The menopause and hot flushes

Hot flushes are the most frequent symptoms of the menopause and the perimenopause. Hot flushes occur in a majority of women during the perimenopause, and especially in women who enter menopause prematurely or whose menopause is induced by medical treatment.

What is a hot flush?

A hot flush is a brief sensation of heat that may be accompanied by a red, flushed face and sweating. The cause of hot flushes is not known, but may be related to changes in circulation.

Hot flushes occur when the blood vessels near the skin's surface dilate to cool. This produces the red, flushed look to the face. A woman may also perspire to cool down her body. In addition, some women experience a rapid heart rate or chills.

Hot flushes accompanied with sweating can also occur at night. These are called night sweats and may interfere with sleep.

How long will I have hot flushes?

The severity and duration of hot flushes varies among women going through the menopause. Some women have hot flushes for a very short time during the menopause; other women may have hot flushes - at least to some degree - for life. Generally, hot flushes become less severe as time passes.

Can I prevent hot flushes?

While it may be impossible to completely avoid hot flushes during the menopause, there are certain triggers that may bring them on more frequently or cause them to be more severe. To help prevent hot flushes, avoid these triggers:

• Stress.
• Caffeine.
• Alcohol.
• Spicy foods.
• Tight clothing.
• Heat.
• Cigarette smoke.

Other things you can do to reduce hot flushes include:

• Stay cool. Keep your bedroom cool at night. Use fans during the day. Wear light layers of clothes with natural fibres such as cotton.
• Try deep, slow abdominal breathing (six to eight breaths per minute). Practise deep breathing for 15 minutes in the morning, 15 minutes in the evening, and at the onset of hot flushes.
• Exercise daily. Walking, swimming, dancing, and bicycling are all good choices.
• Chill your pillows; cooler pillows at night might be helpful.

Talk to your doctor about taking short-term (less than five years) hormone replacement therapy (HRT). This treatment prevents hot flushes in many women. In addition, it can help other symptoms of menopause, including vaginal dryness and mood disorders. However, HRT carries some risks, including cancer, blood clots and gallbladder inflammation. If HRT is not right for you, there are other treatments that may offer relief. These include both over-the-counter and prescription therapies. It is important check with your GP before you start any new medications (including over-the-counter).

Non-prescription treatments include:

• Vitamin B complex.
• Vitamin E.
• Ibuprofen.

Prescription treatments include:

• Clonidine, a blood pressure medication
• Oral contraceptives

Are there complementary therapies to relieve hot flushes?

Although some alternative therapies like botanical and herbal therapies have shown promise for relieving menopausal symptoms such as hot flushes, more research is needed to determine the benefits and risks of these complementary therapies.