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Are you flashing?

23 February 2009 1,529 views No Comment

The ‘hot flash’ (HF), also called a hot flush, is a very common complaint of women in mid life.

It is experienced by up to 75 per cent of pre-menopausal and menopausal women in developed Western societies.

For some women, the problem is minor, but for others, HF is an extremely unpleasant and embarrassing sensation that can disturb sleep and interfere with daily life.

By contrast, the problem is rare in many primitive societies where there is not even a word for the condition in some of their languages.

Although HF is mostly a female problem, men are also affected if the levels of the male sex hormone testosterone drop suddenly. Some 75 per cent of men with prostate cancer who have their testes removed by surgery (orchiectomy) or who take medication to decrease testosterone levels experience HF.



The exact physiologic cause for HF is uncertain, but it is probably triggered by increased heat (or blood flow) to the heat regulatory area of the brain. The brain, sensing this heat, releases chemicals that cause blood vessels in the skin to dilate in an effort to release heat.

It seems that the sex hormones oestrogen and testosterone normally allow the body to better tolerate changes in body temperature. When the levels of these hormones fall, anything increasing body heat or blood flow to the brain may cause a HF. The menopause and the andropause (male menopause), with their accompanying hormonal changes, are the commonest cause of HF in both men and women.


Foods and beverages, physically hot or containing spices like hot pepper, can cause a HF. In this case, the heat directly stimulates and dilates the brain blood vessels. Alcohol, excess caffeine, other food additives or just eating a very large meal can cause HF. We still do not know all the different foods and food additives that can trigger this reaction. Cooling foods like fresh fruit and vegetables, on the other hand, will help prevent them.


Anti-oestrogen drugs (for example, Tamoxifen) often prescribed for breast cancer and anti-androgen drugs (for example, Andracur) commonlyused to treat prostate cancer may cause HF. Many other prescription drugs, such as high-blood pressure medicines, antidepressants or anti-anxiety medications can also cause HF. In fact, all prescription and over-the-counter drugs should be checked to see if the HF is a known side effect.

The B vitamin, niacin, may also produce flushing and heat in some people.


A very common cause of HF is a stress reaction that causes the release of adrenaline into the blood stream. This, in turn, causes increased blood flow and thus increased heat. A hot flash may then ensue. The stressful trigger can even occur subconsciously, during deep sleep, probably while dreaming. This may explain the common occurrence of the HF at night.


Another common cause of a HF is simply that the body is too warm. In general, the warmer your surroundings, the greater the likelihood of you developing a HF. Research shows that menopausal women can reduce by almost 50 per cent, the number of night sweats by lowering the temperature in the bedroom by a few degrees.


First of all, if HFs are mild or occur less than once per day, you might ignore specific treatment and focus on prevention strategies. There are also a number of other medical conditions that may produce HF, so get an initial evaluation from your health-care provider.


Try to avoid your individual triggers, that is, strong emotions, stressful circumstances, excess caffeine, alcohol, cigarette smoking, hot food and drink or hot environments. Drink enough water, usually eight or more glasses per day. Wear cool clothing made of natural materials. Exercise daily – walk, swim, dance or bicycle for 30 or more minutes, preferably in the morning.

Manage stress. Practise relaxation techniques like deep, slow abdominal breathing for 15 minutes in the morning and evening. This can reduce the number of HFs by as much as 50 per cent.


In my opinion, hormone-replacement therapy (HRT) can be safely and effectively used to relieve HF if two important principles are employed. First, a hormonal profile should be done with a blood or saliva test. This will tell which hormone is needed and help in determining the right dosage. Second, only bio-identical hormones should be used. Progesterone, oestrogen or testosterone may be then prescribed, preferably as a skin cream.


Soy-based foods, omega 3 fats, evening primrose oil, magnesium and vitamin E are helpful supplements.


1 Tang Kuei/Dong Quai Root – This well-known herb has been used for thousands of years in Chinese medicine and has long been considered the women’s ginseng. Traditionally used for hot flashes and other menopausal problems, it is also useful for menstrual disorders through its antispasmodic action. I use Dong Quai combined with the relaxing herb chamomile for these problems. This blend is available in a single tablet.


2 Black Cohosh Root – Black Cohosh is a phytoestrogen (plant oestrogen) and is effective in 80 per cent of cases in relieving the symptoms of menopause when used consistently. Some authorities claim that it improves symptoms like HF, vaginal dryness and headaches as effectively as oestrogen-replacement therapy.

3 Chaste Tree Berry/Vitex – This does not contain hormones, but it acts on the pituitary gland, which stimulates the increased production of oestrogen and progesterone. Vitex increases these hormone levels to help regulate the menstrual cycle and reduce menopausal symptoms.

You may email Dr Vendryes at vendryes@mac.com, visit him at www.anounceofprevention.org or listen to An Ounce of Prevention on POWER 106 FM on Fridays at 8 p.m.

Typically, a hot flash is a sudden, warm sensation, often accompanied by a breakout of sweating usually confined to the upper half of the body – chest, neck, face and head. This may develop into an intense feeling of heat with the face, head and neck becoming flushed.

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