Hot flushes

Hot Flushes are the most common symptoms experienced by women as a result of menopause. A Hot Flush is a sudden sensation of intense heat, which is usually accompanied by perspiration and reddening of the skin.

Approximately one third of a woman's life will be lived after menopause. The identification and proper management of menopausal symptoms are crucial to maintaining a woman's quality of life. Flushing and sweating episodes and symptoms of reduced vaginal tone are the most common complaints from women during the menopause. The exact cause of Hot Flushes remains unclear, however, it is thought to be associated with the hormonal changes that occur during menopause e.g., a drop in oestrogen levels.

Hot Flushes occur when there is a reduction in central body temperature causing an increase in heart rate and extra blood being sent to the surface of the body. This blood contains heat, which is then lost through the skin in an attempt to bring the rest of the body's temperature down to the same level as the core body temperature. The extra blood sent to the skin causes the sensation of heat, flushing, perspiration and redness of the skin.

SIGNS AND SYMPTOMS
The most typical description of a hot flush is - a sudden onset of warmth in the chest, spreading upward to involve the neck and face. Hot flushes can last from a few seconds to several minutes, however, the severity of the sensations vary greatly both from time to time in the same woman and from woman to woman. Hot Flushes can occur with dizziness, nausea, headaches, palpitations, profuse sweating and night sweats. How often a woman experiences Hot Flushes also varies, ranging from many times a day to once a week or less. In some women Hot Flushes are provoked by factors such as; hot weather, stress, eating, drinking alcohol etc.

DURATION
Hot Flushes are reported to occur in 17% of healthy women over 42 years of age who are still having regular menstrual cycles. This increases to 40% of women who are in this age group and have irregular menstrual cycles. The majority of women (65%) who have entered menopause for between 1 to 2 years experience Hot Flushes. Approximately half of these women will continue to experience Hot Flushes for between 5 to 10 years after menopause. What is happening to the body during a hot flush is clear, however, why some women flush after menopause and others do not is still not understood.

TREATMENT OPTIONS
As with all conditions your Doctor should be consulted. Your Doctor will diagnose and treat the condition. Ask your Doctor about the latest advice regarding Hot Flushes. Hormone Replacement Therapy (HRT) has been proven to help reduce the frequency and severity of Hot Flushes. The benefits and risk factors involved with HRT should be discussed with your Doctor before the commencement of treatment. Some women choose alternative management including relaxation techniques, nutritional supplementation and lifestyle changes.

The findings from a recent clinical trial indicate that being overweight (having a Body Mass Index above 25), high alcohol intake, smoking, and high dietary fat intake, may increase the risk of having hot flushes and the severity of the flushing. This particularly applies to peri-menopausal women i.e. those women in the very early stages of menopause.

DIET HINTS
• It is a good idea to have a varied and wholesome diet concentrating on all the fresh vegetables, especially the dark green leafy ones. A diet high in fresh fruits and vegetables helps to supply your body with the nutrients needed for good health.
• Cook vegetables only lightly (steam), to preserve the nutrient content.
• Dairy products are very important during menopause as these supply good quantities of the mineral calcium, which is essential for healthy bones. Include low-fat milk, cheese and yoghurt in the diet.
• A recent study has found that foods, which are oestrogenic (the hormone which usually decreases with the onset of menopause) e.g., soy products such as lecithin, soymilk, soybeans, tofu etc., may have a relieving effect on the symptoms of Menopause. Consuming between 45 and 80gms of soy products per may help to reduce the severity of hot flushes
• Always have plenty of raw seeds and nuts available for a snack. Pumpkin and sesame seeds are a source of L-tryptophan (an essential amino acid), which plays a role in mood control, and can be eaten freely.
• Caffeine is thought to block the absorption of calcium and other minerals. Instead of normal tea or coffee, drink chamomile herbal tea. It has no caffeine and has a natural soothing action. Sage tea may also be beneficial in reducing the severity of Hot Flushes.

VITAMINS/MINERALS/HERBS
Nutritional supplements may be of use if dietary intake is inadequate.
• Vitamin E may relieve some menopausal symptoms
• Black Cohosh (Cimicifuga racemosa) may be an effective herb for menopausal symptoms, particularly in relieving hot flushes and vaginal dryness.
• Tribulus and withania are androgen-promoting herbs, which may help to support adrenal gland function and promote ovarian androgen synthesis. Tribulus may provide symptomatic relief for hot flushes, night sweats, depression and insomnia.
• Magnesium may assist with improving and maintaining bone integrity. Research demonstrates that supplemental magnesium can increase bone density in many women and prevent bone loss in others.
• Phyto-oestrogenic herbs may be useful for improving menopausal complications. See the topic on Phyto-oestrogens.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Follow the Diet Hints.
2. Your Pharmacist can answer any queries you may have regarding your prescribed medication.
3. It is a good idea to avoid possible triggers for Hot Flushes such as; stress, smoking, alcohol and very hot weather. These factors may provoke Hot Flushes in some women and not in others.
4. Phyto-oestrogens may also be suggested. Phyto-oestrogens are substances found in plants and foods, which act like oestrogen in the body by stimulating oestrogen receptors on the cell walls in the skin, breast, uterus and vagina. Studies suggest that phyto-oestrogens may help to reduce some of the symptoms of menopause such as vaginal changes, Hot Flushes etc. Fermented soybeans, known as tempeh, provide a source of phyto-oestrogens, which is easily absorbed by the body. Your Pharmacy stocks a powdered nutritional supplement containing phyto-oestrogens.
5. If the diet is inadequate consider some nutritional supplements. A multi-B may help to maintain the health of the nervous system and minerals such as calcium and magnesium are also needed for nervous system support and bone strength. Herbs available from your Pharmacy which are specifically indicated to help relieve the severity of Hot Flushes include; Dong quai, Chaste tree (vitex) and Wild yam.