Hot flashes and night sweats, known as vasomotor symptoms (VMS) of menopause, affect up to 80% of women over 40. These symptoms are linked to declining estrogen levels, which narrow the body's thermoregulatory zone, making temperature fluctuations more disruptive. VMS can last for years, impacting mood, sleep, focus, and relationships.
Understanding Hot Flashes
During perimenopause and menopause, a decrease in estrogen affects the brain's temperature regulation center. This leads to sudden waves of heat, sweating, and sometimes heart palpitations. Symptoms can range from mild warmth to intensely disruptive experiences, often followed by chills and anxiety.
Treatment Options
Hormonal Therapy (HT) is considered the gold standard for VMS. It involves replacing estrogen and, for women with a uterus, progestin. Estrogen therapy alone is for those without a uterus, while combination therapy protects the uterine lining. Transdermal methods like patches and gels are safest, minimizing stroke risk associated with oral pills. HT also offers benefits for bone health, cardiovascular health, and mood regulation.
However, HT carries risks and is not suitable for everyone, particularly those with a history of certain cancers, blood clots, stroke, or cardiovascular disease.
Nonhormonal Medications are available for moderate to severe hot flashes. FDA-approved options like Elinzanetant (Lynkuet) and Fezolinetant (Veozah) work by targeting specific receptors in the brain's temperature control center. These medications can reduce hot flash frequency and severity and improve sleep. Regular liver enzyme monitoring is required for these treatments.
Consult Your Healthcare Provider
It is crucial to discuss persistent hot flashes with a healthcare provider. Preparing for your appointment by tracking symptoms and writing down questions can facilitate an informed decision on the best treatment plan. If your concerns are dismissed, seeking a menopause-certified professional is advised.