Vasomotor symptoms of menopause: Treatment and management - NIIMS HEALTH CARE AND RESEARCH

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Wednesday, June 7, 2017

Vasomotor symptoms of menopause: Treatment and management

Menopause occurs after a woman has not had her period for 12 months. After menopause, she no longer releases eggs for fertilization, and her ovaries do not produce estrogen and progesterone, as they once did.
Hormonal changes associated with menopause cause several symptoms. Hot flashes, flushing, and night sweats are known as vasomotor symptoms.
Doctors do not know what causes vasomotor symptoms precisely, although they are among the most common occurrences of menopause. According to Harvard Health Publications, a woman going through menopause may experience vasomotor symptoms for 5-7 years. However, some women may have symptoms that last up to 11 years or even a lifetime.
Fast facts:
  • 'Vasomotor' refers to the 'vasomotor center,' the part of the brain that manages blood pressure.
  • Hormonal changes lead to vasomotor symptoms in menopause.
  • Causes are thought to relate to hormonal changes post-menopause.
  • Managing symptoms can involve hormonal medication or anti-depressants.

What are the vasomotor symptoms of menopause?

lady fanning herself with paper
Vasomotor symptoms of menopause may include hot flashes and night sweating.
Menopause symptoms can dramatically affect a woman's quality of life, with the vast majority of women experiencing vasomotor symptoms of some kind, as they go through menopause.
Further definitions of vasomotor symptoms include:
  • Hot flashes: The sudden sensation of heat that affects the chest, neck, and face.
  • Night sweating: A woman may wake up and experience extreme episodes of sweating, where her clothes and sometimes sheets are drenched.
Vasomotor conditions can cause a woman to experience anxiety and heart palpitations, as well.

Causes

Doctors agree that the causes of vasomotor symptoms in menopause are unknown.
However, they believe the lack of some hormones may have an impact. They believe this makes the hypothalamus, or part of the brain responsible for temperature regulation, more sensitive to changes in a woman's body heat.
Even a very small increase in body temperature can trigger a hot flash. Researchers are unclear why some women get them, and others do not, or why hot flashes vary in severity.
Over time, hot flashes start to diminish and ultimately disappear altogether. Only a few women experience periodic hot flashes for the rest of their life.

Risk factors

While not all women going through menopause have vasomotor symptoms, a large portion does.
Some women are known to be more at risk of experiencing these symptoms. Risk factors include:
  • Smoking: Women who smoke experience more incidences of hot flashes than women who do not.
  • Obesity: Women that are overweight are more likely to have hot flashes.
  • Ethnic background: African-American women report a higher incidence of hot flashes than do women of European descent. However, Chinese- and Asian-American women report fewer vasomotor symptoms than their European counterparts.
According to an article published in the journal Menopause, women who experienced hypertensive pregnancy diseases, such as preeclampsia, were more likely to experience vasomotor symptoms in menopause.

Complications

lady with insomnia staring at the back of her clock
Chronic vasomotor symptoms may lead to complications such as insomnia.
Some women who experience chronic and prolonged vasomotor symptoms also report having chronic insomnia, which makes it difficult going to or staying asleep.
Women with vasomotor symptoms may also be at a higher risk of:
  • heart disease
  • bone loss
  • early atherosclerosis, a hardening of the arteries that can lead to heart disease and raised risk for heart attack
If a woman experiences vasomotor symptoms, she should talk to her doctor on how she can ensure she improves her heart and bone health after menopause.

Treatments

Doctors may prescribe estrogen to women experiencing significant vasomotor symptoms connected with menopause. However, taking estrogen is associated with other risks, including a higher chance of developing breast and endometrial cancers.
Sometimes the risks outweigh the benefits if a woman starts taking estrogen within 10 years of her last menstrual period.
Women who take estrogen before 60 may also experience greater results with fewer risks than women who are older than 60 when they take it.
If a woman does choose to take hormones, she should use the lowest, most effective dose taken over the shortest possible time.
Some women do not wish to take estrogen or cannot tolerate taking it. If this is the case, a doctor may prescribe other medications, including:
  • anti-depressants, such as paroxetine, venlafaxine, or fluoxetine
  • anti-seizure medications, such as gabapentin
  • clonidine, a medication used for high blood pressure
However, these medicines are not thought to be as effective as taking estrogen therapy.

Lifestyle changes

older lady drinking white  wine
Avoiding alcohol and other triggers known to cause hot
flashes may help to reduce menopause symptoms.

In addition to prescription medications, there are many lifestyle changes that a woman can perform to reduce her menopause symptoms. These include:
  • Avoiding foods known to trigger hot flashes, such as spicy foods, alcohol, and those that are hot in temperature, including soups, coffee, or tea.
  • Quitting smoking, as smoking cigarettes is associated with anti-estrogen activity, which can worsen a woman's symptoms.
  • Dressing in layers, so one or more layers can be removed if a hot flash occurs.
  • Carrying a water bottle with ice water, which helps to cool the body when a hot flash comes on.
  • Keeping a portable fan nearby, and using a ceiling fan to keep cool when sleeping.
  • Avoiding exercise immediately before bedtime, which can cause a higher body temperature that could then make it more difficult to go to sleep. Exercising earlier in the day is associated with better results.
  • Breathing in a slow, deep rhythm when a woman feels a hot flash may be coming on. This practice is known as paced respiration.
According to Massachusetts General Hospital, it is important for women in midlife to maintain a healthy weight early in their menopausal transition, as a means of preventing vasomotor symptoms.
There are many over-the-counter treatments that are rumored to reduce the effects of vasomotor symptoms. Examples include taking supplements or eating foods high in bioactive isoflavones. These contain chemicals that are similar in structure to estrogens and are rumored to exert estrogen-like effects on the body.
Examples include soybeans, chickpeas, lentils, and red clover. However, according to U.S. Pharmacist, these products have not been proven to be effective in reducing menopausal symptoms.

Outlook

Women who experience hot flashes before their menstrual periods tend to experience them for a longer time, about 9-10 years. Women who did not have vasomotor symptoms until after menopause tend to have hot flashes for a shorter time.
Regardless of when a woman starts having vasomotor symptoms, knowing they can last for many years is a reason to seek treatments, so as to enjoy a better quality of life.

However, getting more sleep, and not experiencing anxiety or concern about when she may have another hot flash, can help a woman to live a fuller, more enjoyable life after menopause.

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