Well the answer to that can get complicated! And there is still a lot of research going on in this topic because the actual cause of hot flashes is still NOT completely understood.
The average length of time we deal with hot flashes is about 7 years. This is usually about 3 and a half to 4 years before menopause and 3 and a half years after menopause.
Some women can experience hot flashes only during the average known 7 years... but some women experience hot flashes forever! There are some really lucky women too who never really experience much in the line of hot flashes at all. But as a whole, 75% of all women have some "joyful" experience with hot flashes some time or another.
This is because hot flashes are really a DYSREGULATION of the whole Sex Hormone system. Not just because the Ovaries are no longer working as they did when we are younger.
The Sex Hormone System is called the Hypothalamic-Pituitary-Gonadal Axis, or HPG Axis for short. The Ovaries make up the “Gonadal” part of the Axis and are SUPPOSED to do what the Hypothalamus tells it to do. But during midlife... as the Ovaries start reaching their "old age", they start getting a mind of their own.
The Hypothalamus is the REAL commander of the HPG axis. In fact, I call the Hypothalamus the “Command Central Station” of the brain, because it is also the real commander of Other Hormone Systems as well, including both the Thyroid Hormone System and the Adrenal Hormone System.
And to top it off… the Hypothalamus is the part of the brain that is responsible for Temperature Regulation. You can actually have a “broken Hypothalamus!” But that is actually too much information for this post!
To keep it as simple as possible, when it comes to Menopause being the cause of hot flashes… here is what you need to know.
When the Ovaries start reaching the ripe old age of 50’ish, they stop "listening" to the Command Central Station. And that’s a real problem because the Hypothalamus is THE “Link” between our Nervous System and our Hormone Systems.
The Hypothalamus has the job of regulating the Production of Hormones produced by the different glands in the body, including Sex Hormones, Adrenal Hormones and Thyroid Hormones too!
And like I mentioned above, it also has the job of regulating our body temperature!
Now when the Ovaries stop listening to the Hypothalamus, they start producing erratic amounts of Estrogen – it throws our Estrogen levels way high and then way low - which causes even more havoc on the poor little Hypothalamus who is just trying to keep up with what the Ovaries are doing.
The Ovaries are supposed to respond to the Hypothalamus – NOT the other way around. Kind of like little independent thinking identical twins!
Now this erratic behavior of the Ovaries confuses the Hypothalamus! It can’t keep up with the rapid changes quickly enough in order to keep our body temperature stable.
So here is what happens.
The Ovaries release a sudden surge of Estrogen. This causes the blood vessels to get smaller (constrict). Progesterone helps prevent this effect of Estrogen because Progesterone makes the blood vessels larger (dilate). That is why women with Estrogen Dominance have worse hot flashes!
Anyway, when the blood vessels get smaller, it prevents the body's ability to release heat – and BAM – a hot flash occurs.
When the Hypothalamus can finally “catch up” with what is happening – IT sends a signal to the blood vessels to dilate (get larger!) AND it also sends a signal to the sweat glands to produce sweat to cool off the surface of the skin! BAM AGAIN! Sweat and flushing! OH PLEASE! Really?
So, you see… it is a HPG Axis DYSREGULATION that is occurring when hot flashes occur due to Menopause. And it's CAUSED by Ovarian “craziness”!
Now…. Just for completion purposes…. Do be aware that there are other Hypothalamic Axes that can also cause hot flashes! The HPA Axis is the Hypothalamic-Pituitary-Adrenal Axis which is commonly effected in midlife women. It is our Stress Hormone System.
That’s why women who have a lot of stress in their lives during menopause, (and actually before menopause too), often have worse hot flashes.
Here is a graph showing you what the levels of our hormones are doing 10 (or so) years around Menopause. Notice the blue line and how Estrogen swings high and low due to our Ovary’s "minds of their own" and refusal to listen to the Hypothalamus!
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