A hot flash is a sensation of heat that begins in the head and neck regions. Hot flashes are a common symptom experienced by women prior to, and during the early stages of the menopausal transition. However, not all women approaching themenopausewill develop hot flashes.
Hot flashes are typically brief, lasting from about 30 seconds to a few minutes.
The question of how long during a woman's lifetime that hot flashes last is a different one. Traditionally, it was believed that women only experienced hot flashes for a few years. More recent data suggest that many women may experience hot flashes for longer time periods. In a study from the University of Pennsylvania, the mean duration of hot flashes was 4.9 years, but up to a third of women continued to have hot flashes for up to 10 years. In the Study of Women Across the Nation (SWAN), women had hot flashes for an average of 7.4 years total and for an average of 4.5 years after thelast menstrual period.
Perimenopause describes the time period when a woman is approaching menopause. During this time is when symptoms and signs begin. Examples include, weight gain, vaginal dryness, mood changes, painful sex, and hot flashes.
The complex hormonal changes that accompany theagingprocess, in particular the declining levels of estrogen as a woman approachesmenopause, are thought to be the underlying cause of hot flashes. A disorder in thermoregulation (methods the body uses to control and regulate body temperature) is responsible for the heat sensation, but the exact way in which the changing hormone levels affect thermoregulation is not fully understood.
Hot flashes are considered to be a characteristic symptom of the menopausal transition. They also occur in men and in circumstances other than theperimenopausein women (such as young women or duringpregnancy) as a result of certain uncommon medical conditions that affect the process of thermoregulation. For example, thecarcinoid syndrome, which results from a type of endocrine tumor that secretes large amounts of the hormone serotonin can cause hot flashes. Hot flashes can also develop as a side effect of some medications and sometimes occur with severe infections orcancersthat may be associated withfeversand/ornight sweats.
The timing of the onset of hot flashes in women approaching menopause is variable.
Hot flashes are a symptom, not a medical condition. Taking a thorough medical history, the health-care professional will usually be able to determine whether a woman is having hot flashes. The patient will be asked to describe the hot flashes, including how often and when they occur, and if there are other associated symptoms. A physical examination together with the medical history can help determine the cause of the hot flashes and direct further testing if necessary.
Blood tests may be performed if the diagnosis is unclear, either to measure hormone levels or to look for signs of other conditions (such as infection) that could be responsible for the hot flashes.
There are a variety of treatments for hot flashes such as:
Some of these have not been tested by clinical studies, nor are they approved by the US Food and Drug Administration (FDA).
Traditionally, hot flashes have been treated with either oral or transdermal (such as a patch) forms of estrogen. Hormone therapy (HT) orpostmenopausalhormone therapy (PHT), formerly referred to ashormone replacement therapy(HRT), consists ofestrogensalone or a combination of estrogens andprogesterone(progestin). All available prescription estrogen medications, whether oral or transdermal, are effective in reducing the frequency of hot flashes and their severity. Research indicates that these medications decrease the frequency of hot flashes.
However, long-term studies (the NIH-sponsoredWomen's HealthInitiative, or WHI) of women receiving combined hormone therapy with both estrogen and progesterone were halted when it was discovered that these women had an increased risk forheart attack,stroke, andbreast cancerwhen compared with women who did not receive hormone therapy. Later studies of women taking estrogen therapy alone showed that estrogen was associated with an increased risk forstroke, but not for heart attack orbreast cancer. Estrogen therapy alone, however, is associated with an increased risk of developing endometrialcancer(cancerof the lining of the uterus) in postmenopausal women who have not had their uterus surgically removed.
More recently, it has been noted that the negative effects associated with hormone therapy were described in older women who were years beyond menopause, and some researchers have suggested that these negative outcomes might be lessened or prevented if hormone therapy was given to younger women (prior to or around the age of menopause) instead of women years beyond menopause.
The decision in regard to starting or continuing hormone therapy, therefore, is an individual one in which the patient and doctor must take into account the inherent risks and benefits of the treatment along with each woman's own medical history. It is currently recommended that if hormone therapy is used, it should be used at the smallest effective dose for the shortest possible time.
More Health News »There has been increasing interest in recent years in the use of so-called "bioidentical" hormone therapy for perimenopausal women. Bioidentical hormone preparations are medications that contain hormones that have the same chemical formula as those made naturally in the body. The hormones are created in a laboratory by altering compounds derived from naturally-occurring plant products. Some of these so-called bioidentical hormone preparations are U.S. FDA-approved and manufactured by drug companies, while others are made at special pharmacies called compounding pharmacies, which make the preparations on a case-by-case basis for each patient. These individual preparations are not regulated by the FDA, because compounded products are not standardized.
瑞金的激素疗法的倡导者认为that the products, applied as creams or gels, are absorbed into the body in their active form without the need for "first pass" metabolism in theliver, and that their use may avoid potentially dangerous side effects of synthetic hormones used in conventional hormone therapy. However, studies to establish the long-term safety and effectiveness of these products have not been carried out.
