A Review of Management of Perimenopausal Hot Flashes

Abstract

Vasomotor symptoms, also known as hot flashes, can be defined as a sensation of heat, intense sweating, and flushing, which are experienced episodically by many perimenopausal women. This sensation usually affects the face, neck, and chest. It is estimated that about 75% to 80% of women would suffer from hot flashes at some point during their perimenopausal years. A decline in oestrogen levels during menopause seems to be responsible for the appearance of hot flashes. This decline increases norepinephrine levels, leading to an up regulation of serotonin receptors in the hypothalamus, which are involved in temperature regulation. The outcome of the activation of this norepinephrine serotonin pathway is believed to be the narrower thermoregulation zone, which in turn results in a greater risk of crossing the upper and lower thresholds of the thermoregulatory zone. Thus, it causes sweats and chills in this group of women. The most known effective treatment of hot flashes is hormone replacement therapy (HRT); however, in recent years, other non-hormonal options have become available for those women who cannot or do not want to take HRT.