Aging & Menopause

Midlife Changes: Keeping Your Cool

As we look forward to our next TeamWomen event in September focused on midlife changes and what’s to come, we turned to our own Dr. Deb Krahl for some insightful advice on “keeping your cool” when hot flashes start during menopause and perimenopause. Read on for some great information and tips.

 If you are a woman in your mid-40s to 50s, you have likely experienced various symptoms of menopause. One of the most common, hot flashes, occur with up to 80 percent of all menopausal women in the United States and can be a particular nuisance—ranging from “warm flushes” to random sweating throughout the day to waking up nightly drenched in sweat. The good news is that you no longer need to suffer as your OB/GYN has more options than ever to help keep your cool. But first it can be helpful to know why hot flashes occur.

What are the risk factors?

Risk factors for moderate to severe hot flashes include obesity, smoking and reduced physical activity. In addition, ethnicity can play a role: African-American women have more hot flashes than Caucasian women and Asian women report the least number of hot flashes.

Why do they occur?

Loss of estrogen during menopause disrupts the temperature regulation center in the brain and the feelings of warmth result from peripheral blood vessels dilating and increased blood flow. This causes a release of body heat that turns into a hot flash, which can last from about 30 seconds to several minutes long.  The average duration of hot flashes is just under five years, with some women experiencing them up to 10 years past their last period.

Tips to manage hot flashes

To keep your cool during menopause and perimenopause, Dr. Krahl says that it is best to modify certain behaviors before considering other alternatives such as hormone replacement. Behavior or lifestyle changes could include everything from losing weight through diet and exercise to quitting smoking.  She said there are also ways to keep your core body temperature cool by using fans or layering clothes to keep cool. And of course, women will want to avoid triggers such as spicy food, alcohol or stressful situations, if they notice that these trigger more hot flashes.

Sometimes that’s easier said than done and other treatment methods are necessary. For instance, Dr. Krahl says plant-based therapy can be helpful for women experiencing milder hot flashes – soy-based products with estrogenic properties as well as black cohosh, an herb that is helpful for some patients. She adds that for women with moderate to severe hot flashes, patients really need to see their OB/GYN doctor to discuss other alternative options involving hormonal and non-hormonal medications.

While traditional hormone replacement therapy, in the form of estrogen and progesterone, may be considered as a last resort, it can be life-changing for many women who don’t find relief through other methods.  This treatment is available in pills or patches and most doctors recommend the lowest dose for the shortest amount of time.

Fortunately, women in longer have to suffer in silence.  The best advice is to discuss options with your doctor if you are having hot flashes, vaginal dryness, irritability or painful intercourse since there are many recommendations we can share to reduce discomfort and improve your lives.



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