Menopause & Hot Flushes

“What I would say, which I’ve said to myself and to girlfriends who’ve also experienced hot flushes, in particular, is that change is part of being human. We evolve and should not fear that change. You’re not alone.” ~ Kim Cattrall

Quite right, too, Kim.

Before we can embrace that all-important change, it can help to understand what’s actually going on for us during a hot flush.

Hot Flushes Explained

Hot flushes can sometimes come out of the blue, and for many women they can cause anxiety, embarrassment, stress and also impact sleep. Often hot flushes are almost the first thing that women talk about when it comes to menopause. In fact, they’re probably one of the most common and recognisable symptoms that impacts three in four women (1). Although they can happen at any point during menopause, according to the British Menopause Society, they are most commonly experienced one year after menopause once your periods have stopped (2).

A hot flush is basically similar to how it sounds. They can come on very suddenly and there’s usually a feeling of intense heat that can spread throughout your face, neck, chest and body. Hot flushes might be episodic (one-off episodes, now and then) or periodic (in regular cycles). They might last for a few seconds, minutes or up to an hour for some. Some might experience them a few times a month while others have several daily. Some women feel cool before the hot flush occurs. Others might perspire, feel light-headed or experience heart palpitations. 

It can sometimes catch you off-guard but it’s a perfectly normal occurrence for some during menopause. They can happen any time – in a meeting, in Sainsbury’s or during the night. Some women experience them for around four years and others have been reported to have hot flushes for decades (3). Night sweats are similar to hot flushes. Some women find that they wake several times in the night soaked in sweat and may need to change their clothing or bed linen. 

In earlier stages of menopause, 40 per cent of women have hot flushes around their periods, and later in menopause, up to 80 per cent will have had an experience of them at some point or another (4). If you experience hot flushes, they may not impact your life very much, for others it can disturb sleep and cause stress, anxiety and embarrassment. 

Your Biological Thermostat in Menopause

We don’t know exactly why they happen. One theory around why hot flushes occur is linked to dropping oestrogen levels which affects the brain and influences another hormone, noradrenaline, which regulates the body temperature. Low noradrenaline levels can cause your body core temperature to rise, resulting in a hot flush (5). 

It’s not just the heat that the body struggles to regulate, at times, but there are also sometimes cold flushes. These can occur after a hot flush as a way to seek balance, though you may notice chills. We also know that our mind can have an impact on the experience of hot flushes too. Research shows that up to forty per cent of women see an improvement when using a placebo (6). (Never underestimate the power of a placebo!)

Hot flushes can also impact the mind. Firstly, the fluctuating oestrogen levels can cause your brain to think that your overheating, and most commonly, having a hot flush at work or in public (and even at home) can sometimes cause anxiety. Some women worry what others might think, and for others, it can bring on worry that a hot flush will occur at night and  disturb your sleep. Plus, having a hot flush can just make you feel a bit hot and bothered. 

Noticing Lifestyle & Behavioural Patterns

We spoke to our Clementine community who told us that menopause had impacted their anxiety and mood, and most found it difficult to untangle the impact from the other things happening in their lives. For many women, there’s a sense that life events can exacerbate symptoms. 

Also little things like spicy food, and even a glass of wine (or any alcohol), caffeine and hot drinks can trigger hot flushes. For others, stress, changes in temperature/season, obesity and certain health conditions can also set them off. 

Some women have also reported that stress, smoking and tight clothing can also exacerbate or trigger a hot flush, so it’s about learning to notice patterns. You might like to keep a menopause diary to track your hot flushes, and when, where and how these occur for you.

Reframing Hot Flushes

Did you know that hot flushes are viewed in different ways, depending on the culture? Some countries see hot flushes as a sign of wisdom and deeper insight, something which is afforded to you in your next chapter in life. It’s a rite of passage, if you like. The key is to work with your mind and body to unlock your strength, resilience and inner power. You might like to consider your hot flushes as Wise Woman Waves flowing through your body.

How Hypnotherapy Helps

There’s strong evidence to show that hypnotherapy, Cognitive Behavioural Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) can reduce or eliminate hot flushes. One study showed that hypnosis reduced hot flushes by a staggering 74 per cent (7). Ultimately taking steps to reduce stress will reduce the chance of having hot flushes. In addition, through switching on your ‘cooling system,’ this will reduce stress and anxiety. Another study, Mind Control of Menopause (8), revealed that hypnosis is an effective and promising intervention for hot flushes, with a potential to improve quality of life and insomnia.

Hypnotherapy often includes breathing techniques and these can help turn your awareness towards your body, anchoring you to stay present and calm, supporting your cooling system. A daily practise is ideal for ensuring that you can go to sleep, clear your mind of troubling thoughts and feelings. The trick with this is finding an easy way for you to incorporate some sort of relaxation ritual each day. All you need to do is tap into your powerful and brilliant imagination. That’s where Clementine app comes in.

What Else Cools a Hot Flush

Hormone replacement therapy (HRT) replaces the hormones that are missing. Most symptoms, including hot flushes, are caused by low oestrogen levels, so this is the most important hormone to replace. Also, the womb needs progestogen to protect the lining of the womb, these two factors combined is why the NHS consider HRT to be effective at relieving menopausal symptoms (9).

For many HRT can be a godsend. For others, there are also a range of things you can try to manage these symptoms yourself. Luckily, lifestyle changes can make a difference to your experience of these vasomotor (VSM) symptoms of menopause. Things like stress reduction, improved diet and good sleep can help you cope with hot flushes. There are other nifty changes you can make such as using things like a cooling pillow, scarf or choosing cooler/looser fabrics for your clothing.

How Our Sessions Help

Do you throw off the covers and move about in bed to find a ‘cool spot’? Are night sweats or hot flushes a source of stress that impacts how you feel the next day? This session is perfect for you. Designed to help alleviate hot flushes and night sweats during menopause, to improve the quality of your sleep by helping you stay cool and calm, switch off and get back to sleep. 

Play Cool down and get back to sleep: Cool down after a hot flush and get back to sleep

Sources:
(1) Women’s Health Concern (2015) The Menopause. Marlow: WHC
(2) British Menopause Society
(3) Freedman R R(2013) Menopausal hot flushes: mechanisms, endocrinology, treatment. Journal of Steroid  Biochemistry and Molecular Biology 142: 115-20.
(4) Mindful Menopause by Sophie Fletcher, P.224
(5) Cancer Research UK (2018) Hot flushes and sweats in women
(6) Mindful Menopause by Sophie Fletcher, P.225
(7) Mindful Menopause by Sophie Fletcher, P.225
(8) Mind control of menopause
(9) NHS