Heat Wave:
Battling Hot Flashes and Night Sweats with Wit and Grit
Vasomotor Symptoms of Menopause (Perimenopause) or VMS is like a prankster...
... (not the funny kind) living inside you and playing with your internal thermostat. The erratic nature of your temperature is frustrating enough, never mind having to experience the physiological aspects of your body overheating. So, what is VMS other than something that turns you from just a ‘hot’ tamale into a ‘hot and messy’ tamale?
First, let’s remember you are fabulous no matter how much you’re overheating.
Now, let’s get to the bottom of VMS. During perimenopause and menopause hormones fluctuate and decline, and it becomes hard for your brain to regulate temperature, disrupting your thermoregulatory system.
The physiology of VMS is complicated and not fully understood.
Estrogen is involved — if it weren't, estrogen therapy wouldn't relieve vasomotor symptoms as well as it does — but it's not the whole story. For example, researchers have found no differences in estrogen levels in women who have hot flash symptoms and those who don't.
Some research indicates follicle stimulating hormone (FSH) which becomes elevated in menopause may play a role. Most research has been conducted on menopausal (post menopausal) women.
Focusing on perimenopause might shed light on the causes of hot flashes and open the way to new treatments. Regardless, VMS happen during menopause, and it is not fun. VMS can seriously impact our quality of life.
VMS comprises a group of symptoms that includes:
- Hot flashes
- Night sweats
- Heart palpitations
- Increased sensitivity to temperature changes
The term hot ‘flash’ is inadequate as a description for something that comes on as a wave of heat building from the head, neck, chest, and arms, and spreading across the upper body. You don’t just feel hot, but your skin actually warms. Hot flashes range in severity from a fleeting sense of warmth to a feeling of being consumed by fire "from the inside out."
The rapid increase in temperature results in excessive sweating and flushing. It can also result in nausea, confusion, and anxiety. Moreover, VMS are more than a ‘flash’. Although they come on rapidly, they last on average from two to four minutes as the body cools through vasodilation. Given you were not excessively hot to begin with, the body temperature drops more than it needs to, creating chills and shivering in some women. If you feel like your thermostat is on a roller coaster, it’s because it is.
This can happen on average four to five times a day, and for some women, more than 25 times a day. VMS can impact sleep, mood, concentration and is one of the biggest contributors for women citing challenges at work. How are you supposed to be productive without sleep, while feeling out of sorts, and anxious about what is happening to your mind, body, and spirit!?
If your phone autocorrected your messages introducing embarrassing typos four to five times a day, would you keep using it without checking the settings?
In the same way, you need to address the “settings” of VMS rather than simply ‘dealing’ with them, especially if they are impacting your quality of life.
To make matters worse, there are no predictable triggers for when and why VMS occur. But we do know they are among the most common experiences of perimenopause and menopause.
| Stage of Menopause | Percentage of Women Reporting Symptom |
| Menopause Continuum | 80% |
| Perimenopause | 35% - 50% |
| Menopause | 75% |
Are Hot Flashes and Night Sweats the Same?
Night sweats and hot flashes are grouped together as vasomotor symptoms of menopause (VMS). Night sweats have been described as hot flashes that occur at night. However, some recent evidence suggests they may occur for different reasons.
A hot flash can occur during the day or night and may or may not be associated with sweating, whereas night sweats are periods of intense sweating that occur at night. A night sweat results in you waking up completely soaked in sweat through your pajamas and bed sheets. It is a more intense sweating than a hot flash.