Understand the impact of hot flushes and night sweats in menopause. Explore their cause, who's at risk, implications, and strategies for managing them for a healthier lifestyle.

Key takeaways

• Hot flushes and night sweats are one of the most common menopause symptoms that can significantly impact a woman's quality of life.
• These vasomotor symptoms of menopause can be influenced by hormonal changes, body temperature control, and genetics. Lifestyle choices, particularly smoking, have been strongly linked to the occurrence of hot flushes.
• Research shows that certain ethnicities, obesity, stress, lifestyle factors and mood changes can increase a woman’s risk of vasomotor symptoms.
• There are several options for managing vasomotor symptoms, including holistic practices, hormone replacement therapy (HRT), and lifestyle modifications.

Each year in Australia, millions of women journey through menopause, a natural stage of life that typically lasts between four to eight years. This period represents an end to a woman's reproductive years, characterised by various physical and emotional changes.

Among the multitude of menopause symptoms, hot flushes and night sweats reign as the most common, affecting up to 80% of women. These uncomfortable episodes can have a significant impact on a woman's quality of life, thus making the need for health and effective management strategies so important.

What are hot flushes and night sweats?

Hot flushes and night sweats are often referred to collectively as the vasomotor symptoms of menopause. Research shows these symptoms can have a significant impact on quality of life.

Hot flushes (or 'hot flashes' in other regions) are intense periods of heat and sweating experienced by women during menopause.

How long do hot flushes last? These episodes may last anywhere from a few minutes to a significant portion of an hour, adding to the discomfort. The unpredictability of hot flushes can cause embarrassment and social anxiety for many women, impacting their emotional wellbeing.

Menopause night sweats involve excessive sweating during sleep, often to the extent that it soaks your clothes and bedding. This can lead to disrupted sleep and discomfort. This lack of quality sleep can result in daytime fatigue, difficulty concentrating, mood swings, and decreased overall quality of life. Long-term sleep disruption may also contribute to anxiety and depression.

Research has found that frequent and persistent vasomotor symptoms may be associated with increased risk of cardiovascular disease later on.

What do hot flushes feel like?

A hot flush usually presents as an overwhelming wave of heat, often starting in the face and neck before spreading to the rest of the body. This sensation can be accompanied by red, patchy skin, increased heart rate, and in some cases, heart palpitations.

This heat can lead to a flushed appearance, and can cause heavy sweating and a rapid heartbeat. The heat may be followed by chills as the body cools down. Some women also report experiencing a prickly or tingling sensation during a hot flush.

What causes vasomotor symptoms in menopause?

Vasomotor symptoms in menopause are caused by factors including hormonal changes, stress, alcohol, temperature control and genetics.

Hormone changes

Research shows that women with higher levels of a hormone called follicle-stimulating hormone (FSH) and lower levels of a hormone called oestradiol were more likely to have vasomotor symptoms. However, some women with these hormonal changes do not experience hot flushes and night sweats, suggesting other factors are also at play.

Body temperature control

Our bodies try to maintain a consistent core temperature. During menopause, this temperature range can narrow, meaning even small changes can trigger the body's cooling system, causing sweating and a flushed feeling. More research is needed to confirm this.

Genetics

Finally, your genes may also play a part in whether you experience vasomotor symptoms. Studies have found that certain variations in genes related to hormone activity could increase the likelihood of experiencing hot flushes and night sweats during menopause.

Stress

Psychological distress around the time of menopause, or having poor attitudes towards menopause, is associated with poorer outcomes like hot flushes. Having a more positive attitude seems to be associated with less vasomotor symptoms. Low social support, poor coping skills, depression and anxiety were all associated with worse menopausal symptoms.

Physiological stress can occur for a range of different reasons, from oxidative stress caused by poor nutrition, to excessive exercise, poor sleep, mental health, work stress, relationship stress and more. Stress in whatever form, results in the same physiological outcome. Looking at stress in all its forms may be important for those suffering from problematic hot flushes.

Who is most at risk?

