooler atmosphere because becoming overheated can cause a hot flash.

In an effort to fight the hormonal changes associated with menopause, many people try to increase the amount of plant estrogen in their diets.

The idea is that consuming plant estrogens can lessen hot flashes.

Isoflavones, a kind of plant estrogen, are hypothesized to have weak estrogenic effects that could lessen hot flashes.

Soybeans, chickpeas, and lentils are typically thought to contain the strongest plant estrogens.

But bear in mind that these foods won’t have the same potent effects as human estrogen.

You might try incorporating natural foods into your diet.

Keep in mind that only flaxseed that has been crushed or ground, as opposed to the whole seed or seed oil forms, is likely to be beneficial.

Examples of foods with isoflavones include:

• Soybeans.
• Chickpeas.
• Lentils.
• Flaxseed.
• Grains.
• Beans.
• Fruits.
• Vegetables.

Herbal remedies, supplements and CBD products

There are hundreds, if not thousands, of herbal remedies and supplements on the market claiming to relieve hot flashes and other menopause symptoms.

Generally speaking, it’s a good idea to see your healthcare professional before beginning a new drug or supplement.

When you take into account any additional prescriptions you may be taking or potential medical issues you may have, a product that initially appears safe may not be the best choice for you.

Each of these aspects will be discussed with you by your provider, who will also ensure that the product is secure for you.

Currently CBD products are illegal in most countries and several US states.

If you choose to use a CBD or cannabis product, make sure you do your research and purchase from a reputable dispensary.

Petrol stations are for purchasing fuel, chips and soda, not CBD products for perimenopause.

Opal Cool has wearable cooling therapies that draw heat away from your body and cool your core. These are safe, drug-free, and FDA-registered products helpful for hot flashes. For a Limited Time use Promo Code mysysters20 at checkout for a 20% discount.

Nighttime Hot Flashes aka Night Sweats

Your ability to sleep can also be hampered by hot flashes.

This may also be referred to as night sweats.

Sleep quality can be improved by making a few environmental and lifestyle modifications.

These modifications include:

• A cool, dark bedroom.
• Charge electronics in a different room.
• Avoid using sleep medicines.
• Exercise each day.
• Avoid drinking alcohol and caffeine at night.
• At night, take a warm bath or shower.
• Try milk items before bed or while you sleep (avoid caffeine-containing products, though).

Opal Cool has wearable cooling therapies that draw heat away from your body and cool your core. These are safe, drug-free, and FDA-registered products helpful for hot flashes. For a Limited Time use Promo Code mysysters20 at checkout for a 20% discount.

PRESCRIPTION MEDICATIONS FOR HOT FLASHES

But first, a word to our Superheroes.

Hot flashes are a common symptom of menopause and can be uncomfortable and disruptive.

While many prescription medications are available to manage hot flashes, there is often conflicting information and judgment about taking them.

Seeking healthcare for pregnancy and childbirth is seen as proactive and beneficial, while women are told menopause should be ‘natural.’

Making the choice to seek healthcare for menopause–whether it be for hot flashes, migraines, dry eyes, joint pain or some other symptom–doesn’t make menopause any less ‘natural,’ the same way that prenatal care doesn’t make pregnancy less ‘natural.’

Taking hormone therapy doesn’t delay menopause, it improves the quality of life by lessening the symptoms for those going through it.

No one can decide what your quality of life should be but you.

No one can decide what is best for you but you.

You are the Superhero of your own life.

What you decide is best for you today may change tomorrow.

Most ob/gyns and GPs are great. But If you’re not satisfied with the answers you’re getting, keep asking questions.

If you ask for a test or treatment and your request is denied, tell the healthcare provider you want the denial and the reason for the denial documented in your chart.

It shows you’re taking advocacy for your health seriously and won’t be brushed off.

At the end of this article is a list of some of the major menopause organizations.

These are nonprofit organizations dedicated to advocating for and providing information about menopause.

They are an excellent resource for information–certainly much better than the latest social media doctor guru de jour.

PLEASE check them out before following some of the absolutely BONKERS advice we’ve seen. (And we mean B-O-N-K-E-R-S!)

Now back to the Prescription Medications

From hormone replacement therapy to antidepressants, there is a wide variety of medications that can help reduce the frequency and severity of hot flashes.

If you get hot flashes, especially if they interfere with your everyday activities, speak with your healthcare professional to find out more about your treatment choices.

Taking estrogen is the safest and most efficient way to ease the discomfort of hot flashes, but doing so has risks.

The advantages may outweigh the risks if estrogen is prescribed for you and you begin taking it within ten years of your last period or before the age of 60.

While less effective than hormones, medications including antidepressants and anti-seizure medications may also help lessen hot flashes.

