What we know about managing menopausal hot flashes: navigating without a compass

Adopting strategies with menopausal experiences: A systematic review

Background and Aims

Menopause is one of the most significant stages in women's life. It is accompanied by many complications and a serious challenge. This study aimed to assess the menopause experiences of Iranian women and compatibility strategies.

Methods

We searched PubMed, Web of Science (ISI), Scopus, Ovid, and the Iranian Clinical Trial Registry and Magiran, SID, from January 1990 to January 2021.

Results

Psychological effects, sexual disorders, physical problems, bone pain, insomnia, fatigue, and hot flashes are all menopause experiences. Cultural factors, lifestyle, social factors, education level, employment and economic status, marital status, and the number of pregnancies and births can influence this experience. It is important that menopausal women are aware how menopausal compatibility and prepare for this period. Many factors have affected menopausal adopting strategies. Negative emotions, negative attitudes, worry, and anxiety, and their psychological effects exacerbate the annoying experiences of menopause and decelerate menopausal adoption.

Conclusions

Social support and educational intervention were the practical menopausal adopting strategies. It will guarantee the health of menopausal women in the last third of their lives.

Brain blood flow and cardiovascular responses to hot flashes in postmenopausal women

OBJECTIVE

This study tested two related hypotheses: (1) brain blood flow is reduced during postmenopausal hot flashes, and (2) the magnitude of this reduction in brain blood flow is greater during hot flashes when blood pressure is reduced.

METHODS

Eleven healthy, normotensive postmenopausal women rested in a temperature-controlled laboratory (∼ 25°C) for approximately 120 minutes while waiting for a hot flash to occur. The onset of a hot flash was objectively identified by an abrupt increase in sternal sweat rate (capacitance hygrometry). Middle cerebral artery blood velocity (MCAv; transcranial Doppler) and mean arterial pressure (Finometer) were measured continuously. Each hot flash was divided into eight equal segments, and the segment with the largest reduction in MCAv and mean arterial pressure was identified for each hot flash.

RESULTS

During experimental sessions, 25 hot flashes occurred (lasting a mean [SD] of 6.2 [2.8] min, with a mean frequency of 3 [1] hot flashes per participant). Seventy-six percent of hot flashes were accompanied by a clear reduction (>5%) in brain blood flow. For all hot flashes, the mean maximal decrease in MCAv was 12% (9%) (7 [6] cm s). This value did not correlate with corresponding changes in mean arterial pressure (R = 0.36).

CONCLUSIONS

These findings demonstrate that hot flashes are often accompanied by clear reductions in brain blood flow that do not correspond with short-term reductions in mean arterial blood pressure.

Mechanisms of cutaneous vasodilation during the postmenopausal hot flash

OBJECTIVE

Menopausal hot flashes can seriously disrupt the lives of symptomatic women. The physiological mechanisms of the hot flash efferent responses, particularly in the cutaneous circulation, are not completely understood. The aim of this study was to examine the mechanisms of increases in skin blood flow during the postmenopausal hot flash in symptomatic women.

METHODS

Healthy postmenopausal women rested in a temperature-controlled laboratory while responses before and during hot flashes were recorded for three unique protocols. In protocols 1 and 2, women were locally pretreated with an intradermal injection of botulinum toxin A (BTX; blocks the release of neurotransmitters from sympathetic cholinergic nerves) in the forearm (protocol 1) and in the glabellar region (protocol 2). In protocol 3, skin sympathetic nerve activity from the peroneal nerve was recorded, along with skin blood flow and sweating within the region innervated by that neural signal. Skin blood flow was indexed using laser-Doppler flowmetry at the BTX-treated and adjacent untreated control sites. The onset of a hot flash was objectively identified as a transient and pronounced increase in sternal sweat rate.

RESULTS

The increases in forearm (protocol 1) and glabellar skin (protocol 2) blood flow during hot flashes were attenuated at the BTX sites relative to the adjacent untreated sites (P<0.05 for both protocols). In protocol 3, skin sympathetic nerve activity significantly increased during hot flashes and returned to pre-hot flash levels after the hot flashes.

CONCLUSIONS

Increases in skin blood flow during postmenopausal hot flashes are neurally mediated primarily through BTX-sensitive nerves, presumably sympathetic cholinergic.

[Correlation between subjective and objective measurement of climacteric women's hot flashes]

PURPOSE

The purposes of this study were to explain the phenomena of hot flashes in climacteric women by using Mexameter, Skin Thermometer, Corneometer, and Laser Doppler Perfusion Imager (LDPI) objectively and to identify the interrelation between the subjective and objective measurements of hot flashes by comparing the two as reported in retrospective questionnaires.