Vasomotor symptoms are more common in some people than others. More research is needed in this area.

Ethnicity

Different ethnic groups experience vasomotor symptoms differently. African American and Central American women, for example, often report more hot flushes. In contrast, Chinese and Japanese women report the fewest hot flushes, especially Japanese women. These differences aren't fully understood yet, but they may relate to variations in body weight, hormone levels, smoking habits, use of hormone supplements, and social factors.

Obesity

Research shows that being overweight can increase the likelihood of hot flushes. This might be because body fat can trap heat, causing hot flushes to occur more often or more severely. The specific mechanisms are still unclear, and this effect seems more pronounced for women who are in the early stages of menopause.

Lifestyle factors

Smoking is the lifestyle choice most strongly linked to hot flushes. Smokers are 60% more likely to experience these symptoms. Other lifestyle factors, like poor diet, nutrient deficiencies, poor sleep and exercise, also impact hot flush severity and frequency.

Mood

Mood changes such anxiety, depression, and stress can make hot flushes more likely and more bothersome. This relationship is bi-directional, as hot flushes can also impact mood.

Managing menopausal vasomotor symptoms

Managing these symptoms involves a combination of lifestyle changes, holistic practices and medical treatments like hormone replacement therapy (HRT). These strategies are not one-size-fits-all, and what works for one person may not work for another. Please speak to your health care provider to get a tailored management plan to suit you.

Lifestyle changes

Many women wonder how to stop hot flushes without HRT or medical interventions. The good news is, there is research supporting the positive effect of lifestyle changes and certain herbal formulas can have on hot flushes and night sweats.

Every culture across the planet has evidence of use of herbs around this transitional time. The most evidence-based herbs used for this period in a woman's life include black cohosh, dong quai, evening primrose, hops, Korean ginseng, linseed (flaxseed), red clover, St John's wort and wild yam. Some herbs have more specific indications, for example tribulus, maca and horny goat’s weed. Herbs such as passionflower, melissa balm and lavender have been used commonly for poor sleep, mild anxiety and irritability.

Maintaining a healthy weight, quitting smoking, optimizing your diet, reducing alcohol and incorporating regular physical activity into your daily routine can all help reduce the frequency and severity of vasomotor symptoms. It's also worth noting that certain triggers can lead to hot flushes, such as stress, hot weather, spicy food, alcohol, caffeine, sugar and tight clothing. Identifying and avoiding these triggers can help manage symptoms.

A balanced diet rich in fruits, vegetables, lean proteins, healthy fats and whole grains can help maintain a healthy weight and potentially reduce hot flushes. Some evidence suggests that foods containing phytoestrogens, like soy and flaxseeds, can help symptoms.

One randomised controlled trial found that women who adopted a low-fat, vegan diet with daily cooked soybeans may be effective in reducing hot flushes and other symptoms in postmenopausal women, but more research is needed to be identify whether this would be right for everyone.

Relaxation techniques

Practices like cognitive behavioural therapy (CBT), yoga, tai chi, meditation, and deep breathing exercises can help manage stress levels, which can in turn reduce hot flushes. Time in nature is also important  for regulating circadian rhythms and helping with relaxation.

Medical treatments

HRT is an effective treatment for hot flushes for many women and research is showing that it may have some long term benefits as well.  Other treatments like non-hormonal prescription medications, over-the-counter remedies, and phytoestrogens may also be a great option to try. It is always a good idea to chat with your healthcare provider to optimise your treatment program.

As part of managing menopause and its symptoms, women should also consider a comprehensive approach to overall metabolic health. Vively offers personalised lifestyle advice based on real-time glucose data, assisting women in maintaining a balanced metabolic health during menopause. By offering insights into how different foods and lifestyle choices affect glucose levels, Vively can be a valuable tool for managing symptoms and improving overall health during this significant phase of life.

With the right information and tools, navigating this phase can be less daunting, and treating menopause symptoms can become easier. Remember, every woman's experience is unique, and what works for one might not work for another.