Why Do Women Have Hot Flashes in Menopause

Do women have hot flashes when estrogen fluctuates? It’s a perplexing question, and yet about 80% of individuals will have HF as they transition through menopause, are post partum, or are even men post prostate cancer therapy. P

Poor temperature regulation, and obesity make for less tolerance to hot flashes menopausal transition.

Exactly what the cause of hot flashes are, we aren’t really sure yet. But they aren’t necessarily good in our modern society as they have been linked with stroke, cardiovascular disease, dementia and even earlier death!

Hot flashes disturb sleep and can even cause sleep apnea so it’s possible the tolerance of HF is due to lack of restorative sleep.

White spots that appear in the brains of aging women are more common with diseases like diabetes and hypertension, but also occur more frequently in menopause. It’s these spots that can lead to more thought disruption in older women. 

Menopausal hot flashes are worse in obese patients as they transition through menopause, but farther into menopause some research says obesity can be protective against the hot flashes.

So why do we get them, and do they afford any physiological benefits? The numbers of serious medical consequences: more cognitive impairment, more heart disease, less sleep, more depression, and other unwanted consequences of hot flashes have belied the thinking that these hot flashes could be beneficial for women. Were they just the obvious signal to males of paleolithic times that this woman was no longer fertile? Since few women lived to the age of menopause until the 20th century, it’s hard to figure that this was the ‘societal reason’ that favored the survival of women with hot flashes.

Two anthropologists at the University of Mass have come up with their own theory about hot flashes in menopause.  This study was also reported in the journal Menopause volume 22, 2015. They have postulated that low estrogen post delivery triggers these heat surges that would warm newborn babies in their mother’s embrace. Many studies do document that at least 10% of women after birth complain of hot flashes, and at least a third complain of night hot flashes.

In these studies the results were actually fairly confusing. Women don’t really have extra hot flashes while holding the infant to breastfeed; and women are not accurate when reporting a hot flash has occurred with respect to when their skin temperature elevates. Skin temperatures would elevate regardless. The study was excellent yet moms did not wear monitors for 24 hours, we live in such controlled atmospheres now, and hormonal use for contraception actually confounds the ability to study the theory exhaustively. But their data didn’t really support baby warming as the physiologic evolutionary advantage they were looking for. So for now, womenshealthpractice.com focus on minimizing the ill effects for their patients and working on newer theories regarding hot flashes with hormonal or non-hormonal treatments including options for testosterone pellets.

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Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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