When morning comes, I’m too exhausted to face the day. It’s a never-ending cycle that has affected my ability to concentrate and carry out everyday activities. It has even affected some of my relationships. But I know I’m not the only one.
Vasomotor symptoms (VMS) of menopause – also called hot flashes and night sweats – occur in up to 8 in 10 women and can last 8 to 10 years. They are the main symptom of menopause and can affect your daily life.
The average age of menopause in the United States is 51, but VMS can begin as early as the late 30s and last into the 70s. Hot flashes usually only last a few minutes, but can occur anytime, anywhere, and from one to ten times a day. Black women suffer from VMS longer and at higher rates than any other racial and ethnic group.
What causes VMS?
During perimenopause and menopause, many women experience fluctuations in the hormone estrogen. This hormone helps manage temperature fluctuations in your body. “Changes in our hormone levels affect areas of the brain responsible for temperature regulation,” said Robin Noble, MD, chief medical advisor for Let’s Talk Menopause.
When your estrogen drops, your body expects its core temperature to rise. Your blood vessels begin to dilate and you begin to sweat to release heat. Your skin may become clammy and you may experience heart palpitations and feelings of anxiety. The face, neck and chest may also be red.
We now know that hormone fluctuations are the main cause of hot flashes. But other triggers for hot flashes include:
- Spicy food
- Warm weather
- Heavy clothing
- stress
- alcohol
- Smoke
- Be overheated
- Certain medications
VMS can affect your quality of life
Almost half of women rate their VMS as moderate to severe in the first two years after their last period. Moderate symptoms include mild sweating and usually do not cause major disruption in a woman’s life. But severe VMS can make it difficult to concentrate on everyday activities like going to work and running errands.
VMS can be disruptive and outwardly embarrassing. “You feel uncomfortable, you blush and you have redness. For a lot of people, it can cause them to get stuck,” Noble said. It’s not easy to concentrate on what you’re doing when your face turns red and your body suddenly feels like a furnace.
VMS can also disrupt sleep, contribute to anxiety, and negatively impact relationships. “It impacts families, intimacy, our relationships with the outside world and certainly the workplace,” Noble said. You may not feel able to go out with friends or be intimate with your partner as you try to manage symptoms.
VMS can even affect your diet and ability to exercise. If you’re experiencing a lack of energy because you’re having trouble sleeping due to night sweats, you may not make healthy food choices or feel like moving your body the next day.
Dealing with VMS symptoms
Fortunately, there are ways to relieve VMS symptoms. lifestyle changes such as losing weight; eat a healthy, plant-based diet; avoiding alcohol, hot drinks and caffeine; and quitting smoking can help. Adjusting the temperature in your bedroom at night, sleeping with the fan on, and drinking cold water before bed are other ways to relieve VMS.
Noble recommends dressing in layers so you don’t have to sweat through your clothes. She also recommends predicting when hot flashes are most likely to better prepare for them. “The more people understand what’s going on, the stronger they are,” she said.
The Menopause Society also suggests that cognitive behavioral therapy and clinical hypnosis may be helpful. If these strategies don’t work, you should talk to your doctor about medication. Studies show that hormone therapy can control hot flashes and has the added benefit of supporting cardiovascular and bone health.
There are also non-hormonal medications called neurokinin receptor antagonists that have been approved by the FDA as an option for treating menopausal hot flashes. Additionally, an antidepressant is FDA-approved to treat hot flashes. “We have a lot of options and can tailor it to the person and their preferences,” Noble said.
When should you see a healthcare provider for VMS?
One study found that VMS is the number one reason women make an appointment with their HCP. However, Noble recommends scheduling a consultation before you experience symptoms of perimenopause. She advises her own patients when they are in their late 30s or early 40s.
Scheduling an appointment with a doctor before bothersome symptoms appear can help you feel more prepared. Having these conversations earlier can also help you figure out whether you’re at increased risk of other menopause-related problems, like osteoporosis or cardiovascular disease, according to Noble. “It is important to get reliable information and not get sucked into all areas of the internet that sell supplements and other menopause products that may not be effective.”
Speak openly and honestly with your doctor about your symptoms and concerns. If you feel like your symptoms aren’t being treated, it’s time to find another provider. There are so many options available that no one should have to bother with VMS.
This educational resource was created with support from Astellas, a member of the HealthyWomen Corporate Advisory Council.
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