The Hot Flash!

The Hot Flash!

Menopause and the Hot Flash! – Dr. Rob America’s Fitness Doctor®

The average American woman’s life expectancy currently exceeds 80 years of age and most women can expect to live more than one-third of their lives well beyond their childbearing years, which means all women will have to deal with menopause!

Menopause is no longer a back room topic and women open discuss their daily struggles with this unavoidable female experience. Both the non-medical and medical communities throughout our country now openly address the implications of menopause. Billions of dollars are spent each year on advertising targeted at the 40 million-plus women who are near or in the menopausal category.

Menopause refers to that time in every woman’s life when menstruation ( the period) stops completely. The ovaries decrease their output of estrogen and progesterone and women begin experiencing the effects of deceasing levels of these hormones.

This marks the end of a woman’s ability to have children.  But it does not stop there because female hormones affect the entire endocrine system. This whole process takes about three to five years to complete. The early phase, or transitional phase, is called the climacteric period, or perimenopause.

Menopause is considered complete when a woman hasn’t had a period for a full year. Although timing varies from woman to woman, menopause is generally completed by the early to mid-50s.

The Hot Flash!

Naturally every woman is an individual, but in general there are a number of signs and symptoms that can be anticipated with perimenopause and menopause and the hot flash is the one physical complaint that is professed most often. There is no need to try and tough these out as there are many therapies that can decrease both the intensity and frequency of the hot flash! However, the reality is that the decline of a woman’s hormonal levels results in changes that can seriously affect not only her physical and mental health but also her hopes for quality of life with longevity.

Vasomotor Symptoms 
or hot flash is the most common symptom associated with menopause.   A hot flash is a sudden sensation of intense heat. Some women actually experience skin changes, such as breaking out in red blotches on their chest, back and/or arms. Some women sweat profusely, many also experience cold and shivering until their bodies readjust. This can frequently occur during the night resulting in insomnia, which is a common complaint among perimenopausal and menopausal women.

Some women experience an “aura” just before the onset of a hot flash, which may include tingling, anxiety and a pressure like sensation in their head.   One patient recently described the sensation as like “a thousand ants crawling under my scalp”!

While some women never experience hot flashes, other women can have them for up to 30 minutes at a time.  For the majority of women, symptoms will last two to five years and for the unfortunate few, about 1 out of 20 women will have persistent symptoms.  And for these unlucky few about 20% of women can have symptoms for up to 15 years!

Vasomotor symptoms have long been thought by some to be a fact of life to be tolerated and of little real clinical significance. However, studies have now demonstrated they are associated with sleep disturbances, impaired quality of life and depressed mood.   No woman should have to live with any of these!

While the exact cause of hot flashes is not fully understood, they are thought to be the result of changes in the hypothalamic thermoregulatory set point; I know that was a mouthful, which occurs with the endocrine changes of ovarian failure. The neurotransmitters serotonin and norepinephrine, as well as estrogen acting as a neuromodulator, are known to have input to this area. As estrogen levels decline, changes occur in serotonin and norepinephrine production, release, degradation, and reuptake and receptor activity.

Here is an overview of menopause:

  • Female menopause affects all women
  • Symptoms begin abruptly
  • Drop in estrogen along with progesterone and testosterone around 40-50
  • Decrease in hormones result in decreased physical and mental health
  • Symptoms include decreased sexual arousal, vaginal dryness, cardiovascular, weight gain, osteoporosis, hot flashes, anxiety, irritability, and loss of elasticity, aches and pains
  • As ovaries decrease their estrogen and progesterone output, women experience the decreased effect of diminished hormones.
  • Menopause takes about 3-5 years to transition called climacteric
  • Menopausal symptoms such as mood swings, bloating, and weight gain
  • Estrogen surges create breast tenderness; sleep disturbance and irregular cycles decreased libido, fatigue, depression, headaches, backaches, decreased metabolism, and unstable blood sugars

Here is what you can do about it!  The following list are suggestions tried by my patients over the years that have reduced the intensity and frequency of their hot flashes and one of these may certainly help you.  The most popular alternative choice amongst my female patients is Estroven.

Alternatives to Estrogen therapy to decease the Intensity & Frequency of Hot Flashes and Night Sweats

  • Black Cohosh 20mg twice daily
  • Soy Isoflavone 50-100mg twice daily
  • Estroven is a combination product of black cohosh, soy isoflavones, magnolia bark, melatonin, ginkgo biloba and L-theanine and B vitamins
  • Vitamin E 15mg daily
  • Evening Primrose Oil (GLA) 500-1000mg twice daily
  • Vitamin D3 2000IU daily
  • Flax seed 1-2 tablespoons daily
  • I-cool (isoflavone)
  • Melatonin 3mg every night
  • Shatavari
  • Soymilk, tofu, edamame
  • Dark Chocolate 60% and greater 1-2 ounces daily
  • Soy protein concentrate water extracted???
  • Regular Daily Exercise
If none of these alternative therapies alleviate your symptoms see your physician to find out if personalized hormone optimization is right for you.


“Fitness is the Footprint of Life.  Follow It!”

Dr. Rob Kominiarek,  America’s Fitness Doctor®

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