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Review
. 2014 Jul:142:115-20.
doi: 10.1016/j.jsbmb.2013.08.010. Epub 2013 Sep 4.

Menopausal hot flashes: mechanisms, endocrinology, treatment

Robert R Freedman  1
Affiliations
Review

Menopausal hot flashes: mechanisms, endocrinology, treatment

Robert R Freedman. J Steroid Biochem Mol Biol. 2014 Jul.

Abstract

Hot flashes (HFs) are a rapid and exaggerated heat dissipation response, consisting of profuse sweating, peripheral vasodilation, and feelings of intense, internal heat. They are triggered by small elevations in core body temperature (Tc) acting within a greatly reduced thermoneutral zone, i.e., the Tc region between the upper (sweating) and lower (shivering) thresholds. This is due in part, but not entirely, to estrogen depletion at menopause. Elevated central sympathetic activation, mediated through α2-adrenergic receptors, is one factor responsible for narrowing of the thermoneutral zone. Procedures which reduce this activation, such as paced respiration and clonidine administration, ameliorate HFs as will peripheral cooling. HFs are responsible for some, but not all, of the sleep disturbance reported during menopause. Recent work calls into question the role of serotonin in HFs. This article is part of a Special Issue entitled 'Menopause'.

Keywords: Hot flashes; Menopause; Sleep; Thermoregulation.

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Conflict of interest statement

Conflict of interest statement

Dr. Freedman is the President and CEO of Biomedical Monitors, LLC, the manufacturer of the hot flash recorder described herein.

Figures

Fig. 1
Fig. 1
(A), Core body temperature (means) during menopausal hot flashes. (B), Respiratory exchange ratio (means) during hot flashes. (C), Mean skin temperature (means) during hot flashes. (D), Sternal skin conductance (means) during hot flashes. Time 0 is the beginning of the sternal skin conductance response. Intervals between arrows are significantly different from each other at P<.05, Duncan’s test.
Fig. 2
Fig. 2
Miniature hot flash recorder invented by the author.
Fig. 3
Fig. 3
Hot flash frequency and Tc during 24h. Hot flash frequency in 10 symptomatic women (bars); best-fit cosine curve for hot flash frequency (dashed line); 24h Tc data for 10 symptomatic women (○) with best fit cosine curve (solid line); 24h Tc data in 6 asymptomatic women (□) with best-fit cosine curve (dotted line).
See this image and copyright information in PMC

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