GRAND Magazine - May/June 2018 - 10

women's health

Kiss Hot Flashes Goodbye!
BY MARGARET NACHTIGALL, M.D.

Q. Some women experience hot flashes from
their 40s well into their 60s. What percentage of women have this experience and is there
anything outside of HRT that reliably makes a
difference?

A. Hot flashes are really the hallmark of menopause and
are the most common symptom women experience during
menopause. There was a recent practice bulletin for physicians published by the American College of OBGYN and they
said that approximately anywhere from 60-82% of women will
experience hot flashes during a natural menopause. So, they
are a very common symptom of menopause. Therefore, many
women experience hot flashes. Women vary on the age they
enter menopause, the average age is 51, but can range from
45 to 55 and many women will start experiencing hot flashes in
their 40s.
There are definitely many treatment options for women who
are experiencing hot flashes. One of the most common and
effective treatments that alleviates hot flashes is estrogen, or
hormone therapy. Estrogen can make a huge difference in lowering the number of incidents of hot flashes. Some women do
not want to take hormone therapy (HT) or cannot because it is
contraindicated for them. For these women, there are non-hormonal options, including prescription medication as well as
over-the-counter products that can be helpful.
There is increasing evidence that the antidepressant agents
SSRIs and SSNRIs are effective for the treatment of flushes
associated with menopause. Gabapentin and Clonidine have
also shown some benefit in decreasing hot flashes during
menopause.

10 GRAND

MAY JUNE 2018

Over-the-counter options are also available to aid in the treatment of hot flashes.
Femarelle is an excellent non-hormonal option
for women It is made from an extract from
soy, DT56a, but is not soy, combined with flax
and other ingredients. When taken by women,
it binds to the estrogen receptors and so the
body thinks there is estrogen, but there is
not. It can really make a difference in
reducing hot flashes and alleviating a lot of the symptoms that
go along with menopause, so
this is an attractive option
for many women. Relizen is
another OTC product which
has shown promise in reducing
hot flashes. I recommend that
women discuss options with
their physician to see what is
best for them. No two women
are the same and individualized
care is ideal when choosing the
right help for menopause.

Q. Do diet and exercise
play any real part?

A. I really feel like a healthy diet
and exercise play a role in everything.
I'm a huge proponent of getting some
exercise, even if it is a small amount every

day. You really do see that a healthy diet which
has enough protein and has good amounts of
vitamin D makes a difference. Exercise certainly
has been shown to improve overall health; better
for the heart, better for the brain and may have
some effect on reducing hot flashes. Exercise
and diet definitely play a role and definitely improve your health.

Q. Why do some
women suffer while
others never experience a hot flash?
What is the physical explanation for
that?

A. Women are all
so different. We still
don't 100% understand the mechanism of a hot flash,
but when women
go into menopause,
or when their estrogen levels become
really low, there is a
change in the thermoregulatory zone. Women will feel hot
at lower temperatures and
cold at higher temperatures,
Continued on next page



GRAND Magazine - May/June 2018

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