The cause of hot flashes, and why it's time to talk about it
Posted: October 06, 2022 | Word Count: 888
Hot flashes and night sweats — the common terms for vasomotor symptoms (VMS) associated with menopause — are experienced by up to 80% of women during the menopausal transition.1 They can be sudden1, disruptive2 and downright embarrassing.3 VMS can range in severity and frequency, and also lasts for a longer period of time for some women.4
"VMS can have a negative impact on quality of life since these symptoms can occur day or night, and can impact sleep, work and relationships,"2 said Dr. Mary Jane Minkin, MD and clinical professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the Yale University School of Medicine. "We now have a new understanding of why these occur and it’s not just due to a decrease in estrogen like previously thought.”1
The science behind the symptoms
Dr. Minkin explains that VMS originates in a part of your brain called the hypothalamus, which regulates your body’s temperature.1 To keep your internal thermostat in check, your body relies on having a balance between estrogen and a brain chemical called neurokinin B (NKB).1 During the menopausal transition, levels of estrogen and NKB become unbalanced.1 This imbalance causes neurons in the hypothalamus to tell your body you’re hot when you’re not.5 To cool down, the hypothalamus triggers hot flashes and night sweats.5
Little-known facts about VMS
- VMS can last for years: Women experience VMS for a median duration of 7.4 years6 and some women for as long as 10 or more years.4
- VMS can impact a number of aspects of daily life: Women who have experienced menopause report that VMS negatively impacts sleep (82%), concentration (69%), mood (69%), energy (63%) and sexual activity (41%).7
- VMS can be intense: Hot flashes are a sudden intense sensation of heat in the upper body (usually in the face, neck and chest), which last between 1 and 5 minutes, and may be accompanied by sweating, chills, anxiety and heart palpitations.1 Night sweats are hot flashes that occur during sleep.1
- VMS impact some women more than others: VMS disproportionately impacts African American women (46%) and Hispanic women (35%). The prevalence is lower in Caucasian women (31%), Chinese women (21%) and women of Japanese ethnicity (18%).8
- VMS can start before your final menstrual period and last postmenopause: VMS may begin up to two years prior to the final menstrual period and are most common in the first two years postmenopause9, yet 10% of women continue to experience VMS for more than 10 years.4
"VMS can leave a woman feeling exhausted if sleep is interrupted and feel anxious in social and work situations as no one wants to turn the color of a beet and start profusely sweating in public,”2 continued Dr. Minkin. “This can last for years and impact so many women.”4
October is World Menopause Month, celebrated annually around the globe to raise awareness of the impact menopausal symptoms can have on everyday life. It’s also a time to encourage more open dialogue and action so women can feel empowered to speak openly about their journey10 through this normal life stage.7
Dr. Minkin explains she wants to normalize talking about it because no one woman is alone in experiencing it. She encourages women experiencing VMS to reach out to a friend and have a conversation. And most importantly, to talk to a health care provider and not hide your hot flashes. For more information about VMS, visit WhatsVMS.com.
Sponsored by Astellas Pharma US, Inc.
1 Thurston RC. Vasomotor symptoms. In: Crandall CJ, Bachman GA, Faubion SS, et al., eds. Menopause Practice: A Clinician's Guide. 6th ed. Pepper Pike, OH: The North American Menopause Society, 2019:43-55.
2 English M, Stoykova B, Slota C, et al. Qualitative study: burden of menopause-associated vasomotor symptoms (VMS) and validation of PROMIS sleep disturbance and sleep-related impairment measures for assessment of VMS impact on sleep. J Patient Rep Outcomes 2021;5(37):1-13. Erratum in: J Patient Rep Outcomes 2021;5:42.
3 Pinkerton JV, Abraham L, Bushmakin AG, Cappelleri JC, Komm BS. Relationship between changes in vasomotor symptoms and changes in menopause-specific quality of life and sleep parameters. Menopause 2016;23(10):1060-6.
4 Utian WH. Psychosocial and socioeconomic burden of vasomotor symptoms in menopause: a comprehensive review. Health Qual Life Outcomes 2005;3:47.
5 Padilla SL, Johnson CW, Barker FD, Patterson MA, Palmiter RD. A neural circuit underlying the generation of hot flushes. Cell Rep 2018;24(2):271-7.
6 Avis NE, Crawford SL, Greendale G. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med 2015;175(4):531-9.
7 Williams RE, Levine KB, Kalilani L, Lewis J, Clark RV. Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Mauritas 2009;62(2):153-9.
8 Freeman EW, Sharif K. Prevalence of hot flushes and night sweats around the world: a systemic review. Climacteric 2007;10(3):197-214.
9 Avis NE, Crawford SL, Green R. Vasomotor symptoms across the menopause transition: differences among women. Obstet Gynecol Clin North Am 2018;45(4):629-40.
10 Parish SJ, Nappi RE, Kingsberg S. Perspectives on counseling patients about menopausal hormone therapy: strategies in a complex data environment. Menopause 2018;25(8):937-49.