Thursday, February 26, 2015

Cold Facts on Hot Flashes


Because of our icy weather and emergency conditions in Tennessee, I have been glued to the news, monitoring school closings and road conditions.  Headlines yesterday posted “news” that many of my patients could have shared long ago:  hot flashes last longer than the medical community had previously acknowledged!  Is this a news flash to anyone?

I am currently working with a patient who has been experiencing hot flashes for years without relief, and her experience has inspired this week’s post.  For those of you who have yet to experience a hot flash, just think of it as an internal volcano.  The eruption begins, and progresses to a full explosion of discomfort that finds little relief from an external source because it all happens inside the body.  No one in the immediate vicinity understands why the person beside them is suddenly panting for breath and pulling at clothing in a futile effort for relief.

Although we do not yet have a perfect solution, there is a scientific explanation.  Each person has a thermoneutral zone.  In simplest terms, this is the temperature tolerance range.  Go too far one way and shivering occurs.  Go too far the other way; sweating is the result.  In some postmenopausal women, this zone is greatly reduced, which means that a slight temperature variation can trigger flushing.  This slight temperature variation can also be tilted by stress because the chemicals that the body releases during stress can cause changes in the core body temperature and can be enough to initiate a hot flash.  Therefore, the postmenopausal woman can be supremely sensitive to physical and emotional changes in her surroundings that others will never feel.  Again, this is not news to my postmenopausal patients!

Having this information is useful because it helps us realize that there are environmental changes (like wearing lighter, looser clothing) that we can make to help hot flashes.  Although medications like gabapentin, clonidine and venlafaxine are being used for treatment, I would always suggest environmental changes first as any medication can have side effects.

Changes to make include stopping smoking!  We have already covered this, but it will always top the list.  Losing weight can help as the extra body fat works as insulation and can prolong the hot flash.  Wearing loose clothing and having a cool drink (water) at hand is useful.  Deep breathing and meditation exercises have been found to be helpful, so this is the time to begin yoga and to recall the Lamaze training.  Fans and air conditioning help, but initiating deep breathing at the onset of a hot flash has been shown to be the most effective at reducing symptoms.  The onset of a hot flash is like the beginning of a panic attack, so it is important to practice breathing exercises beforehand to be able to have any kind of good result.  Layered, loose clothing can help reduce the thermostat battle. 

The theme continues to be balanced diet, exercise, and stress reduction…..

Healthy for life with John Hollis Pharmacy!

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