Some women report thatexerciseprograms or relaxation methods have helped to control hot flashes, but controlled studies have failed to show a benefit of these practices in relieving the symptoms of hot flashes. Maintaining a coolsleepenvironment and the use of cotton bedclothes can help ease some of the discomfort associated with hot flashes and associated night sweats.
Many women turn to alternative therapies, including herbal products,vitamins, plant estrogens, and other substances, for the treatment of hot flashes. Doctors can be reluctant to recommend alternative treatments because these nonprescription products are not regulated by the FDA (like prescription medications), and their ingredients and strength can vary from manufacturer to manufacturer. For products that are not regulated by the FDA, testing and proof of safety is not required for marketing of these products. Long-term, scientifically controlled studies for these products are either lacking or have not proved the safely and effectiveness of many of the so-called natural or alternative remedies.
Some alternative treatments, however, have been evaluated in well-designedclinical trials. Alternative treatments that have been scientifically studied with some research include phytoestrogens (plant estrogens, isoflavones), black cohosh, andvitamin E.
Black cohosh is an herbal preparation that is becoming more and more popular in the U.S., and the North American Menopause Society does support the short-term use of black cohosh for treating menopausal symptoms, for a period of up to six months (because of its relatively low incidence of side effects when used over the short-term).
Some studies have shown that black cohosh can reduce hot flashes, but most of the studies have not been considered to be rigorous enough in their design to firmly prove any benefit. There also have not been scientific studies done to establish the long-term benefits and safety of this product. Research is ongoing to further determine the effectiveness and safety of black cohosh.
Isoflavones are chemical compounds found insoy和其他植物(如小鸡豌豆和小扁豆)that are phytoestrogens, or plant-derived estrogens. They have a chemical structure that is similar to the estrogens naturally produced by the body, but their effectiveness as an estrogen has been determined to be much lower than true estrogens.
Some studies have shown that these compounds may help relieve hot flashes and othersymptoms of menopause. In particular, women who have hadbreast cancerand do not want to take hormone therapy (HT) with estrogen sometimes use soy products for relief of menopausal symptoms. However, some phytoestrogens can actually have anti-estrogenic properties in certain situations, and the overall risks of these preparations have not yet been determined.
There is also a perception among many women that plant estrogens are "natural" and therefore safer than hormone therapy, but this has never been proven scientifically. Further research is needed to fully characterize the safety and potential risks of phytoestrogens.
There are many othersupplementsand substances that have been used as treatments for symptoms of menopause such as hot flashes, including:
For more information, please read ourAlternative Treatments for Hot Flashesarticle.
Scientific studies to prove the safety and effectiveness of these products in relieving hot flashes have not been adequately performed.
Many women will consult their gynecologist for the management of hot flashes associated with approaching menopause. Hot flashes are also treated by primary care providers, including internists and family practitioners. Hot flashes related to uncommon conditions, serious infections, or cancers are treated by the specialists treating the underlying condition.
While the development of hot flashes cannot be prevented, the treatment methods as described in the above section may be able to reduce their incidence and severity.
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Night sweats are severe hot flashes that occur at night and result in a drenching sweat. The causes of night sweats in most people are not serious, like menopause in women, sleep apnea, medications, alcohol withdrawal, and thyroid problems. However, more serious diseases like cancer and HIV also can cause night sweats. Your doctor will treat your night sweats depending upon the cause.
You may experience other signs and symptoms that are associated with night sweats, which depend upon the cause, but may include, shaking, and chills with a fever caused by an infection like the flu or pneumonia; unexplained weight loss due to lymphoma; women in perimenopause or menopause may also have vaginal dryness, mood swings, and hot flashes during the day; and low blood sugar in people with diabetes.
Other causes of night sweats include medications like NSAIDs (aspirin, acetaminophen, ibuprofen (Motrin, Advil), and naproxen (Aleve, Naprosyn), antidepressants, sildenafil (Viagra), and abuse of prescription or illegal drugs and drug withdrawal; hormone disorders like pheochromocytoma and carcinoid syndrome; idiopathic hyperhidrosis; infections like endocarditis, AIDs, and abscesses; alcoholism and alcohol withdrawal; drug abuse, addiction, and withdrawal; and stroke.
A doctor or other health care professional can treat your night sweats after the cause has been diagnosed.
经前焦虑障碍(PMDD)是考虑ed a severe form of premenstrual syndrome (PMS). PMDD has also been referred to as late luteal phase dysphoric disorder. The cause of PMDD is unknown. Some of the common symptoms of PMDD (not an inclusive list) include mood swings, bloating, fatigue, headache, irritability, headache, breast tenderness, acne, and hot flashes.
Treatment for PMDD is with medication to treat the symptoms of PMDD.
