Weight Gain

Hot flashes are often the first sign for a woman that she is transitioning to menopause. It’s the symptom we tend to know about before we reach midlife because it’s joked about and talked about more than any other symptom. 

The good news is that for many women hot flashes can be mild and you just need to make some small adjustments to deal with them, such as dressing in layers, so you can strip down and add on as the hot flashes come and go. A portable fan is a good idea. You can get a mini-fan to plug into your computer too (best invention).

At night, try light layers of bedding so you can adjust if you get hot. Keep the room temperature cooler if you can. Try sleeping in the nude (it’s supposed to be better for our health anyway: https://www.healthline.com/health/benefits-of-sleeping-naked). If you prefer not to go nude, try moisture-wicking clothing. Drink cold water before bed and keep some bedside. 

Unfortunately, the earlier in life hot flashes begin, the longer you may have them. If you’re overweight, you may experience longer and more severe hot flashes, so getting in shape and staying in shape can help with managing this symptom (and there are all the other health benefits to a healthy weight too). Research shows that African American and Hispanic women experience hot flashes for more years than white and Asian women. 

There are some common things that trigger hot flashes, so it helps to keep track of when you have them and what might have instigated it. Try to avoid alcohol, spicy foods and caffeine (if you can). If you smoke, try to quit. Smoking can make hot flashes worse (and it’s bad for your health overall). 

Other things you can do to cope with hot flashes and night sweats include mindfulness meditation, yoga, tai chi, and any other relaxation techniques (here are some examples: https://www.health.harvard.edu/mind-and-mood/six-relaxation-techniques-to-reduce-stress.)

If lifestyle changes don’t help you to cope with the onset of hot flashes or night sweats or if your experience with them is severe and disrupting your quality of life, talk with your healthcare provider about other options. There are options for treating these symptoms, so don’t be afraid to ask about them!

The U.S. Food and Drug Administration (FDA) has approved the use of paroxetine, a low-dose selective serotonin reuptake inhibitor (SSRI) antidepressant, to treat hot flashes. Women who use an antidepressant to help manage hot flashes generally take a lower dose than people who use the medication to treat depression. There are side effects from antidepressants, so as with all medication, talk with your healthcare provider about the risks and whether the benefits outweigh them. 

Another option for treating hot flashes and night sweats is hormone therapy. Hormone Replacement Therapy (HRT) has received a lot of negative press and many women are wary of it.  As with all medical treatment, there are risks to HRT, but those risks need to be weighed against the benefit of improvement to your health and well-being. This is an important discussion to have with your healthcare provider. 

The loss of estrogen and progesterone during the menopausal transition is different in every woman. Hormone therapy steadies the levels of these estrogen and progesterone in the body. It can be a very effective treatment for many women. The risks associated with hormone therapy depend on your age and other health conditions you may have. Some risks associated with taking hormones include increased risk of heart attack, stroke, blood clots, breast cancer, gallbladder disease, and demensia. You can find out more information about the risks and benefits of hormone therapy here: https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy/risks–benefits

Hormone treatments can take the form of pills, patches, rings, implants, gels, or creams. You can find out more about the types of hormone therapy here: http://menopause.org/for-women/expert-answers-to-frequently-asked-questions-about-menopause/hormone-therapy-menopause-faqs.

Hormones can also be effective in reducing vaginal dryness and bone loss – other common symptoms of menopause. 

Back in 2002, a study that was part of the Women’s Health Initiative (WHI), funded by the National Institutes of Health, was stopped early because participants who received a certain kind of estrogen with progesterone were found to have a significantly higher risk of stroke, heart attacks, breast cancer, dementia, urinary incontinence, and gallbladder disease.

A lot of research has been done since then and found that younger women may be at less risk and have more potential benefits than what was shown in the WHI study. The scary outcomes of the WHI hormone treatments mostly affected women who were over age 60 and post-menopausal. Newer treatments may reduce the risks associated with hormone therapy, but additional research is needed to determine long-term safety of these newer treatments.

A new study released in the journal The Lancet has found an even stronger connection between Menopausal Hormone Therapy (MHT) and breast cancer. The research showed that the risk increased steadily the longer women were on MHT. The cancer risk in women who used Hormone Replacement Therapy or MHT compared to women who didn’t was increased from 6.3% to 8.3%. That’s an increase of about one extra cancer case in every 50 users of the therapy, according to the research.  Women need to know there is a small increase in risk if they take hormone replacement therapy and talk with their healthcare provider about whether the benefits of treatment outweigh the risk given their personal medical history.

Many women swear by other treatments for hot flashes including black cohosh and soy isoflavones. You must consider the risks and side effects associated with these products too, so talk with your healthcare provider before taking anything to treat your hot flash symptoms. Most have not been scientifically proven as treatments and need a lot more research to determine the long-term effects. You can find out more about herb or supplements here: https://www.nia.nih.gov/health/dietary-supplements.

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