What Hot Flashes Are Telling You About Your Health
You’re going about your day—perhaps making some work calls, taking a yoga class, tending your garden, or dining with your mate—when all of a sudden you’re hot. Like, steaming hot. Your face and chest flush and you begin to sweat like you just ran a 5K in Miami. And this isn’t a one time thing. It happens often. Maybe this particular hot flash only lasts a couple of minutes, but on some days, they have you soaking through your clothes.
Vasomotor symptoms (VMS)—the technical term for hot flashes and night sweats—are an annoying side effect of menopause, and they’re extremely common. About 80 percent of women experience VMS in varying degrees of severity during the menopause transition, and seeing that more than a million women in the U.S. go through menopause each year, that’s a lot of heat.
It all begins in the hypothalamus, the region of the brain that controls your body temperature. As estrogen levels decline, the brain produces higher amounts of chemicals called neurokinins, which tell the body it’s hot—even when it’s not. This can occur any time of day or night, causing an increase in blood flow to the skin, flushing, rapid heartbeat, chills, and sweating. Hot flashes generally last two to four minutes, and episodes typically occur numerous times per day.
Unfortunately, hot flashes are more than just a nuisance. Recent studies reveal that they may also indicate underlying health conditions. This means that writing off hot flashes and night sweats as simply annoying could set you up for potential health conditions as you age. Below are issues your VMS could be signaling, depending on the frequency, severity, and nature of the symptoms. If any of these worry you, make it a point to speak to your doctor about them.
Adverse bone health
If you experience VMS at all, you could be at risk of decreased bone health. Data from the Study of Women’s Health Across the Nation (SWAN) found that early and late perimenopausal women with VMS had significantly higher N-telopeptide (NTX) levels than those who didn’t have these symptoms. NTX blood tests measure whether the breakdown of bone is outpacing its formation—a sign of potential osteopenia (a loss of bone mineral density).
If you experience VMS and have not had a bone density test, ask your doctor for one. And if you want to strengthen your bones—always a good idea—exercising could help according to a meta-analysis that assessed the activity on bone density on nearly 2,900 post-menopausal women.
Cardiovascular disease
The number of times per day you have a hot flash could indicate that you’re at a higher risk for cardiovascular disease (CVD). “According to SWAN study, women with frequent or persistent VMS symptoms had a 50 to 77 percent increased risk for future cardiovascular disease events,” says Stephanie Faubion, M.D., OBGYN, medical director for the North American Menopause Society (NAMS) in Rochester, MN. And what constitutes “frequent?” One study published in the Journal of the American Heart Association defines it as experiencing symptoms six or more days in the previous two weeks.
Despite this disturbing parallel, the exact relationship between VMS and CVD is still unclear. “We don’t know if there’s a direct link between VMS and CVD or its associated risk factors (i.e., that they are causative, which is less likely), or if there is a shared physiologic pathway that could explain both (which is more likely),” says Dr. Faubion. The bottom line is, if you’re experiencing VMS often, it’s a good idea to focus on heart-healthy eating and exercise.
Obesity
Women entering menopause typically gain weight due to hormone fluctuations and a drop in metabolism. What’s more, the severity of hot flashes was associated with the accumulation of body fat around the midsection and an increase in obesity, according to research published in Frontiers in Endocrinology.
Fortunately, there could be a way to counteract this. Maintaining lean body mass—i.e. muscle tissue—during menopause could help protect women against developing VMS symptoms in the first place, suggests a large population study published in Women’s Midlife Health. The easiest way to maintain lean body mass is to make sure strength training, either using weights or your own body weight, is a regular part of your day.
Cognitive health
According to the SWAN study, 39 percent of menopausal women complained of forgetfulness and poorer verbal memory (such as word recognition). Frequent night sweats—which are hot flashes that occur at night—have been associated with changes in cognition and brain function. “They’re related to the same physiologic changes in the hypothalamus but may have different effects on women, such as disturbed sleep,” says Dr. Faubion. Night sweats have also been linked to greater numbers of white matter hyperintensities, lesions in the brain that could indicate a higher risk of Alzheimer’s disease or vascular dementia. And while not specifically looking at VMS, one study published in Scientific Reports found that menopausal women had a higher incidence of amyloid buildup in the brain—which could be a sign of Alzheimer’s—than males and premenopausal women.
The Savvy VMS Solution
The three conditions above are only what is known now; researchers are examining whether VMS may have broader health implications. If you are experiencing them, talk to your doctor. In addition to helping to find relief from the hot flashes and night sweats, they’ll be able to continually screen you for osteopenia, cardiovascular issues, and cognition as you age, and keep you informed as to whether your VMS may indicate you’re at risk of other conditions that might be uncovered.
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