Do you feel to ask one of the following things- What can I do about this? What can I do to minimize the chance that I'll have hot flashes? Why are Hot Flashes happening to me?

About 75% of women, at some sort of time (during menopause) experience Hot Flashes.

Starting at the beginning of the day, the first thing is that nice hot shower in the morning should probably be more tepid because many women complain that they can't even get dressed in the morning before breaking out in a sweat. They can't put makeup on. So it’s better to start with a much cooler shower. The other thing is choosing the things that you will be wearing during the day. It’s advised to choose to dress in layers that you can indeed peel off if you begin to have hot flashes and then put your sweater back on when that passes feeling cool.

Some of the things that we eat and drink can cause hot flashes and so if you notice that every time you have a spicy meal that's a miserable time that evening then you want to avoid those kinds of foods. Alcohol is a well-known trigger of hot flashes, so you may need to moderate the amount of alcohol that you drink. People wonder about that morning cup of coffee sometimes and whether caffeine is a trigger for some women. It can be exercise which causes just about everybody to sweat if you are doing it right can actually minimize hot flashes.

Many women when they're asked whether they're having hot flashes, will describe it as a sensation of warmth that can be as little as something that would cause you to wipe your brow but as significant as something that makes you want to take your sweater off causing your hair to become wet, can cause your clothing to become wet as if you've just run a mile and then all of a sudden it's gone and you may actually experience a sense of chill after it's gone.

The key is that it's repetitive it goes away, it comes back. It can happen many times during the day and during the night or you may be one of the fortunate women who has only a couple during a day. Once a woman is having some difficulty with hot flashes, one of the main questions is how long is this going to go on because if it's going to be a month well then it can be dealt with but if it's going to be 10 years maybe something is needed to assist.

So usually we think in terms of seven years as an average but really women can begin to have hot flashes even before they have the diagnosis of menopause and it can last as many as 10 or 15 years for some women. There is medication that is designed to address whatever residual symptoms there are and those medications fall basically into two categories, one is hormones that are designed to give back some of the hormone that women are making to little of to control their symptoms and one is non-hormonal.

A woman should see their doctor at least once a year for a general discussion of their reproductive health and that visit will include discussions about what is going on in terms of movement out of the reproductive age into menopause that perimenopausal timeframe that can be so disrupted as well as whether there are any menopausal symptoms that need to be addressed.

It is believed that women that have hot flashes particularly early in menopause and actually in before they fully become menopausal, those women tended to have more abnormal flow media dilatation what that means is that surrogate marker has been linked to more cardiovascular events long-term.

So what is important is to recognize first of all heart disease is the number one killer for both men and women and that when women have these symptoms going into menopause it's something that they should at least talk to their doctor about because it might indicate that they are more at risk for heart disease down the road. I don't think somebody should be fearful that if she is having a hot flash that means she is going to have a heart attack.

I think it tells us that woman's arteries may be responding differently as she's going through menopause and that's what this FMD, this flow media dilatation is an assessment of it's really telling us that the arteries aren't working quite normally. That's more common in women who are menopausal anyway I think the issue is that as a woman gets older the other standard cardiovascular risk becomes more prevalent so that the hot flashes as an independent thing isn't as strong.

When you're younger you don't have those other risk factors may be as prevalent abnormal cholesterol high blood pressure those things so that those hot flashes may be an early marker that something is going to happen or something is wrong and then later in life when you're fully menopausal that may not be as much of an impact because the other risk factors sort of become more prevalent. It doesn't seem to be directly related to estrogen levels which is the study actually also mentioned so we don't know exactly what's happening but there's something happening in a neurotransmitter in the brain.

We don't really know what it is so when we don't know what it is how we help it is unclear and the question is by treating hot flashes do you improve any of these and that hasn't no study has really looked at that that if you treat hot flashes with a hormone therapy or some other medication do you change the way the arteries look or act.

What we found when we were doing our menopause consults was that we found older women presenting for menopause consults which surprised us. When we looked at the literature we found that in other countries such as Sweden and Australia, they found that women in their 60s and 70s were presenting with menopausal symptoms or vasomotor symptoms such as hot flashes and night sweats. We decided to look at that in our own data and found that 20% of women present with hot flashes night sweats who are over the age of 60.

Menopausal symptoms should only be treated for as long as they're having hot flashes. Now we're beginning to find that there are some women who have hot flashes into their 60s, 70s and even 80s. Our current study found that about 18% of women over the age of 60 continue to have hot flashes and night sweats typically we will treat women for these symptoms with hormones and speaking with your physician you can determine whether hormones are right for you or another medication and if these medications should be continued past the age of 60.

There is a window for hormone therapy usually is within the ten years after the onset of menopause typically we like for that to be closer to the onset of their menopause but there are some women who either for personal reasons decide not to go on hormone therapy or they're still continuing to have hot flashes into their 60s and 70s and they're not on hormone therapy and what do you do for those women? Well there are certainly some non hormonal options that are available some of them are medications such as gabapentin or some of the antidepressants like SSRIs or snr eyes.