Why Do Hot Flashes Start in Perimenopause? Understanding Vasomotor Symptoms
“Is it hot in here, or is it just me?” If this sounds familiar, you’re not alone.
For many women, hot flashes in women are one of the earliest and most common symptoms of perimenopause and menopause, affecting up to 85% of women at some point.
These sudden waves of heat, also referred to as vasomotor symptoms, can be uncomfortable, disruptive, and sometimes downright frustrating.
But what’s really happening when you feel like you’ve stepped into an invisible sauna? Let’s break it down.
What Are Vasomotor Symptoms?
Hot flashes and night sweats fall under the umbrella of vasomotor symptoms. The term “vasomotor” refers to the nerves and muscles that control the constriction and dilation of blood vessels, a process that helps regulate body temperature.
During a hot flash, vasodilation (the widening of blood vessels) happens suddenly, flooding the skin with warmth. This rapid dilation can trigger extreme sweating, leaving you feeling overheated one moment and chilled the next.
Hot flashes in women are different experiences, but one that’s unfortunately common during menopause.
What Does a Hot Flash Feel Like?
A hot flash is a sudden and intense feeling of heat that typically starts in the upper body, often affecting the face, neck, and chest. It can last anywhere from a few seconds to several minutes.
Some women also experience accompanying symptoms such as:
Chills
Anxiety or a feeling of unease
Lightheadedness
Heart palpitations
At night, these symptoms can lead to what’s known as hot flashes at night, which can disrupt your sleep and leave you reaching for a change of clothes or sheets.
Why Do Hot Flashes Happen?
Vasomotor symptoms seem to be closely tied to hormonal changes, particularly the decline in estrogen (specifically estradiol) during perimenopause and menopause.
But why do these hormonal shifts lead to such dramatic temperature changes? Researchers have identified three primary reasons:
Increased Sensitivity to Core Body Temperature Changes:
As estrogen levels drop, your body becomes more sensitive to even minor fluctuations in core temperature. This hypersensitivity triggers your body’s cooling mechanisms, like sweating and vasodilation, even when there’s no real need to cool down.
Stress Response:
Hormonal changes can amplify your body’s stress response, leading to increased levels of norepinephrine. This stress hormone can make your blood vessels dilate more quickly, triggering a hot flash.Increased Neurokinin B Levels:
Neurokinin B, a protein that rises during perimenopause and postmenopause, plays a role in regulating hormones like GnRH (gonadotropin-releasing hormone) and LH (luteinising hormone). It also appears to directly influence the frequency and severity of hot flashes.
The Variability of Hot Flashes
Not all hot flashes are created equal. Hot flashes in women can differ in terms of:
Duration: Some last seconds, while others can stretch on for several minutes.
Severity: They can range from mild warmth to an overwhelming heatwave.
Frequency: For some, they occur once or twice a week, while others may experience them multiple times a day.
These differences can change as you transition from perimenopause to postmenopause. Genetics, lifestyle, and overall health all play a role in how hot flashes manifest. Interestingly, about 20% of women don’t experience them at all.
Factors That Influence Hot Flashes
Research suggests that certain factors may increase the likelihood or intensity of vasomotor symptoms, including:
Ethnicity: Some studies show variations in hot flash rates among different ethnic groups.
Lifestyle: Smoking, higher alcohol intake, and lower physical activity levels are associated with more severe symptoms.
Health Conditions: Higher BMI, elevated fasting glucose levels, and a history of depression or anxiety can contribute to more frequent or intense hot flashes.
Education Level: Studies suggest that women with lower education levels may experience higher rates of hot flashes, possibly due to differences in healthcare access or lifestyle factors.
Managing Hot Flashes
Understanding the causes and triggers of hot flashes can help you take steps to manage them. Here are some strategies to try:
Stay Cool: Dress in lightweight, breathable fabrics and use fans or air conditioning to keep your environment comfortable.
Identify Triggers: Common triggers include spicy foods, caffeine, alcohol, and stress. Keeping a symptom journal can help you pinpoint your personal triggers.
Practice Stress Management: Techniques like mindfulness, yoga, and deep breathing exercises can help reduce the stress response that exacerbates hot flashes.
Stay Active: Regular physical activity has been shown to reduce the severity and frequency of hot flashes at night for some women.
Talk to Your Doctor: If hot flashes are significantly impacting your quality of life, hormone therapy or other treatments may be an option.
Hot flashes are a shared experience for many women navigating menopause, but they’re not something you have to endure in silence. By understanding what’s happening in your body and exploring ways to manage symptoms, you can regain a sense of control and comfort. And remember, if you ever feel overwhelmed, don’t hesitate to reach out for support.
Book a free call with me VIVIENNE STALLWOOD today to see how I can help you manage your symptoms naturally. During our 15-minute Menopause Clarity Call, we’ll talk about your experiences and explore personalised strategies to help you feel more comfortable and in control. There’s no pressure, just an opportunity to connect and find the support you deserve.
