Where do hot flashes come from?

The hot flash is one of the most infamous symbols of menopause, and it's no laughing matter. But what exactly is a hot flash, and what causes it? In this podcast, Cristen and Molly break down the science behind hot flashes.

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Episode Transcript

Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to Stump Mom Never told you?
From house top works dot com. Hello, welcome to the podcast.
This is Molly and I'm Kristen. Kristen. The topic for

(00:21):
today is the hot flash. I would say it's probably
the most famous or infamous uh symbol of menopause, and
it's it's so often used as a punchline. I feel
like that's how I knew. It's just those movies or
TV shows where uh, middle aged woman just starts banning
herself having a hot flash breakout in a sweat. But

(00:43):
the more research I did on them, it's no laughing matter.
It is no laughing matter. Hot flash is not a
pleasant experience that can last anywhere from two minutes, which
that's okay. I can handle two minutes a heat, but
how about a thirty minute hot flash? And you know
it's it's one thing just to say you get really hot.
But listen to this description that's on our website how

(01:04):
stuff works dot com. You experience a sudden wave of
intense heat rushing through your body within seconds of its arrival.
The strange feeling that you're experiencing causes you to sweat,
and you'd swear that your skin is on fire. As
foolish as it sounds, you feel like stripping off the
clothing that you're wearing and finding the coolest place you can,
even if it's the middle of winter. Within minutes or
even hours, in some cases, the feeling passes and this

(01:26):
od sensation disappears just as quickly as it arrived. I mean,
I oh, if I was experiencing that, get out of
the way, Just get out of the way. I just
was like, like, also like a stereotype of meeting like
a sexy stranger on a train. That's maybe that's the
way to like spice up the hot flashes reputation. Just

(01:50):
call it a sexy sexy visitor feeling. I don't think
menopausal women would appreciate it that much, because while hot
flashes can be brief, lasting only a few minutes, they
can come up over a period of five plus years.
Five plus years, Molly and well, and you know, it

(02:10):
varies so much from woman to woman, as as most
things tend to do, but that five plus marker can
be really scary when you're trying to figure out the
way that you're going to treat your hot flashes, which
we'll talk about a little bit later, but let's get
into why this happens, Christen, because everyone associates this phenomenon
with menopause, but what specifically is going on in the
body that causes the sexy visitor on the train feeling.

(02:32):
Hot flashes originate in the hypothalamus, and this is a
part of the brain that regulates the body's temperature and
it's linked so often to menopause because levels of estrogen
and testosterone will influence the hypothalamus, endearing menopause. When levels
of estrogen drop, the hypothalamus will think that the body

(02:54):
is overheated and going to overdrive. Right, all your blood
vessels dilate, which causes more more blood to rush through
the vessels very rapidly, which is what results in those
symptoms like a feeling of warmth or intense heat pressure
in your head as that blood really starts pumping, sweating,
the flash appearance, rapid heartbeat, and then um, it's like

(03:15):
if your body thinks it's overheated and it's cooling down,
that's why you get chilled. Almost immediately after the hot
flash ships sides, and this is experienced by women who
are going through menopause. No fun. But there are environmental
factors that can influence the frequency of hot flashes as well,
such as smoking. Women who smoke are more likely to

(03:37):
get hot flashes. Women with a high body mass index
tend to have more hot flashes people who are physically inactive,
and also ethnicity has a correlation to hot flashes UM.
According to Discovery Health, more African American women report menopausal
hot flashes, and they're also less common in women of
Japanese and Chinese descent. But I did you Christen that

(04:00):
they just don't know if that's because the Asian women
won't report a hot flash UM or if they really
do experience them less because you know, probably not the
easiest thing to talk about with your doctor, and it's
not it's one of those things that really can't be
measured per se. It's all about your subjective experience of
what what you're going through. And you might hear hot
flashes referred to as night sweats um in of women

(04:24):
who are going through menopause. Hot flashes or night sweats
will wake them up in the middle of the night.
Although we did come across the study that um it
tracked women who claimed they were frequently woken up in
the night by hot flashes, and they found that during
the first half of the night it was a hot
flash that woke the women up. During the second half

