Hot Flash News Flash

You’ll know it when you feel it. But in case you haven’t had one and are wondering what you can expect, here’s how women describe what a hot flash feels like:

"Suddenly boom your face is flushing. Mine always seems to start at my neck and go up for some reason. Remember that Disney film where the character's head just burst into flames? Like that."

"Like when you've had a high fever and it breaks. Sweat runs down your back and you hate the world."

"I thought it would be welcome in my case because I’m freezing all the time. But no, I’m still freezing with two-minute intervals of burning up. I’d say it starts at the back of my neck and works its way around."

"Feels like sticking your face in the oven. Instant flush from neck up."

"It feels like you are burning from the inside out. It usually starts in my feet and then my hands and then the heat spreads to the rest of my body. It lasts for a few minutes and subsides."

What’s actually happening is not fully understood, but some likely causes are changes in reproductive hormones or to the hypothalamus. Fun fact: not every woman gets them, but some women endure them for years.

"It’s not a hot flash, it’s really a hot flush. A woman is fine and then suddenly there’s a sensation of heat," says Dr. L. Wayne Houk, an OB-GYN at INTEGRIS.  "What’s the cause? We don’t know."

He says that while we may not know the precise cause, we do know that if a woman is going to suffer from hot flashes, it’s likely going to be during perimenopause or menopause. “When is a woman in menopause? When she’s gone a year with no period,” Dr. Houk says. This leads scientists to believe that hot flashes and estrogen are linked.

Some factions say it’s the decrease in estrogen that sets a woman’s face on fire; others say it’s the extreme fluctuations that happen to a woman during perimenopause and menopause. Either way, says Dr. Houk, hot flashes tend to visit their victims in three-month cycles.

"Some research says that pre-menopausal women do experience estrogen fluctuations day-to-day, hour-by-hour, but they are smooth. Over the course of a month, they do experience fluctuations, but the change isn’t dramatic on an hourly basis. But by her late 40s, a woman’s hour-to-hour fluctuations can be very dramatic, which might trigger flashes. They can be bad for three months or so and then they’ll improve for a few months."

Mostly, hot flashes are a just nuisance, along with their sweaty cousin, night sweats. They aren’t a precursor to something worse, they won’t destroy your health (but they will give your antiperspirant a run for its money), and eventually they’ll go away on their own. This may be after a few months, or after several years. They may stop for a few months, or longer, and suddenly pop back into your life.

How to rid yourself of hot flashes (or at least make them less of a hassle)

It’s actually not as hard as you might think. "There are a lot of  'cures' that have no science behind them at all, which I would politely call hogwash," Houk says. But there are also a few treatments that do offer actual, scientifically-proven relief for many women.

"Hot flashes are just one symptom of menopause. Grumpiness, sleep interruption, fatigue, night sweats, anxiety and moodiness are other symptoms that come with menopause. You can either live with it, or if it’s enough of a nuisance, talk with your gynecologist and do something about it," Houk says.

Hormone replacement therapy is one effective treatment, although it’s often misunderstood.  Low-dose birth control pills, estrogen supplements and a combination of estrogen and progesterone are three regimens most often suggested.

"Let’s say I have a patient come in, she’s about 45 years old, she doesn’t smoke and she’s having hot flashes. If I prescribe her a low-dose birth control, her risks are negligible and it will often help lessen her hot flashes," says Dr. Houk.

A slightly older woman, say early 50s, might come in with similar symptoms, but Houk would treat this woman slightly differently. "Adding estrogen helps with hot flashes. We know this. For the woman who no longer has a uterus, we can give her estrogen alone, and she’ll often see relief pretty quickly," he says.

However, women with an intact uterus will receive a combination regimen of estrogen and progesterone, because with an estrogen-only regimen, there is an increased risk of uterine cancer. And, Dr. Houk continues, "Progesterone alone won’t do any good for anyone. It helps nothing." Dr. Houk also says to be wary of blood tests for progesterone levels, because a woman’s progesterone level is supposed to be low for most of the month.

Antidepressants can also be taken to cool your flashes. Fluoxetine (sold under the name Prozac), venlafaxine (Effexor XR, Pristiq) and paroxetine (Paxil, Pexeva) are often prescribed, and Houk says there is research to back their effectiveness.

For night sweats, some women find temporary relief with a cooling pillow. INTEGRIS Medical Supply recommends and sells the Contour Cool Gel Memory Foam ventilated pillow. For more information visit the website or call 405-945-4411.

Things that will not work to get rid of hot flashes (or even make them less of a hassle)

Herbal or over-the-counter remedies, Houk says, are ineffective. Women often mistake the natural ebbing and increasing of hot flashes for a 'cure' after taking herbal or over-the-counter remedies. "They do nothing," he says. "And some of the so-called herbal supplements that say they are calming are actually made in China, and it turns out the reason they are calming is because they are laced with small amounts of valium," says Dr. Houk. Since regulations in some overseas countries are not stringent, all bets are off on knowing exactly what you are getting.

(If you do insist on trying an herbal supplement like black cohosh against Dr. Houk's advice, please read this advisory statement from Dr. Andrew Weil, who is a world-renowned pioneer in the field of Integrative Medicine and director of the Arizona Center for Integrative Medicine).  

The bottom line? If you are experiencing power surges, aka hot flashes, and you need help managing them, call your doctor. It’s not rocket science, but it is science.