Hot Flashes & Night Sweats
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aka. Vasomotor Symptoms
Roughly 80% of women experience hot flashes, which llast an average of 10 years and average 4 - 20 per day (Avis et al, 2018)
TLDR. Changes in hormones can impact the body's temperature comfort zone.
Vasomotor Symptoms (aka Hot Flashes and Night Sweats) are experienced by 80% of women and last approximately 10 years on average. Hot flashes are a sudden sensation of warmth that typically will last for about 15 minutes, and will vary in impact on activities. Some women experience them as a mild sensation of heat, but they can be severe enough to significantly disrupt activity. During a “severe” hot flash, it is difficult to continue normal activity. Hot flashes most often will peak in the late perimenopause and the few years of postmenopause, but it is highly variable. Most women eventually have improvement in hot flashes, but some are “superflashers” and have symptoms that start earlier in the transition and last longer. Night sweats are thought to be due to a similar phenomenon occurring during sleep and they can significantly disrupt sleep.
What causes hot flashes & night sweats?
As the ovary makes less estradiol, a group of neurons called the KNDy neurons (kisspeptin - neurokinin B - dynorphin) become overactive, which in turn causes the temperature regulation center of the hypothalamus to have a narrowed “comfort zone” of temperature. Small variations in temperature that would have previously been fine for the body now prompt large responses of flushing and sweating (Deecher and Dories, 2007 and Rapkin, 2006).
Relationship to other symptoms
Newer research also suggests that patients with vasomotor symptoms may also have a higher rate of other complications such as cardiovascular disease (Thurston et al, 2021), low bone density (Anagnostis et al, 2024), high blood pressure (Lee et al, 2024), and cognitive decline (Thurston et al, 2023). It is unclear at this time if severe vasomotor symptoms cause the health issues, or if they are associated with the health issues. Ongoing research is needed. The data are complex around the question of: “will treatment of the vasomotor symptoms reduce my risk?”. There are specifics of age, timing of menopause, personal medical history and goals that need to be discussed with your physician that will impact how this question is answered for you.
The primary reason to treat vasomotor symptoms is the significant impact on sleep and daily function that it can have on many people. The lack of sleep can make mood regulation and brain fog symptoms worse. There are treatments that are effective, both hormonal and non-hormonal.
You're not alone. Not knowing when hot flashes might be coming and knowing those around you can see what's happening can be incredibly difficult and may feel isolating. Know you're not alone in dealing with these changes, and that these changes typically end in post menopause. Leverage your support network to make adjustments, seek additional options if what you try initially doesn't work, and emotional support as you navigate this new phase of life.
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