AARP Eye Center
If you’re menopausal and getting your advice from your mom, an older friend or even a doctor who’s failed to keep pace with changes in the field, you might be receiving some pretty outdated information. One clue you’ve been ill-informed? You think hot flashes will disappear in a year or two, or that hormonal treatments used to treat them are quite dangerous.
It’s true that hot flashes aren’t a long-lasting problem for everyone, and there are certainly some women who may be better off avoiding hormones. But research now shows that this very bothersome perimenopausal or menopausal symptom lasts, on average, about seven years, though it can be far longer for some women. Studies also suggest that hormone therapy is relatively safe and effective for most women, especially those in their 50s, says Stephanie Faubion, M.D., medical director for the North American Menopause Society.
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“A lot of doctors are scared because they don’t have the updated information,” she says, adding that a particular study called the “Women’s Health Initiative” influenced the thinking of a medical generation.
In 2002, researchers stopped a part of that study after finding a small increased risk of breast cancer and cardiovascular disease among women on hormone therapy. As a result, droves of menopausal women stopped using hormones, and many doctors became disinclined to prescribe them. Yet by 2007, additional analyses of the data revealed that some of the risks were overhyped and that hormone therapy might even have health benefits for women in their 50s.
Whether or not you’re interested in trying hormones, the fact remains that hot flashes are often long-lasting, potentially debilitating and not something you necessarily have to live with.
What’s behind a hot flash (or years of them)
Experts are still sussing out exactly what causes hot flashes, but they know in broad terms that it involves declining estrogen and the impact that it has on the hypothalamus, which acts as your internal thermostat. The hypothalamus controls your “thermoneutral zone,” which is the temperature range in which you’re not shivering or sweating. Experts believe the menopausal transition slightly raises core body temperature and shrinks the thermoneutral zone so that it becomes easy to go from comfortable to overheated in an instant.
During a hot flash, your face, neck and chest might feel warm or turn red, your heart might beat faster and, yes, you’re going to sweat, because that’s your body’s way of cooling down.
As unpleasant as they are, there’s also emerging evidence that hot flashes may spell bad news for your health. Research published in the Journal of the American Heart Association earlier this year found that women who experienced them more frequently in their 40s or early 50s were more apt to have a heart attack, stroke or other serious cardiovascular event during the subsequent two decades. Whether treating hot flashes would be protective is still unclear, says Faubion.