Heat Waves & Hot Flashes in Perimenopause

I remember the uncertain winter of my entrance into perimenopause so well. It began in my late 40s, with hot flashes that came on like heat waves every half hour.

In the dead of winter, I found myself flinging open windows to let in the freezing air; I soon found out that having hot flashes in winter was nothing like having them in summer, when the added heat and humidity made them feel more like mini-meltdowns. 

How to Cool Down without Melting Down

Perimenopause is a hormonally challenged transition during which the ovaries gradually begin to make less estrogen and progesterone; it lasts up until menopause, when the ovaries stop releasing eggs altogether. For some, perimenopause spans just a few months, but for others, it can last as long as 10 years. Regardless of its length of time, no one likes being plagued by hot flashes, night sweats, or other common symptoms such as foggy thinking, fatigue, and mood swings.

Fluctuations of female hormones, particularly progesterone and estrogen, are largely responsible for hot flashes and night sweats . . . 80% of women with shifting and declining estrogen levels will experience hot flashes.

During this transition, it’s important to realize that the extent to which we suffer from persistent symptoms has much do with the extent to which our hormones are out of balance.

To help you picture that in your mind, imagine several synchronized swimmers all pointing their toes in perfect petal formation at the exact moment. Suddenly, one swims off in a different direction (let’s call her progesterone), another dives to the bottom of the pool (call her testosterone), and a few more splash up and down (diurnal cortisols) while the last of the swimmers (call her estrogen) starts making waves that disrupt the whole routine.

It is these fluctuations of female hormones, particularly out-of-sync progesterone and estrogen levels, that are largely responsible for hot flashes and night sweats. In fact, 80% of women with shifting and declining estrogen levels will experience hot flashes at some point in their progression toward menopause (which is officially defined as 12 sequential months without a menstrual cycle).

To find out if you have a hormonal imbalance, hormone testing is the way to go. Test results can provide answers by identifying specific imbalances and matching them up with the symptoms you are experiencing. The comprehensive evaluation serves as a guide to natural hormone rebalancing and prescribed treatments tailored to individual need.

What You Can Do 

Avoid alcohol (especially sweet white wines), caffeine, sugars, spicy foods, and hot soups and drinks that actually trigger or worsen hot flashes. 

Avoid unnecessary stress, one of the biggest causes of hot flashes and night sweats. Your body reacts to constant stress by raising cortisol levels, which alters the normal balance of hormones in the body. Vow not to let stress take center stage in your life. Start to banish it now by breathing deeply to get oxygen to the brain; this is an instant stress reliever. Make time to read, relax, soak in the tub, go for a 20-minute walk, or take a 10-minute nap. Cancel appointments that aren’t top priority. Identify what is top priority; do whatever it takes to lower stress hormones and quell the hot flashes.

Reset the thermostat in your house to 68 degrees. Sleep researchers observe that sleeping in a cooler room can lead to deeper, more restorative sleep. Night sweats can also be triggered by changes in room temperature, so if you start off cool and use minimal covers you are less likely to awake in a sweat as your body warms up through the night.

Exercise daily to release tension held in the muscles, which will allow your body to truly relax. Exercise also triggers endorphins: the feel goodhormones that help you feel calmer and increase your overall sense owell-being. Experts tell us that women who make exercise a part of their daily routine have fewer hot flashes, night sweats, and other symptoms of imbalance.

What You Can Take

Bioidentical progesterone is known to dramatically reduce the strength and frequency of hot flashes by keeping estrogen and progesterone balanced and less prone to erratic fluctuation. Studies have shown up to 80% relief from hot flashes in women using bioidentical progesterone in a “Goldilocks” dose—no more, no less than the body needs to mimic natural physiology.

Many find that hot flashes worsen when they switch from synthetic to natural hormones, so it’s important to use test results for appropriate dosing, and to retest levels in three months to track progress and make adjustments. For example, women whose test results repeatedly show low estrogen levels may need to supplement bioidentical estrogen in concert with progesterone.

Anti-stress multi-vitamins and trace minerals include vitamins like C, B-complex, and E to help quell hot flashes and get you through the night without breaking a sweat. Trace minerals such as zinc and selenium may also help. 

Essential fatty acids balance estrogen production and may help reduce hot flashes.

DIM, or dindolylmethane, is the active ingredient in cruciferous vegetables; it promotes proper hormone metabolism and helps improve estrogen/ progesterone equilibrium to steady the hot flashes and related symptoms. Try eating plenty of broccoli, Brussels sprouts, cauliflower, cabbage, and kale, and/or taking additional DIM in supplement form.

Soy protein (non-GMO) in moderation has been shown in studies to relieve hot flashes and night sweats. Asian women with soy-rich diets are famous for their lack of hot flashes and menopause symptoms. The best sources are naturally fermented tofu, tempeh, miso, tamari, etc., vs. processed versions such as soy milks, cereals, chips, and bars.

Phytonutrients such as magnolia, red clover, dong quai, black cohosh, and rhodiola, among other plant-based herbs with mild estrogenic effects, can be used as teas, tinctures, and/or supplements to cool hot flashes and help you refocus. Flaxseed (grind your own and sprinkle on salads, oatmeal, in smoothies, etc.) contains a phytoestrogen known to help diminish hot flashes by providing natural plant-based estrogenic nutrients.

Most women are well aware of perimenopause and menopause symptoms as they approach their 40th and 50th birthdays; they discover with hot flashes or night sweats that there is no “getting out” of menopause.

However, what is not inevitable is a perpetually perspiring, red-faced woman staring back at you in the mirror. Remember that whatever the time of year, hot flashes are not forever! With a little research and help from your health care practitioner, you can find relief during this period of transition.

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