Talk to your doctor about the advantages and disadvantages of various treatments.

You may not want or need treatment if hot flashes don’t interfere with your life.

The hormone most frequently used to lessen hot flashes is estrogen.

The majority of hysterectomy patients can take estrogen by itself.

It’s recommended that progesterone and estrogen be taken together if you still have a uterus to guard against endometrial cancer, which is a cancer of the uterus’ lining.

The therapy must be customized to YOUR needs for any regimen.

For symptom control, guidelines advise using the lowest effective dose.

The balance between your risks determines how long you use the medicine.

Progesterone-related adverse effects can occur in some women who are receiving estrogen therapy while taking progesterone.

A combination medication called Duavee that contains bazedoxifene and conjugated estrogens is also approved to treat menopausal symptoms in women who cannot tolerate oral progesterone.

Similar to how progesterone works, using bazedoxifene along with estrogen may reduce your risk of developing endometrial cancer.

Consult your doctor about estrogen therapy if you have a history of

• breast cancer,
• endometrial cancer,
• heart disease,
• a stroke,
• or blood clots,
• or if you are at risk for any of these conditions.

NONHORMONE TREATMENTS

A low-dose form of paroxetine (Brisdelle) is the only nonhormone treatment for hot flashes approved by the U.S. Food and Drug Administration.

Other antidepressants that have been used to treat hot flashes include:

• Venlafaxine (Effexor XR)
• Paroxetine (Paxil, Pexeva)
• Citalopram (Celexa)
• Escitalopram (Lexapro)

These medications aren’t as effective as hormone therapy for severe hot flashes, but they can be helpful to women who can’t use hormones.

Possible side effects include

• nausea,
• difficulty sleeping or drowsiness,
• weight gain,
• dry mouth or
• sexual dysfunction.

Other medications that may be used for hot flashes

Gabapentin, also known as Neurontin and Gralise. The anti-seizure drug gabapentin is only marginally effective in suppressing hot flashes. Drowsiness, vertigo, edema (water retention in the limbs), and weariness are possible side effects.

Lyrica (pregabalin). Another anti-seizure drug that has the potential to lessen hot flashes is pregabalin. Dizziness, tiredness, difficulty concentrating, and weight gain are possible side effects.

(Ditropan XL, Oxytrol) is oxybutynin. The most common symptoms treated with oxybutynin, a tablet or patch, include overactive bladder. Some women may find that it relieves their hot flashes. Dry mouth, dry eyes, constipation, nausea, and dizziness are possible side effects.

Clonidine (Catapres, Kapvay, among other drugs). Hot flashes may be somewhat alleviated by clonidine, a tablet or patch generally used to treat high blood pressure. Among the side effects are dizziness, drowsiness, dry mouth and constipation.

Opal Cool has wearable cooling therapies that draw heat away from your body and cool your core. These are safe, drug-free, and FDA-registered products helpful for hot flashes. For a Limited Time use Promo Code mysysters20 at checkout for a 20% discount.

How long will I have Hot Flashes

Hot flashes typically last for 5-7 years, but some women continue to experience symptoms for at least 10-15 years.

A large US longitudinal observational study found that vasomotor symptoms persisted for a median of 7.4 years.

However, some women will have occasional hot flashes throughout their lives.

While annoying and sometimes inconvenient, these hot flashes are manageable.

At least to the person having them.

You might notice the people around you are wearing an extraordinary number of layers while you’re in a shirt and shorts and still sweating.

Opal Cool has wearable cooling therapies that draw heat away from your body and cool your core. These are safe, drug-free, and FDA-registered products helpful for hot flashes. For a Limited Time use Promo Code mysysters20 at checkout for a 20% discount.

mySysters is an app for women in perimenopause and menopause. Good Housekeeping and Woman’s Day named mySysters the Best App for Women in Perimenopause and a Must Have App for Women.

The information and other content provided in this blog, website or in any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment.

Cindy Moy Carr is the founder and CEO of Vorsdatter Ltd which created mySysters, the first app for women in perimenopause. Cindy is an attorney, journalist and author, including the ABA’s Guide to Healthcare Law.

RESOURCES: International Menopause Society https://www.imsociety.org/ Australasian Menopause Society https://www.menopause.org.au/ North American Menopause Society (NAMS) https://www.menopause.org/ British Menopause Society https://thebms.org.uk/

SOURCES: https://www.nia.nih.gov/health/hot-flashes-what-can-i-do https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause https://nwhn.org/hot-flashes/ https://www.yalemedicine.org/conditions/menopause https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20352790 https://www.who.int/news-room/fact-sheets/detail/menopause https://www.nice.org.uk/guidance/ng23