By Leslie Price
Hot flashes, like so many other health issues, are one of those things that you probably don’t care much about unless you’re currently experiencing them (if so, sorry about that). But one of the most common symptoms of perimenopause is the hot flash, and so you’ll likely be plagued with them at some point in your life. The majority of women (up to 80%!) experience hot flashes during their 40s or 50s, with Black women at increased risk. Yet up until recently, there was little clarity on what exactly triggers them.
Here’s an example of how hot flashes are typically explained (or not explained, rather): “It’s not clear exactly how hormonal changes cause hot flashes. But most research suggests that hot flashes occur when decreased estrogen levels cause your body’s thermostat (hypothalamus) to become more sensitive to slight changes in body temperature.”
Researchers now know that a specific group of neurons in the hypothalamus, a part of the brain responsible for keeping our bodies in homeostasis, are affected by a lack of estrogen. This discovery is paving the way for a group of non-hormonal medications targeting these neurons – an exciting possibility for those who suffer from hot flashes and are unable to (or don’t want to) go on hormone therapy.
As Genevieve Neal-Perry, a doctor who is researching one of the new medications targeting hot flashes, says in National Geographic, “The fact that we haven’t understood the biology of hot flashes until the last decade is pretty amazing.” If approved, according to the article, they’d be the first “new class of drugs specific to hot flashes” in 82 years.
Hot flashes are your brain’s way of tricking your body into thinking it’s overheating, and its systems respond in kind. “Because everything that is experienced happens in your brain,” Dr. Jen Gunter writes, “the person affected feels hot. Core temperature doesn’t rise, meaning your body temperature stays the same, but it feels like it has and that’s all that matters. What does your body do when you are hot? It deploys cooling mechanisms, such as sweating and flushing.”
Medicine has known for some time that HRT can “virtually eliminate hot flashes,” along with other bothersome symptoms. Doctors also can prescribe SSRIs for this issue, with proven effectiveness. Updated guidance on HRT was issued this year from the North American Menopause Association, who say that hormone therapy “remains the most effective treatment for vasomotor symptoms (hot flashes, night sweats).” Given that, any new medications are probably not so much of a cure for hot flashes as an alternative to hormone therapy.
But what’s interesting about all this isn’t necessarily new drugs – it’s that we are only now cracking the code of one of the main miseries of women in middle age. Better late than never?
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