Hot Flashes And Night Sweats? Welcome To The Joys Of The Menopause!
Menopausal hot flashes and night sweats got you questioning if you’ll ever get to wear your favorite chunky sweater again?
Your last good night’s sleep, just a very distant memory?
Would it help to know you’re not alone?!
Because you most definitely are not - up to a mind-blowing 75% of women will experience hot flashes and night sweats during their menopausal transition and for some women, these will continue for more than 10 years!!!.
And look, honestly? I can’t tell you that understanding these, apparently, random power-ups of some internal blast furnace will make them disappear, but I hope it will empower you to have more informed conversations with your health care professional.
And that’s gotta be worth 10 minutes of your time, right?
The key to understanding pretty much any misbehaving body part or system is to know how that piece of us is supposed to work, so if I throw out the word, thermostat, what comes to mind?
A fancy digital NestTM?
An antique Honeywell?
Either one, high or low tech, we all know what thermostats do.
We program our preferred home temperature into them and they do the rest - switching furnaces and HVAC systems on and off, keeping our surroundings at that perfect number. Our own biological thermostat, a pea-sized part of the brain called the hypothalamus, works in much the same way. Evolution has programmed it with a set point of around 97.8°F and 24/7, it bosses around our heating and cooling mechanisms keeping our core body temperature incredibly close to this key number.
Really, the same pre-set temperature for all of us?
Pretty much.
In humans, everything works best at around 98°F: our lungs can fully load up our blood with oxygen, vital electrical signals sprint through our heart and nervous system and within our more than 35 trillion cells, millions of essential biochemical reactions will continue their steady hum
(Biochemical reactions btw? Mix bicarbonate of soda and vinegar for a science fair volcano? That’s a chemical reaction! Mixing yeast and flour together to make bread? Yup, another chemical reaction.
All of our tiny cells are constantly mixing ingredients in chemical reactions. We just call these internal, biology reactions, biochemical reactions).
Back to our hypothalamic thermostat.
Specialized nerve endings in our skin and deeper organs continuously monitor our temperature and despatch reports to this tiny part of our brain. Any mismatch between the temperature newsflash and our 97.8°F set point fires up the hypothalamus and in turn, it triggers processes to return our temperature back to the appropriate level.
How?
Ever stepped out on a bright December day, fooled by the sunshine and thought, no need for a coat?
Should’ve listened to mom, but didn’t?!
Too late, it’s freezing out, our core temperature starts to drop but wait, here comes the hypothalamus. It yells out orders, rousing our muscles to make small but rapid, heat producing contractions (shivering) and making our body hairs stand to attention, trapping a layer of warm air next to the skin (goose bumps).
At the same time and perhaps rather less obviously, our thermostat also messages many of the blood vessels in our skin, instructing them to narrow.
Why’s that useful?
Because blood’s amazing.
We think about blood flowing around the body and transporting useful stuff like oxygen and sugar but it’s also moving heat, through the body and to and from the skin.
Our skin is like a poorly insulated wall in a toasty warm house. As warm blood moves through our scantily insulated skin much of its heat flies out across the skin and into the wild blue yonder!
Now, we can’t easily change the amount of heat-insulating materials in our body skin but we can change the amount of blood flowing through our skin.
And that’s really, really useful when it comes to regulating our body temperature.
When we’re cold, our hypothalamus narrowing blood vessels to the skin means less warm blood gets delivered to our skin and hurray, less heat escapes from the body.
Simple, but effective!
When our temperature heads in the opposite direction and we start to sizzle, our hypothalamus pokes these very same blood vessels not now to narrow but to widen, more warm blood heads for our skin and those extra Fahrenheits get to flee the body.
Yes simple, but brilliant!
Often times though, we can’t lose enough heat this way and so, activated by our overachieving hypothalamus, our several million sweat glands whir into action too.
(By the way, sweat is only useful for heat loss if it gets to evaporate. Sweat vaporizes into the heavens, using some of that lovely heat in our skin recently delivered by that increased skin blood flow. If we towel down trying to be a considerate gym buddy, we don’t give that sweat the chance to evaporate and take away that extra heat - in fact, we lose all the benefit of that sweat.
Stay stinky, people!)
Clearly then, our hypothalamus is at the heart of all things heat-related and when things go a little awry with our temperature balance, it’s frequently because something sneaked in and did a reset on our brain thermostat..
What kind of something?
Estrogen for one!
Those menopausal hot flashes and night sweats? We can thank the dying estrogen gasps of our ovaries for dramatic, rapid but short-lived downward resets of that hypothalamic set point.
Downward?
That’s weird isn’t it, I mean, don’t hot flashes mean women feel, um, hotter?
Let’s put some numbers to this.
Say for the last hour in bed our hypothalamus has been keeping our core at 98°F, but an ovarian estrogen burp a second ago, adjusted that set point to 95°F. The body temperature reports sent into the hypothalamus say “body holding at 98°F” whereupon the hypothalamus screams “whaaaat, noooooooo, 3°F degrees too hot” and immediately activates those heat loss mechanisms we just talked about: increased blood flow to the skin makes us feel like we’re burning up and those sweat glands can get busy enough to have us needing to change our PJs.
And finally, if you somehow hung in with this article whilst thinking “don’t know why I’m reading this, I’ve got testes not ovaries” thank you and I guarantee you, there are women in your life who will appreciate this new wisdom you’ve gained.
Women who you might see at some point staring into the fridge for 10 minutes considering the merits of peach vs. strawberry yoghurt.
They’re not interested in yoghurt!
They’re trying desperately not to look like they’ve just run a marathon in a sauna.
Help the women in your world feel comfortable talking about this very uncomfortable but entirely natural part of their lives. After all, at some point you may be bending their ear, telling them all the fascinating stuff you learned in our blog about your prostate gland!
And remember, as always, I’m not here to give medical advice, just to help you have those conversations!
P.S one last thing, if you haven’t checked out the “gifts of evolution” answers, slide on over to our geek out pages and you’ll find them there, let me know what you think :)
