Hot Flash Theories in a Nut Shell!
There are a 4 theories behind why women get hot flashes. They have all been well studied by research doctors and are ALL at least partially right - within their own particular times and situations. And it is helpful for you to know them so you can kick em' in the booty!
First for a quick review:
Hot flashes are strong and sudden sensations of heat on mostly our chest, neck, and face that last about 5 minutes but sometimes longer – up to 10 minutes! They are sometimes associated with heart palpitations About 40 - 70% of women have to deal with these frustrating symptoms during their perimenopausal years - which may go on for a year or two after menopause or even longer!
In fact, a fairly high percentage of women (about 10%) deal with hot flashes for many years beyond menopause. I had one lovely lady in her 90’s still suffering from hot flashes, even breaking out in a sweat in front of my eyes.
And as you know... Hot flashes affect the quality of our life, interfering with both our work and leisure time. It is totally frustrating to be overcome by something you have no way to stop or control!
When a hot flash attacks you, blanketing you with a FRICKEN hot, annoying, body, neck and head flame from the inside out… you want to jump up and strip off your clothes!
If you’ve ever had a hot flash, you know what I mean!
Ugh… I think the worse hot flashes are when you are with others and are forced to sit still - and pretend that you’re fully listening, while your face flushes and sweat beads up on your forehead and drips down your back… (and yes… into your crack!)… you want to say… “REALLY? Where's the candid camera?"
It can be totally embarrassing and distressing! Yes, we have to admit… hot flashes are most definitely associated with negative effects on our mental and emotional wellbeing!
So, what causes them anyway? What is actually happening inside the body that brings these boogers on so quickly?
There are a basically 4 theories behind why women get hot flashes.
The FIRST theory is called the “Thermoregulatory Theory” and one you likely have heard me and other physicians talk about.
As we get closer to menopause, we hit the “Perimenopausal” time of our life-cycle. Progesterone has already been declining a long before this time (about 10 years sooner) and so a woman who has not supplemented with Progesterone during her EDD (Estrogen Dominant DECADE) is Progesterone deficient and thus already dealing with an imbalance between her Progesterone and Estrogen. Basically, her hormones are already “wack-a-jobbed”!
She has already lost the balance between these primary female hormones and now she enters the phase where her Estrogen starts to decline.
UNFORTUNATLEY the decline isn’t all that smoothly in women. The decline of Estrogen doesn’t just slide downhill like you would imagine sliding down a water slide or a swing set slide. Instead the slide is more like a rollercoaster heading down from its peak height – as it plummets down toward the ground… it also has an up and down “hilly” ride!
So not only is the Estrogen heading downhill, it’s also fluctuating up and down the downhill slide causing a totally confusing signal to the brain.
When the brain senses the Estrogen declining rapidly, it constricts the blood vessels. (Estrogen normally DIALATES blood vessels and this is one of the other reasons it is good for the heart and brain!). Anyway… when the brain suddenly constricts blood vessels, not only can palpitations occur, the body HEATS UP quickly.
THEN guess what happens. Well you know the sweat that starts pouring down your temples?
When the brain then recognizes your body is HOT… it tries to cool itself off as quickly as it can and so it will rapidly DIALATE your blood vessels and produce a sweat to cool off the skin. UGH… SWEAT.
And NOW come the CHILLS! Isn’t that just delightful? NOT!
The SECOND theory is called the “Autonomic Nervous System Theory” and is based on the imbalance between the Sympathetic and Parasympathetic nervous systems.
You don’t hear about this one much because it requires even more explaining! BUT IT IS VERY COMMON! AND You Savvy Sisters know how to understand it because WE understand the importance of a balance between the Sympathetic and Parasympathic nervous systems!
Both the Sympathetic and Parasympathetic branches of your nervous system are a part of a whole system called the AUTONOMIC Nervous system (and that is how this theory got its name).
The SYMPATHETIC nervous system is what you likely recall as that part of your nervous system that gets you out of trouble FAST. It is your “fight or flight” response. When your brain senses that you are in trouble, it starts shutting down all the body functions it doesn’t need at that moment to survive like digestion and immune function and focuses on increasing heart rate, breathing capacity, muscle strength, balance and so forth. Your eyes become far more razor sharp and your hearing is tuned up!