METHODS

The participants were one hundred women (45-60 yr) who were not currently on hormone therapy, and had reached hot flash scores of 10 or higher. Hot flashes were measured in a temperature and humidity controlled room for 7 hr from 10 am to 5 pm. Hot flashes were measured subjectively and recorded via the Hot Flash Diary Report. When participants felt the hot flashes, they were measured objectively by Mexameter, Skin Thermometer, Corneometer, and LDPI .

RESULTS

The frequency of hot flashes in participants ranged from 1 to 7 times. When hot flashes occurred in participants, the erythema, skin temperature, skin hydration, and blood perfusion showed statistically significant changes in all measurements. But, the subjective and objective measurements of hot flashes showed only weak correlations.

CONCLUSION

Results indicate a need for future research with subjective and objective measuring instruments chosen depending variations identified for the study.

The effects of perceived stress and attitudes toward menopause and aging on symptoms of menopause

INTRODUCTION

As part of a longitudinal study of midlife women, the aim of this investigation was to describe the intensity of menopausal symptoms in relation to the level of perceived stress in a woman's life and her attitudes toward menopause and aging.

METHODS

Data were collected on 347 women between 40 and 50 years of age in Northern California who began the study while premenopausal. Women self-identified as African American, European American, or Mexican/Central American. Data collected over three time points in the first 12 months were used for this analysis. An investigator-developed tool for the perception of specific types of stress was used. Attitudes toward menopause and aging were measured using the Attitudes Toward Menopause and Attitude Toward Aging scales. Attitudes toward aging and menopause, perceived stress, and income were related to intensity of symptoms.

RESULTS

There was no ethnic group difference in perceived stress or attitude toward menopause. However, European and African Americans had a more positive attitude toward aging than Mexican/Central Americans.

DISCUSSION

A lower income, higher perceived stress, a more negative attitude toward aging, and a more positive attitude toward menopause influenced menopausal symptom experience.

Cutaneous and hemodynamic responses during hot flashes in symptomatic postmenopausal women

OBJECTIVE

The aim of this study was to test the hypothesis that the postmenopausal hot flash is accompanied by rapid decreases in arterial blood pressure and increases in cutaneous vascular conductance (CVC), as evaluated by continuous measurements of these variables in symptomatic women.

DESIGN

Twelve healthy, normotensive, postmenopausal women rested in a temperature-controlled laboratory (26 degrees C) for approximately 90 minutes. The onset of a hot flash was objectively identified as a transient and pronounced elevation of sternal sweat rate (capacitance hygrometry).

RESULTS

Twenty-three hot flashes were recorded during the experimental sessions (3.4 +/- 1.4 min; range, 1.3-6.5 min). Mean arterial blood pressure decreased 13 +/- 2 mm Hg during 11 hot flashes in five participants. Data from these participants, categorized as responders, were analyzed separately from data for those participants whose blood pressure did not change during their hot flashes (n = 7, 12 hot flashes). Heart rate (obtained from an electrocardiogram) significantly increased during the hot flashes, but there was no difference between the responder and nonresponder groups (9 +/- 2 vs 10 +/- 1 beats/min, respectively; P > 0.05). The increase in CVC was not different between groups at either the forearm (15% +/- 3% vs 12% +/- 3% maximal CVC, P > 0.05) or sternum (24% +/- 5% vs 21% +/- 3% maximal CVC, P > 0.05).

CONCLUSIONS

These data demonstrate that in a subset of participants, the hot flash is accompanied by a significant reduction in blood pressure, but there is no difference in CVC between these women and women with no drop in blood pressure.

The effect of dietary intake on hot flashes in menopausal women

OBJECTIVES

To describe the relation between dietary intake and menopausal hot flashes.

DESIGN

Two studies are reported: a controlled, repeated-measures study and a descriptive study.

SETTING

The controlled study was conducted in a general clinical research center of a large Midwestern university. The descriptive study was conducted in a metropolitan community in the Southwest.

PARTICIPANTS

Ten healthy symptomatic postmenopausal women participated in the controlled study and 21 symptomatic women completed the observational study.

INTERVENTIONS

The controlled study included a 30-hour intensive blood sampling protocol of two sequential experimental phases with an observational phase between them. In the observational phase, each participant served protocol-specific meals and snacks at predetermined times.

MAIN OUTCOME MEASURE

Skin conductance monitoring provided continual assessment while blood glucose levels were analyzed every 30 minutes in the controlled study.

RESULTS

Eating provided a hot flash-free period that averaged 90 minutes in both studies. Also, hot flash frequency increased as time between meals increased.

CONCLUSIONS

Our evidence indicates that hot flash frequency is suppressed after eating, while hot flashes are experienced when blood glucose falls between meals. Nursing interventions aimed at maintaining stability in blood glucose level may be effective in reducing menopausal hot flashes.