Research: SHAW, Marquette Universit

Listed in Issue 24


SHAW, Marquette University College of Nursing, Milwaukee, Wisconsin USA writes that the hot flash (flush) (HF ) or vasomotor instability is experienced by 75% of perimenopausal and menopausal women in the US.




While in some women HF are a minor annoyance, for others HF is intensely unpleasant and disruptive to their lives. HF is thought to be triggered by various external and internal stimuli including anxiety, stress, ambient high temperatures, caffeine and alcohol. Thinner women tend to experience more severe and frequent HFs than women with more fatty tissue, probably due to the ability of fatty tissue to transform androstenedione to oestrone and oestradiol. Smoking history tends to be associated with the experience of HFs at an earlier age. The aetiology of HFs in the decreasing oestrogen state is associated with a downward resetting of the hypothalamic thermoregulating mechanism, via norepinephrine, which is usually modulated by oestrogen. When the body attempts to dissipate unwanted body heat by vasodilation, this causes the sensation of the HF. The most successful treatments have been hormone replacement therapy with oestrogen and progesterone, although alpha 2-adrenergic blockers have also shown some limited effectiveness. There is anecdotal support for many alternative therapies including vitamin E, evening primrose oil, dong quai and black cohash, but these have not been thoroughly studied. Relaxation, exercise, avoidance of triggering factors and control of external environment have all be used with some success by women.



Shaw CR. The perimenopausal hot flash: epidemiology, physiology, and treatment. Nurse Pract 22(3): 55-6; 61-6. Mar 1997.

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