Hot flushes are consistently reported as the most common symptom during the menopausal stage in women with approximately 75% of menopausal women experiencing them. Severity and frequency can vary widely between women, with some women finding their day to day life is affected.
What causes a hot flush?
It is not fully understood what causes a hot flush, however, research suggests that hot flushes are associated with altered hormone levels (oestrogen, progesterone and other hormones) as well as alterations in how the body regulates temperature (1).
The brain, or more specifically, the hypothalamus plays a central role in regulating body temperature. Each person has what it known as a ‘thermoneutral zone’, within which any fluctuation in body temperature does not cause sweating and flushing or shivering. Flushing appears to occur as a result of disturbance of the hypothalamus, and possibly by a reduction in the persons ‘thermoneutral zone’ (2).
Oestrogen appears to be critical to this process; supported by the positive results obtained via oestrogen therapy. The exact mechanism of action oestrogen has on hot flushes, however, is unknown (2).
So what role does stress have to play? It is thought that stress, or more specifically the hormone adrenaline, which is secreted during stress, may narrow the ‘thermoneutral zone’, increasing a persons risk of a hot flush (3).
To provide some evidence of this possible connection, a cohort study followed 233 women over 14 years and assessed hot flush frequency and severity, hormone levels, anxiety symptoms amongst other measures. The study found that women with high perceived anxiety had a greater risk of hot flushes (4).
Due to the close relationship between hot flushes and stress, it remains unclear whether stress is a cause or consequence of hot flushes.
How can we manage stress/anxiety in relation to hot flushes?
We know that stress increases circulating adrenaline which is the hormone potentially involved in exacerbating the hot flush, so how do we reduce it?
Deep, slow breathing is thought to help to reduce levels of this hormone and facilitate relaxation; so could be an easy technique to employ in the management of hot flushes.
A randomised controlled trial in 68 women over 9 weeks found that a 52% reduction in hot flushes in women undertaking a breathing technique of 6 breaths/minute for 15 minutes twice per day (5).
The 6 breaths/minute technique is easy to do and involves breathing ‘in for 4 counts’ and ‘out for 6 counts’ for 15 minutes twice per day…. so why not give it a go!!
Menopause and its relating symptoms are complex and individual. In addition to the above information there are many other potential recommendations that could be made to support you through menopause.
1 Freedman, R. R. (2014). Menopausal hot flashes: mechanisms, endocrinology, treatment. The Journal of Steroid Biochemistry and Molecular Biology, 142, 115–20. https://doi.org/10.1016/j.jsbmb.2013.08.010
2 Sturdee, D. W. (2008). The menopausal hot flush—Anything new? Maturitas, 60(1), 42–49. https://doi.org/10.1016/j.maturitas.2008.02.006
3 Gast, G.-C. M., Grobbee, D. E., Pop, V. J. M., Keyzer, J. J., Wijnands-Van Gent, C. J. M., Samsioe, G. N., … Van Der Schouw, Y. T. (n.d.). Menopausal Complaints Are Associated With Cardiovascular Risk Factors. https://doi.org/10.1161/HYPERTENSIONAHA.107.106526
4 Freeman, E. W., & Sammel, M. D. (2016). Anxiety as a risk factor for menopausal hot flashes: evidence from the Penn Ovarian Aging cohort. Menopause (New York, N.Y.), 23(9), 942–9. https://doi.org/10.1097/GME.0000000000000662
5 Sood, R., Sood, A., Wolf, S. L., Linquist, B. M., Liu, H., Sloan, J. A., … Barton, D. L. (2012). Paced breathing compared with usual breathing for hot flashes. Menopause: The Journal of The North American Menopause Society, 20(2), 1. https://doi.org/10.1097/gme.0b013e31826934b6