Choosing NOT to Suffer with Hot Flashes

Have you felt embarrassed at work because you break out in a sweat for no reason and look flushed?

Do you wear a fan around your neck?

Does your partner wear additional layers to bed at night because you’ve made the house into an ice box to ease your symptoms?

Those are vasomotor symptoms.

Vasomotor symptoms is the clinical term for the hot symptoms of the menopausal transition, the hot flashes and the night sweats.

As a patient once told me, “it’s not a hot flash, it’s internal combustion.”

The best treatment for these symptoms is Hormone Replacement Therapy (HRT).  After a study released in 2002 showed an increased risk in breast cancer among users of HRT, the prescriptions and use of HRT took a nosedive.  There is still a pervasive fear of hormones in society because of this study, 22 years later.

The obvious problem with vasomotor symptoms is they are bothersome. They interrupt daily activities.  They interfere with quality of life.

I used to tell patients that if it doesn’t bother you, then it doesn’t bother me.  If it gets to the point that it is interfering with daily activities or quality of life, come back to my office to discuss treatment.

I have had to change my tack here a bit for a couple of reasons.

The first is these vasomotor symptoms can last a long time.  The average duration is 7 years.  7 years!  This astounds me.  For some, especially Black women, this can be up to 10-14 years.

The second is because we are learning that vasomotor symptoms are more than just bothersome.  They’re not as benign as we once thought, though we’ve always known that they suck.

We are learning now that having vasomotor symptoms, in addition to age and being menopausal, can lead to osteoporosis, diabetes, and heart disease - you know, that thing that will kill most of us.

The other change is talking to patients about HRT and non-hormonal treatments for vasomotor symptoms.  HRT is the most effective, but some people are unable or unwilling to use HRT.  Through teaching myself about menopause and its management (it really is not taught in residency), I’ve learned how to discuss the options with patients in an accurate, individualized way.  There is a growing list of non-hormonal treatments, so not all is lost if you are unable or unwilling to use HRT.

The good news is, there is treatment.  Choose to talk to someone about the options!  Choose your short-term and long-term quality of life.

Resources:

Study of Women’s Health Across the Nation study

Midi health webinar 8/29/2024