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What is causing all these hot flashes - Ogden Clinic provided source, Standard-Examiner 08/07/2014

(Standard-Examiner) OGDEN -- Going through menopause? You may want to lay off the caffeine.

A new Mayo Clinic study found caffeine intake causes more bothersome hot flashes and night sweats in postmenopausal women.

On the flip side, the study also found perimenopausal women have fewer problems with mood, memory and concentration if they consume caffeine.

"The true cause of hot flashes is unknown," said Dr. Kirk Lammi, an obstetrician and gynecologist with the Ogden Clinic. "They are thought to be due to a problem with the body’s thermostat due to estrogen withdrawal. Caffeine is a stimulant that might disrupt the body’s ability to regulate this thermostat resulting in hot flashes."

Hot flashes are related to changes in the hypothalamus, Lammi said. This is a part of the brain that controls the body’s temperature. Once the hypothalamus thinks the body is too warm, there is an increased amount of blood flow to the skin. This causes sweating that cools the body down. The body shivers to restore the body temperature.

"Hot flashes start as a sudden sensation of heat on the face and chest that radiates out to the body," Lammi said. "The sensation of heat lasts between two to four minutes. Hot flashes will sometimes cause profuse perspiration followed by chills and shivering."

Lammi said hot flashes can occur as few as one time per day and as much as one time per hour. They can also cause arousal from sleep resulting in an unrestful night.

Approximately 85 percent of the U.S. population consumes some form of caffeinated beverage according to the study. About 79 percent of perimenopausal and 65 percent of postmenopausal women suffer from them.

"Caffeine is a central nervous system stimulant," said Dr. Steven C. Meek, an OB/GYN at Tanner Clinic. "The hot flash is centered in the central nervous system. The link of caffeine to the hot flash is similar to the link of caffeine to other mood disorders, such as premenstrual dysphoric disorder."

Meek said there is no known prevention of hot flashes, but limiting caffeine may certainly help limit the severity. Limiting alcohol, tobacco, hot drinks and spicy food can also help in addition to stress reduction and dressing in layers.

Lammi said yoga, massage and acupuncture have the potential to reduce hot flashes, as does losing weight if needed and avoiding foods with monosodium glutamate (MSG).

There are a variety of hormonal and non-hormonal treatments for menopausal hot flashes, said Lammi. Estrogen hormone therapy is the most effective therapy to treat hot flashes. "Estrogen hormone therapy stops 80 percent of hot flashes. There are some antidepressants effective at reducing hot flashes. Venlafaxine, citalopram and paroxetine can reduce hot flashes by as much as 60 percent."

Lammi said Gabapentin, a medication that treats seizure disorder, and the blood pressure medication, clonidine appears to be effective in reducing the frequency of hot flashes. High doses of progestins appear to be effective to decrease the number of hot flashes as well.

"The North American Menopause Society does not recommend the use of custom-compounded bioidentical hormone therapy," Lammi said. "The active ingredients of custom compounded hormones are government approved, but the mixtures are not. There have been no studies that prove that these products are safe."

Lammi also said it’s not clear if any natural treatments are harmful.

"The safety and efficacy of these therapies aren’t known. The studies have shown the natural treatments such as ginseng, dong quai, evening primrose oil, and wild yam are not effective at reducing hot flashes any more than placebo," he said. "In addition, phytoestrogens like soy supplements, flaxseed and red clover may stimulate breast cancer growth."

Meek agrees.

"Natural treatments are assumed to be safe because they are 'natural'. This is a misconception," Meek said. "They are drugs and can have side effects. Bio-identical estradiol is a well studied safe treatment for hot flashes which can be taken safely for up to five year with no increase in breast cancer risk."

Meek and Lammi said other things you can do to help with hot flashes include trying to stay cool during the day and while sleeping. Dress in layers during the day and light cotton pajamas at night in bed. Use layered bedding that can be adjusted at night. Use sheets and garments that absorb moisture from the skin onto the surface of the fabric where it evaporates and use a ceiling fan or keep a portable fan at your bedside.