Relief of Hot Flashes

We ask 50 women over 50 about what supplements have helped support the symptoms of menopause and what they recommend.

Photo by RODNAE Productions

What is happening during a Hot Flash ?

Genny one day felt this strange scary sensation going up her arms , chest, and head and to the point where she thought she was having a minor stroke. It finally went a way. Then late at night it happened again and caused her to go into a severe panic attack. She was already dealing with post traumatic stress and anxiety this put her in a state of rage. She thought okay I must be now in menopause. Before her periods were time on then started to not come as much thank goodness she wasn’t sexually active at the time so she knew it wasn’t pregnancy. She laughed and thought maybe immaculate conception. She wandered if that is what women thought back then. So she decided to start her research and found nothing helpful. No support group nothing and so frustrating and annoying. Magazines online just talk about the symptoms not the causes. MD sites even her own doctor didn’t try to help her understand it was like she had to diagnose herself. What the heck are we paying healthcare costs for that?

Then the pandemic hit and started to really make it worse. She was like GEEZ can you just be a bit of a Jerk God or Higher Power on top of this. Then the sleepless nights then anger and uncontrollable rages and thoughts she never ever had ever in her life. She felt like she was poccesssed by a demon. LOL.

And to her she was. She started praying which she never really did and trying to understand what was wrong with her. Family and Friends were afraid of her at points and didn’t want to be around her. Then she saw this commercial on TV. Where these two women meeting for coffee and asked how eachothers ” Menopause was doing” watch so funny and it gave her some relief.

If your body says, “I’m too hot,” it triggers the mechanisms to get rid of heat. These heat loss mechanisms are the components of a flush — blood rises to the surface of your skin, you get red, heat radiates from your skin to the external environment, and you start sweating, which gets rid of heat. This is a normal response to elevated body temperature. But in menopause, this heat loss response is stimulated inappropriately.

Flushing is caused by the decline in estrogen secretion as women go through menopause.   Estrogen is produced by the ovarian follicles, and these structures also contain immature eggs. Women are born with a limited number of follicles, which decline over a woman’s life. Estrogen also affects the health of the reproductive system, urinary tract, bones, and more. As the body loses follicles and therefore loses estrogen, it tries in vain to stimulate the production of more estrogen.

What brain circuits are involved in hot flashes?

In the hypothalamus, there is a set of neurons known as the KNDy neurons. These neurons get their name from the presence of three peptides — kisspeptin, neurokinin B, and dynorphin. In postmenopausal women these neurons in the hypothalamus get larger due to the loss of ovarian estrogen. These neurons synapse on the gonadotropin-releasing hormone neurons that control reproduction and stimulates the secretion of luteinizing hormone from the anterior pituitary gland. Releasing luteinizing hormones in young women increases estrogen. But, due to the loss of ovarian follicles, estrogen remains low in postmenopausal women. Thus, KNDy neurons are part of the brain circuity that is activated in response to losing estrogen.

KNDy neurons also synapse on neurons in the preoptic area, a region of the hypothalamus that controls body temperature. By releasing neurokinin B and stimulating the neurokinin B receptor (the neurokinin 3 receptor), these neurons stimulate the heat loss mechanisms that produce a flash. This hypothesis is supported by clinical studies. Infusing neurokinin B into the blood stream of young women triggers a hot flash. Conversely, treatment with a NK3 receptor antagonist reduces the severity and frequency of hot flashes.

I’ve heard men experience menopause as well. Do they also get hot flashes?

Men have changes in reproductive function as they age, but it’s not like the total loss of ovarian follicles in women. Testosterone decreases gradually, and it can decrease to a point where men do report hot flashes. Men with prostate cancer also experience this — one common treatment is to deplete the production of testosterone. This results in pretty severe hot flashes. They call this Andropause.

Are there any available treatments for hot flashes?

 One study showed the risks of taking estrogen outweighed the benefits — it increased the risks of breast cancer, stroke, and coronary heart disease. There are many other treatments, including antidepressants but estrogen is probably the most efficacious treatment we have at this time.

However, other ways to treat hot flashes are in development. KNDy neurons possess neurokinin 3 receptors and stimulate the neurokinin 3 receptors in the preoptic area to produce a flash. This means you could conceivably treat hot flashes with drugs that block this receptor. In several clinical studies these blocking drugs, called neurokinin 3 receptor antagonists, effectively reduced hot flashes in women within three days and lasted as long as the women took the drugs. There’s hope this will provide a new targeted treatment of flashes that doesn’t involve taking estrogens. One drug is in Phase III clinical trials now.

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