For many women, hot flushes are the biggest inconvenience associated with the menopause. Everyone implies they are a short phase that happens as you “go through the change”. The NHS website says: “As a result of these hormonal changes, many women have physical and emotional symptoms such as hot flushes, night sweats and irritability.” Sounds pretty transient if they result from the changes doesn’t it? Once the changes have happened then everything calms down – doesn’t it?
So we arrive at the menopause (defined as the cessation of menstruation) expecting to suffer some inconvenience during the year or so when menstruation tails off and a new, tampon and towel-free life begins. However, for a large proportion of women, the cessation of periods is just the start of what are inaccurately called “menopausal symptoms”.
Hot flushes can be highly disruptive if you have several a day (or, even, several an hour). At their worst you feel queasy for a few minutes and then the heat builds in your upper body until it feels as if you have a 2000 watt spotlight positioned just in front of your face. Blood rushes from your brain to your skin and leaves befuddlement in its wake. You have a panicky urge to escape from your clothing and fling open windows. Then, two or three minutes later you start to feel chilly, replace your discarded layers and look for another one to add.
If you happen to be lounging in the shade, watching the play of light on the sea, you just reach for you fan and take sips of ice water while the moment passes. Not so easy if you are in the middle of something - an important meeting maybe; trying to teach a class of lively teenagers or driving a car in heavy traffic. Annoying to have one's ability to function temporarily impaired. Embarrassing too and even, at times, dangerous. Hot flushes can also wake you several times in the night and, if they are accompanied by night sweats, they can drench your sheets with perspiration.
Irritability huh? I wonder what might be causing that?
HRT can be used to stop flushes in their tracks, but as with all hormone treatments, it has both benefits and risks. Whether or not to take it, and for how long, is a difficult and individual choice.
Recent research reveals what many of us know – hot flushes are not just for a year, they commence in earnest once the menopause is complete and they can run on for decades. Researchers in Pennsylvania found that the average duration was about 5 years and a third of their group experienced medium/severe hot flushes for over 10 years. I find it interesting that this information is only now available – it highlights the incomplete knowledge that women and doctors have when they are making decisions about HRT and other drug treatments.
Many women resort to herbal remedies as an alternative to HRT but these are poorly researched and the effects of taking them daily for a decade or more are unknown.
I hope I may be excused from surmising that if a significant percentage of men, at the height of middle-age, was struck down by disabling waves of heat, many times a day, combined with significant sleep-disruption, then maybe the medical world would be taking the problem more seriously? Is it just possible that there would be a lot more research in the area? And that we wouldn’t have waited this long to have clear evidence that flushes don’t just happen when you are “going through the menopause”?
Or do those of us who suffer perhaps collude in this myth that hot flushes are really a feature of the menopause, rather than post-menopause? Is it somehow more acceptable to say that we’re going through the menopause rather than admit the reality - that we are ten or more years beyond it?
Perhaps, in the light of this research, it is time to be more open, to press for more research so that treatment options can be discussed in the light of better information.