Hot flashes and night sweats are something we often work with in women’s health and fertility. Sometimes it happens after a woman has taken fertility medications; sometimes it happens gradually or sporadically. It can happen toward the end of our reproductive years, and it can happen during pregnancy. Sometimes the discomfort is limited to a few surges of heat during the day; but some women wake in the middle of the night and have to change their soaked bedsheets. These symptoms can sometimes happen because of illness or infection, but if they occur due to hormonal factors, the cause is usually attributed to a change in estrogen levels.
THE BIOLOGY OF HOT FLASHES AND NIGHT SWEATS
Control of the body’s internal core temperature, referred to as thermoregulation, is regulated primarily in an area of the brain called the hypothalamus. When estrogen levels in the body drop (either from high levels to normal levels as seen with fertility medications, or normal levels to low levels as seen around menopause) they trigger the release of noradrenaline from the adrenal glands. This “estrogen withdrawal” is a interpreted as a stress to the body. It activates the body’s sympathetic nervous system (the “flight or fight” response), and results in the hypothalamus narrowing the window of body temperature in which we feel comfortable. If the body also sweats, it is because a hormonal cascade has been triggered to actually cool the body down. Factors which stress the body (smoking, emotional stress, alcohol, overwork, poor sleep) tend to make the hot flashes and night sweats worse.
MENOPAUSE AND HORMONE REPLACEMENT THERAPY / BIOIDENTICAL HORMONES
Menopause is best defined as when a year has passed since the last menstrual period. By this point, ovarian function has largely ceased as a woman enters her mature life following her reproductive life. It is normal during this time to see lower estrogen and progesterone levels. Perimenopause is best defined as the period of time before and for a year after the last menstrual cycle. Women’s ovaries at this stage are often making more estrogen than normal, but less progesterone (1). Because the pituitary gland releases the FSH hormone (which stimulates the ovarian follicles, producing estrogen) in a “pulses” or “bursts” (2), it is believed that these inconsistent estrogen levels in perimenopausal women are to blame for the hot flashes or night sweats symptoms.
The conventional therapy, therefore, for menopausal and perimenopausal women has been to replace their estrogen levels to reproductive levels using synthetic or animal derived hormones (called HRT, or Hormone Replacement Therapy). However, some serious side effects and dangers (such as cancer and blood clots) have been reported with synthetic estrogen therapy. Bio-identical hormones, which are derived from plant sources and are identical on a molecular level with naturally occurring estrogen in humans, are being used more frequently because of their lower risk for side effect and greater treatment efficacy (3).
CHINESE MEDICINE AND HEAT – EXCESS OR DEFICIENT
In Traditional Chinese Medicine theory, feelings of heat in the body can be due to either too much of something (known as Excess Heat) or too little of something (known as Deficient Heat). Pathogenic heat can build up in the body from poor circulation, diet, external invasion (immune system response) or toxins; the principle of treatment through acupuncture, herbal medicine, and diet in these cases would be to clear heat, promote circulation, and relieve toxicity. Heat can also be a result of an inadequate cooling system; the principle of treatment in these cases would be to nourish and “moisten” the body to help quell the fire.
In my experience, those women who are going through fertility treatments, or who are in their perimenopausal transitions tend to show heat signs which are more of the “excess” type; they find relief from symptoms if we can restore smooth circulation in their body, vent some heat, and minimize their body’s sympathetic nervous system stress response. Women who are truly menopausal often present with more “deficient” heat signs, and benefit most from nourishing the blood and fluids (Yin) to damper and contain the heat (Yang). However, just as every woman and their journey is different, so too are their patterns of disharmony. A complete treatment plan should include all aspects of health when implemented.
NATURAL TREATMENT OPTIONS
If you are interested in natural methods of alleviating hot flashes and / or night sweats, arrange for a 15 minute phone consultation to see what might work best for you.
Acupuncture, Chinese Herbal Medicine, dietary advice, and Bioidentical Hormones are all treatment possibilities available from Yinstill Reproductive Wellness.
Call 604-873-9355 or email firstname.lastname@example.org to set up a free 15 minute consult with Dr. Erin Flynn.