What causes hot flashes?
According to the website, Breast Cancer.Org., beginning in perimenopause, the years leading up to menopause, hormonal fluctuations, particularly diminished estrogen levels, play a major role. These hormonal variations affect the hypothalamus, which is the part of the brain that regulates our sleep cycles, appetite, and body temperature. It is assumed, but not proven, that the diminished estrogen tricks the hypothalamus, otherwise known as the body’s thermostat, into the heat mode. The brain signals to the heart, blood vessels, and central nervous system, the need to eliminate the hot feeling by causing the sweat glands to release sweat. This, in turn, cools down one’s body temperature.

During a hot flash, does a woman's body temperature typically rise?
For some women, skin temperature can rise as much as six degrees centigrade during a hot flash. As the body cools down, the result is profuse sweating, which can cause embarrassment for the individual, should this occur in either the workplace, or in a social situation. Occurring during sleep, hot flashes can awaken the individual several times, often leaving the one experiencing it, with daytime fatigue.

How many women suffer from menopausal hot flashes?
As many as 80-85% of all women in the United States experience some form of hot flashes as they approach menopause, and for the first couple of years following the cessation of their menstrual cycle.

What are the factors that influence one’s likelihood of getting hot flashes?
According to Women to Women.com, women with a history of severe anxiety can be up to five times as likely to experience hot flashes and night sweats. Other contributing factors are smoking and being overweight, as well as consuming caffeine, alcohol and spicy foods.

Should I be worried about risks associated with hormone replacement therapy (HRT)? What other options do I have?
Although many women opt to try HRT to remedy their discomfort, many symptoms of menopause, such as night sweats and hot flashes, may eventually lessen over time without any medical intervention. Because HRT has been associated with breast cancer, it is always advisable to discuss the risks vs. benefits with your physician. In the August 2008 issue of Johns Hopkins “Health After 50,” Medical Letter, selective serotonin reuptake inhibitor (SSRI) antidepressants given in low doses, may be effective against hot flashes in some women. Avoiding hot beverages, spicy foods, as well as limiting alcohol consumption, may also reduce hot flashes.

Do supplements derived from plant estrogen really relieve hot flashes?
The answer depends upon who you ask. Although some women claim to have had some relief from their hot flashes when using plant estrogens, recent research contradicts these reports. Furthermore, “phytoestrogens are not approved by the Food and Drug Administration, so their safety and efficacy have not been substantiated in rigorous clinical trials.” Additionally, according to a study that was published in the Annals of Internal Medicine, 351 women found that the herbal medicine, Black Cohosh, relieved hot flashes no better than placebo.