And as you might guess… if your Sympathetic nervous system is in OVER-DRIVE… you eventually get fatigued and depressed. There is no balance when you are in “over-drive” all the time. This is also fueled by CORTISOL!
That’s right… now you are seeing how things really work together and how one part of the body effects another part of the body! (So it won't be any surprise to you when you hear about the other theories too!)
The BALANCING end to the Sympathetic System is called the PARASYMPATHETIC Nervous System. The Parasympathetic branch is responsible for RESTORING functions of your body that were put on hold when the Sympathetic System is dominant. In other words, the RECOVERY phase.
The Parasympathetic Nervous System is often called the REST and DIGEST system because it is responsible for slowing the heart rate, slowing respirations, and turning on digestion processes.
When it comes to Hot Flashes, it is felt that the Parasympathetic Nervous System and Sympathetic Nervous system are not in balance, and that there is a Sympathetic OVER-DRIVE occurring while the Parasympathetic System is LESS Active.
Makes sense right?
There has been a lot of research on this theory! One interesting study showed that women who have higher levels of stress in their lives suffer with far more hot flashes than women who do not have as significant ongoing stress.
In fact, not only do hot flashes appear to be brought on by stress alone, the SEVERITY of a woman’s hot flashes are far worse when our stress levels are high or we are experiencing anxiety!
One study reported women who described feeling “SOMEWHAT anxious”, had THREE times More Hot Flashes than other women who did not suffer from anxiety.
And women with described “HIGH anxiety” had FIVE times the number of hot flashes as women without anxiety.
And as I hinted just a moment ago about CORTISOL playing a roll… you can now start filling in the blanks by knowing that stress and anxiety raises Cortisol levels.
But it doesn’t end there with Cortisol Spikes and Stress Induced Hot Flashes, because this is where Theory THREE comes in: The “Glucose-INSULIN Resistance Theory”.
In a study, (confirmed with additional research) over 3000 women who suffer with hot flashes and night sweats were examined for Glucose and Insulin Resistance (among many other factors.). There was a very high correlation between Insulin Resistance and elevated Glucose levels with Hot Flashes and Night sweats.
There was proof also that women with NON elevated glucose levels but POSITIVE elevated fasting Insulin levels were ALSO at risk of more severe and frequent Hot Flashes.
This means that you don't have to actually have elevated blood glucose levels... you just have to have elevated fasting INSULIN levels. And few doctors even test for Fasting Insulin!
And as you may know, stress increases Cortisol, which increases Glucose, which increases Insulin production and eventually causes Insulin Resistance.
Okay, how about the final theory on Hot Flashes and Night sweats! It’s called the “Brain-Glucose Theory”.
The brain uses sugar (from carbohydrates) as fuel faster and more efficiently than fat or protein. This is why people who go on keto diets get such bad “Keto-Flu” or Keto-Brain after a few days without carbohydrates - (which by the way can last for weeks until their brain gets used to using fat for fuel instead of carbohydrates)!
The brain needs sugar (glucose) as fuel, and when active, it actually needs it very quickly. (This is one of the reasons I think we are going to eventually uncover that ONGOING Ketogenic diets is unhealthy).
Anyway! The brain doesn't just MAKE glucose! It is dependent on getting glucose transported across the blood brain barrier by a specific “Glucose-Transport System” called GLUT-1.
And surprise surprise! GLUT-1 is highly dependent on ESTROGEN! As Estrogen declines, GLUT-1 is impaired (AKA! Brain Fog!)
Therefore, the brain… in a major time of need… must figure out a way to get more sugar and does so by sending signals to the blood vessels to DILATE! (Sound familiar? We’re back to theory ONE!)
This is an interesting theory and likely has some part in the big picture of some women’s hot flashes for sure. Hot flashes are the RESULT of the brain’s attempt to quickly dilate blood vessels in order to obtain more blood supply to the brain so that it can utilize the blood sugar for normal brain function!
So there you go! The whole Kit and Kaboodle! Now you know more than your doctor!
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