Are You In Menopause?

Are You In Menopause? (<i>cont'd</i>)

Do you have hot flashes?

Hot flashes are a sensation of heat suffusing your neck, head and face for a few seconds to a few minutes. They are thought to be caused by increasingly strong signals from the hypothalamus, a small pea-sized structure in your brain, which sets off secretions (follicle stimulating hormone or FSH) from the pituitary gland that are meant to trigger ovulation by stimulating the production of estrogen in your ovaries.

It is also thought that the second brain signal in the ovulation process, luteinizing hormone or LH, which is intended to trigger the release from the follicle of a matured egg into the fallopian tube, is also involved in hot flashes. The sharp decrease in your body's production of progesterone when ovulation has stopped may have something to do with this process as well.

The hypothalamus is also your body's thermostat, sending chemical signals to cool off the body when it gets too hot. During menopause, the hypothalamus appears to go awry, sending its cooling-off signal at the wrong time. As a result, after the hot flash, many women have chills. About 85 percent of women experience hot flashes, some for a few months, some for as many as five years. You may have heart palpitations, sweating, chills or dizziness along with hot flashes.

Some women get relief from hot flashes with estrogen replacement therapy or hormone replacement therapy (a combination of estrogen and progesterone). Other women find vitamin E supplements are helpful, and still others are using alternative remedies such as black cohosh to relieve hot flashes. Other helpful lifestyle changes include reducing the amount of caffeine in all forms that you consume, reducing smoking (which constricts blood vessels), and increasing aerobic exercise to improve blood flow.

Do you have trouble getting to sleep, staying asleep, or waking too early?

Sleep disturbances are common in menopause. Either you can't get to sleep or you wake frequently during the night and don't get enough REM (rapid eye movement) sleep, thought to be essential for rest. The next morning, you are exhausted. Over time, this constant battle for sleep takes its toll.

The regular production of estrogen, progesterone, and androgens (testosterone) during ovulation has helped to regulate your sleep cycle, until now. In menopause, lower levels of progesterone, a natural sedative, in relation to fluctuating levels of estrogen—which, when high, can cause anxiety and restlessness—leave you less able to drift off into restful sleep and stay asleep. Women who suffer from night sweats, the nighttime equivalent of hot flashes, also experience sleep disturbances and may awake in the middle of the night with their sheets soaked.

Women have tried a number of solutions to this problem. Changing your exercise time to earlier in the day rather than in the evening after work may help. Avoiding all caffeine products is advisable. Some women have had success with hormone replacement therapy and others have turned to herbal remedies such as chamomile tea or kava kava. Consult your healthcare provider about what may work for you.