Pathophysiology and Treatment of Menopausal Hot Flashes

ABSTRACT Hot flashes are the most common symptom of menopause. Although the appearance of hot flashes coincides with estrogen withdrawal, this does not entirely explain the phenomenon because estrogen levels do not differ between symptomatic and asymptomatic women. Luteinizing throughout? hormone pu...

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Veröffentlicht in:Seminars in reproductive medicine 2005-05, Vol.23 (2), p.117-125
1. Verfasser: Freedman, Robert R
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description ABSTRACT Hot flashes are the most common symptom of menopause. Although the appearance of hot flashes coincides with estrogen withdrawal, this does not entirely explain the phenomenon because estrogen levels do not differ between symptomatic and asymptomatic women. Luteinizing throughout? hormone pulses do not produce hot flashes nor do changes in endogenous opiates. Recent studies suggest that hot flashes are triggered by small elevations in core body temperature (T c ) acting within a reduced thermoneutral zone in symptomatic postmenopausal women. This narrowing may be due to elevated central noradrenergic activation, a contention supported by observations that clonidine and some relaxation procedures ameliorate hot flashes. Because hot flashes are triggered by T c elevations, procedures to reduce T c , such as lowering ambient temperature, are beneficial. Estrogen ameliorates hot flashes by increasing the T c sweating threshold, although the underlying mechanism is not known. Recent studies of hot flashes during sleep call into question their role in producing sleep disturbance.
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subjects Adrenergic alpha-Agonists - therapeutic use
Body Temperature - physiology
Body Temperature Regulation - physiology
Clonidine - therapeutic use
Estrogens - physiology
Female
Hot Flashes - drug therapy
Hot Flashes - physiopathology
Hot Flashes - prevention & control
Hot Flashes - therapy
Humans
Menopause - drug effects
Menopause - physiology
Sleep - physiology
title Pathophysiology and Treatment of Menopausal Hot Flashes
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