Menopause. Hot Flashes. Uncomfortable, disturbing, nauseating, fuzzy brain, disturbed sleep....hot flashes are listed as one of the most negative aspects of our peri to post menopausal years. We begin to feel like Goldilocks, desperately seeking a "not too hot, not too cold, just right" kind of world.
75% of women have hot flashes during their menopausal transition. Moderate to severe hot flashes typically last 7 to 10 years on average and less frequent or severe (either end of the spectrum) can last even longer. Let's talk about how you can influence the frequency and intensity of hot flashes, sleep and feel better!
We enjoy a breadth of temperatures in our lives before surgical (full hysterectomy), chemical (induced by medication) or natural menopause....we can be too warm or too cold and simply put on or remove a layer of clothing and stay comfortable. This is due to our clever hypothalamus, the part of our brain noticing and controlling thermoregulation. When it sense that we're becoming too warm or cold, it send signals to our organs, muscles and hormonal systems. They collectively respond to bring our internal core temperature back to normal. With menopause, the range of acceptable fore body temperature is drastically narrowed. We become more sensitive to external temperatures so much that we experience a sense of panicking with crisis messages zipping around, causing blood vessel dilation, sweating, wakefulness, peeling off of clothing/blankets....the list is long!
Why now? There are a number of theories including declining estrogen theory, elevated noradrenergic activation (stress) theory, east vs. west (consumption of phytoestrogens) theory, stress-coping theory, perception of menopause theory and thyroid dysfunction masquerading as menopause symptom theory. Estrogen does 400 jobs in our premenopausal body each and every day. We have declining estrogen with menopause, reducing support to our hypothalamus, making our threshold to heating much more sensitive. Simply adding estrogen sounds logical, but isn't an answer for women who are sensitive to estrogen (a history of estrogen related cancers), nor for those who are estrogen dominant (actually have low progesterone in relation to their estrogen). This is a condition that is more common in recent decades due to chronically high stress hormones that creates chronically low progesterone in relation to our declining estrogen. It's all in the balance.
We need stress hormones in our lives in order to wake up each morning, but again, not too much stress. With our reducing estrogen, we handle stress less well after menopause due to altering of our neurotransmitter activity. Rather than thinking that we've become wimpy, we now know that our stress response is more sensitive through menopause due to physiological changes! Those of us who dread menopause or fear aging, those who are stressed by daily life (financially, physically, relationally, emotionally), those who have suffered trauma and those who smoke and/or are obese are likely to experience more frequent, intense and long lasting hot flashes.
Triggers for hot flashes include caffeine, dehydration, alcohol, smoking, sugar, hot foods (spicy and temperature), stressful situations, stressful thoughts, sleeping in a hot/unventilated room, wearing too many clothes/blankets, focusing on/worrying about hot flashes/aging and not prioritizing restoration time (like quietude, meditation, prayer or nature walks). Hmmmm......notice any patterns for you?
Begin by keeping a hot flash diary for a week. When do they come? How severe are they? How long do they last? Which of the triggers can you align with your hot flashes? Each woman is unique and it's up to you to sort yourself out. Be your own personal sleuth.
Some general guidelines are: Address one personal trigger per week from your list, beginning with your toughest personal challenge. Stop and congratulate yourself, knowing that the balance of the list will be easier. Learn and practice calm breathing by doing the following: breathe in for a count of four and out for a count of four. Keep going for 5 minutes, building up to 10 minutes, repeating 2 - 4x/day. Lose 5 pounds; repeat if needed. Begin a gratitude journal, noting 3 items each day that you're grateful for. Controlling your controllables is your first step! You'll sleep better, fell better and enjoy life more.