Menopausal hot flashes and night sweats: Role of genes, causes and prevention

By: Mohan Garikiparithi | Menopause | Thursday, October 15, 2015 - 05:00 PM

Menopausal hot flashes and night sweats: Role of genes, causes and preventionMenopausal hot flashes and night sweats can make living in your own skin seem unbearable. The constant heat and sweating can be uncomfortable and make sleeping quite difficult.

A hot flash is a sudden feeling of heat, sometimes followed by redness and sweating. The cause of hot flashes is still unknown, but they tend to be a common symptom of menopause. Some doctors believe hot flashes occur due to changes in circulation. How long a hot flash will last is different for each woman.

Recent research presented at the American Menopause Society 2015 Annual Meeting has now linked genes to hot flashes.

Role of genes in menopausal hot flashes

Role of genes in menopausal hot flashesResearchers have found that postmenopausal women who have a gene variant for tachykinin receptor 3 are more likely to experience symptoms such as hot flashes and night sweats. Lead investigator, Carolyn Crandall, M.D., said, “Although these results are not conclusive, because we still don’t clearly understand the biology that is responsible for vasomotor symptoms, these results open new pathways for investigating the biological mechanisms underlying symptoms. If other studies confirm a role for the tachykinin receptor 3, these results could lead to new drug targets to help manage severe vasomotor symptoms.”

The research was conducted with a wide genome study to find markers in DNA and gene variations. Dr. Crandall added, “To our knowledge, this is the first genome-wide study that has investigated genetic variation in relation to vasomotor symptoms in a large cohort of postmenopausal women in the United States.”

The study involved a baseline of 17,695 genotype samples of women enrolled in the three Women’s Health Initiative genetic studies. More than 19 million single-nucleotide polymorphisms (SNPs) were evaluated.

They found that 39.3 percent of women reported using hormone therapy and 19 percent reported undergoing bilateral oophorectomy.

Dr. Crandall added, “Mutations in this tachykinin receptor 3 gene cause understimulation of GNRH, leading to hypogonadism in animal studies, so it seems to make biological sense. However, this is the first genome-wide association study, so we have to be cautious in our interpretation. This information will be very valuable in understanding the underlying biological mechanism and pointing to new therapeutic targets.”

Menopausal hot flashes and night sweats can last seven years or more

Menopausal hot flashes and night sweats can last seven years or moreResearch published in JAMA Internal Medicine revealed that menopausal hot flashes and night sweats can last up to seven years or longer. The study examined women who were transitioning to menopause. Frequent vasomotor symptoms (VMS) – hot flashes and night sweats – were defined as occurring at least six times in a two week period.

The median total of VMS duration was 7.4 years. Women who were premenopausal or early perimenopausal had the longest duration of VMS – median duration was 11.8 years. Postmenopausal women had the shortest duration at 3.4 years.

African American women were found to have the longest VMS (10.1 years) and Asian women had the shortest (4.8 years). Hispanic and Caucasian women were respectively in the middle with duration at 8.9 years and 6.5 years.

Age, education level, perceived stress, sensitivity to symptoms and higher depressive and anxiety symptoms were also factors that determined VMS duration.

The study concluded, “These findings can help health care professionals counsel patients about expectations regarding VMS and assist women in making treatment decisions based on the probability of their VMS persisting. In addition, the median total VMS duration of 7.4 years highlights the limitations of guidance recommending short-term HT [hormone therapy] use and emphasizes the need to identify safe long-term therapies for the treatment of VMS.”


Other causes and symptoms of hot flashes in menopause

Other causes and symptoms of hot flashes in menopauseAlthough the exact cause of hot flashes is unclear, there are still theories as to why they happen.

Decrease in estrogen: This is a debatable cause of hot flashes;  many doctors and researchers are not in agreement about it. The Mayo Clinic specifically points out that low estrogen alone does not lead to hot flashes as seen in different age groups of women. However, when menopause accompanies low estrogen it seems to bring on hot flashes.

Lifestyle causes: Hot flashes aren’t experienced by all women, and those who do experience them have varying degrees. In order to combat hot flashes, it’s important to look at lifestyle factors, which can make them worse. Some known factors that worsen hot flashes are obesity, smoking and lack of physical activity.

Inciting factors: Many factors are out of a woman’s control when it comes to hot flashes, but stimulants such as spicy food, caffeine, alcohol, and being in hot temperatures, which can all worsen hot flashes, are controllable factors. The good news is by learning and understanding your own triggers you can better avoid or minimize them.

Aside from feeling hot and flushed, other symptoms of hot flashes include:

  • Tingling fingers
  • Rapid heartbeat
  • Warm skin
  • Sweating
  • Red and flushed face


Menopausal night sweats

Night sweats are similar to hot flashes but occur in the evening. This can be problematic because they can create insomnia or make it difficult to sleep, which can worsen symptoms of hot flashes the following morning.

It’s believed that fluctuating estrogen levels are responsible for menopausal night sweats. This change in estrogen affects the hypothalamus, which is the region in the brain that controls and moderates temperature. The hypothalamus may become confused with the changes in estrogen, so when the body attempts to cool down it increases body temperature by dilating blood vessels and triggering sweat glands. When this occurs during the night it leads to night sweats, leaving you in bed wet and uncomfortable.

Other research suggests night sweats also contribute to poor cardiovascular health. One study in particular linked night sweats to high cholesterol and coronary heart disease.


Prevention and treating menopausal hot flashes

One part of preventing menopausal hot flashes is avoiding triggers. Common triggers for menopausal hot flashes are:

  • Stress
  • Caffeine
  • Alcohol
  • Spicy foods
  • Tight clothing
  • Heat
  • Cigarette smokePrevention and treating menopausal hot flashes

Other tips to better manage menopausal hot flashes are:

  • Try and stay cool – keep your home and bedroom cooler at night as well.
  • Wear light layers of clothing and try to stick with cotton.
  • Exercise daily.
  • Try using a chill pillow.

Related Reading:

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