(04:44):
the night, when the women were in deeper sleep, the
things that were actually waking them up where things like
sleep apnea and restless leg syndrome. So that's it's instead
of solving a puzzle for researchers, that gave them something
else to work on, because right now, what people are
trying to figure out is how hot flashes and other
symptoms of menopaus are related to these other conditions that
women of a certain age experience. For example, depression is

(05:07):
a big one. Right there is seems to be huge
connection between depression, menopause, and hot flashes, and doctors have
tried to figure out whether or not depression precedes the
onset of hot flashes, or if hot flashes start and
then the depression begins. Because one of the main therapies

(05:28):
that doctors are now using prescribing for hot flashes are
different types of anti depressants. So what they did with
this study that was reported by Mass General hospital the
Center for Women's Health Is they examined whether depression came
first or the hot flashes came first. And according to
the study that lasted ten years, uh fifty seven of

(05:49):
the women of the seventy women who experienced both hot
flashes and depressive symptoms. Of the women expressed experience the
depressive symptoms first, experience the hot flashes first, so that
the symptoms emerge concurrently. So again, something's going. I mean, granted,
if you're having these really extreme hot flashes, I can

(06:11):
see how that brings depression on. But with women saying
they experienced the depressive symptoms first and nearly a quarter
saying that they happen at the same time, there's something
linked there. And you know, we always talk about hormones
or this mysterious thing that researchers can't quite figure out.
But this is another example of how, you know, doctors
and researchers aren't sure what's causing what, how they can

(06:32):
treat one and treat the other. It's it's very interesting
to see how they're unraveling these connections in the body.
And a recent study on the effect of the antidepressant
Lexapro on relieving hot flashes had a very interesting result
um that says a lot about this potential mind body
connection with with menopause. Uh. The researchers had one group

(06:57):
of study participants take the Lexepro for hot flashes, and
they gave the other group a placebo. Now, while the
study participants were taking their placebo or alexi Pro, about
the people on luxe Pro experienced a decreased by at
least half of hot flash frequency. And then for the
folks taking the placebo, about thirty of the women experienced

(07:20):
hot flash relief. But after they stopped taking their placebo
or the Lexapro, the women who had just been taking
the lexi Pro immediately experienced a resurgence in hot flashes. However,
the people who are taking the placebo pills continue to
have the lowered incidence rate of hot flashes. Right, really

(07:44):
interesting that maybe the mind can work some magic over
the body control these kinds of hot flashes. Although I'm
sure the amy woman who's had a hot flash says,
this is not in my mind, and if I could
control it with my mind, I would, right. But this
study is really interesting because antidepressants are one of the
main and therapy is being considered right now for hot flashes,
and to go back to Christian's uh pointing out that

(08:06):
these can last for more than five years. I mean,
to be on an antidepressant for five years is a
really scary prospect to some women. And that's I mean,
that's sort of what you have to weigh against these
odds when you consider some of the therapies available. For example,
one of the main therapies for some women who are
candidates for it is hormone replacement therapy. But because of

(08:27):
this landmark study that linked hormone replacement therapy with an
increase of rate of heart disease, stroke, blood clots, hormone
replacement therapy is only an option. You know, they tell
you to be on the lowest possible dose for the
shortest amount of time possible. So when you're thinking of
you know, you really can't do that for five years,
how are we going to deal with these hot flashes?

(08:49):
A lot of women don't deal with them. It's you
don't have to get treatment for them if they're not
affecting your life. So after the controversy surrounding hormone replacement therapy,
the market for natural remedies for hot flashes and other
menopausal symptoms have skyrocketed. There is an article in the
New York Times from two thousand nine reporting that, uh,

(09:13):
the market grew from two hundred and eleven million and
ninety nine to three hundred and thirty nine million dollars
in two thousand seven. And this is just for dietary
supplements associated with menopause. And a lot of those dietary
supplements will involve things like soy and red clover that
are supposed to sort of I guess performed the same

(09:36):
type of role as the estrogen replacement. And another one
that you'll see is black co hosh. And you know,
we have an article on our site Kristin called how
to Treat menopause with a rooman Therapy. So if you're
looking for another natural option, according to Kathy Hivill, essential
oils ease hot flashes included clary sage, lemon, and peppermint. Yeah,
especially geraniums. The essential oils from geraniums supposed to be

