What is the most common symptom of menopause experienced by 75% of women at some point?
Hot flashes. This problem is attributed to estrogen withdrawal or fluctuating estrogen usually in the absence of adequate progesterone. As of the year 2012 there were approximately 50 million women reaching menopause; with the aging baby boomer population this number is only growing. With such a common symptom affecting such a large percentage of the world’s population, it’s no wonder research continues to focus on ways to gain relief.
It all has to do with THE TRANSITION!
During the transition from peri menopause to menopause, hot flashes are associated with a rise in the body’s core temperature and a narrowing of the body’s thermoneutral zone, with a decrease of the sweating threshold and an increase of the shivering threshold. Simply put, peri and menopausal women tend to run a bit warmer than pre-menopausal women with an increased tolerance for cold and a decreased tolerance for heat. These changes in the body’s temperature regulation are associated with multiple fluctuations in hormones, including changes in estrogen, norepinephrine and serotonin.
So what is the connection? Well, in the brain, estrogen increases serotonin’s ability to activate its receptors. Estrogen withdrawal during menopause causes decreased serotonin receptor sensitivity, resulting in multiple physiological changes including the temperature regulation changes that contribute to menopausal hot flashes. Modulating estrogen levels and maintaining adequate progesterone levels during this time will go a long way towards controlling hot flashes.
Known to be a symptom of low or fluctuating estrogen, a more commonly known treatment option for hot flash relief may be estrogen supplementation. However, Supplementing estrogen may increase the risk of estrogen-dependent cancers including uterine and breast cancer and would certainly not be an option with anyone with a genetic pre-disposition to breast cancer.
Testing is Best!!
Establishing baseline hormone levels with a saliva test – testing of estrogen and progesterone levels will demonstrate if a woman is estrogen dominant. Continued monitoring of her symptoms and hormone levels at regular intervals while participating in a hormone balancing supplementation program will ensure she is enjoying her peri and post menopausal years hot flash free.
Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? Postgrad Med. 2009 Jan;121(1):73-85.
Freeman EW, et al. Efficacy of escitalopram for hot flashes in healthy menopausal women: a randomized controlled trial. JAMA. 2011 Jan 19;305(3):267-74.
Kusakabe, T., Deficient Cytochrome b5 Reductase Activity in Nontoxic Goiter with Iodide Organification Defect Metabolism. 24(10):1103-1113, 1975.