(10:00):
very relieving. But the fact that so many things can
start competing for our attention in this treatment spectrum when
we really don't even know of a full proof method
to treat things is you know, it's telling it's another
one of these conditions that affect women that uh, doctors
haven't quite figured out yet and don't know exactly how
to treat. And that maybe why so many women don't

(10:20):
report hot flashes to their doctor or don't seek treatment
for them in any way. But women are not we
should mention the only people who can experience hot flashes exactly.
Although we tend to associate hot flashes with menopausal women,
guess what, men, you can get them too. And a
lot of times men who get hot flashes are those

(10:42):
who have gone through prostate cancer or have had their
prostate removed for some reason. Because like the drop in
estrogen that triggers the hypothalmus going haywire and then setting
off the hot flashes and men, drops in testosterone will
also interfere with the hypothalamus and cause a similar effect

(11:02):
with body temperature. But process cancer is not the only
thing linked to hot flashes and men. A number of
conditions can also cause them, including hyperthyroidism, low blood sugar,
and hypoglycemia. And you know, menopausal women are not the
only women who have hot flashes either. About one and
one women will start experiencing the symptoms of menopause before

(11:25):
age forty, and this has linked to a condition called
primary O variant insufficiency or p o I, and it's
not not very common, but it's worth talking to your
doctor about. Other symptoms of this condition include irregular periods
because what will eventually happen with p o I s
you're usually rendered infertile and then you become at risk

(11:45):
for bone fractors and heart disease, which is why it's
important to start talking to your doctor about it. Um
And so women who experienced those really early onset symptoms
may have that condition. Now. The National Institutes of Health
noted that this used to be your or two as
premature menopause or premature ovarian failure, but research has since
shown that ovarian function is unpredictable a lot of times

(12:08):
in these women, and sometimes it can turn off, but
then also turn on and you will go um go
on to produce eggs. So menopause not the only thing
that can cause a hot flash, though. Se of women
going through a menopause do experience them, and like we said,
the treatment ranges from doing nothing and just trying to
alleviate environmental factors, you know, keeping the air conditioning on

(12:32):
even when it's winter. That that can be you know,
a simple fix breathing exercises to relax your body and
not eating spicy food or smoking if those are triggers.
But we want to hear from our listeners about what
has worked for you. I mean, we can read a
dozen articles that talk about wearing loose fitting clothing to
beds so you don't have a hot flash that wakes
you up. But we want to know what worked for you.

(12:53):
So email us at mom stuff at house stuffwork dot
com and we will share with everyone else your menopause
hot flash tips. So well. In the meantime, I've got
an email here from Helena and this is in response
to our recent podcast on lying, and she says, I
actually paused the podcast to write this to you and

(13:15):
your podcast online. You say that people generally don't tell
lies about themselves that would make themselves look worse. However,
I've noticed, much to my dismay, that I've told lies
about my grades in college. I was the kid messing
up your curb. What can I say? Linear algebra just
spoke to me. I was good at it. Nonetheless, you'd
never catch me admitting it. When a group of fellow

(13:37):
students approached me to ask if I was the one
who got the A plus on the last test, I
deny it. When the professor would ask me how I
had gotten a certain answer to a difficult problem, I
shrugged it off as a lucky guest and made a
self deprecating joke to deflect attention. I was math girl,
but I guarded my secret identity like Clark Kent years later.
Looking back, I'm very annoyed at young math girl. People

(13:58):
will still like you if you smart, little math girl. Boys,
We'll still ask you out, girls will still want to
be your friend. Lies to downplay your intellect are silly. Indeed,
I think we've all been guilty of that every now
and then. I sure hope the math girl superhero takes off.
Do you ever lie about podcast girl Molly? Of course not.
Would never lie about this sacred space between us. If

(14:22):
you've got something to tell us, hopefully not a lie,
because we treasure your honesty's right, send us an email.
The email addresses mom Stuff at how stuff works dot com.
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(14:48):
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