Biochemical, metabolic, and vascular mechanisms in menopausal hot flashes
Open accessAbstract
Objective To determine if increases in core body temperature preceding most hot flashes are caused by increased metabolic rate, peripheral vasoconstriction, or central noradrenergic activation.Design Laboratory physiological study.Setting University medical center.Patient(s) Fourteen healthy, postmenopausal women reporting frequent hot flashes.Intervention(s) Data were recorded for 3 hours in a temperature- and humidity-controlled room.Main outcome measure(s) Core body temperature, mean skin temperature, respiratory exchange ratio, sternal skin conductance, plasma 3-methoxy-4-hydroxyphenylglycol, and vanillylmandelic acid.Result(s) Twenty-nine physiologically defined hot flashes were recorded. Increases in core body temperature, measured with an ingested radiotelemetry capsule, preceded 76% of the flashes. Increased metabolic rate began after increased core temperature. Peripheral vasoconstriction did not occur. Plasma levels of 3-methoxy-4-hydroxyphenylglycol, a metabolite of brain norepinephrine, increased significantly, whereas vanillylmandelic acid, a peripheral metabolite, did not.Conclusion(s) Core body temperature elevations preceding menopausal hot flashes are not driven by peripheral vasoconstriction or increased metabolic rate, but probably by a central noradrenergic mechanism.
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Physiological hot flashes were measured by sternal skin conductance using the Biolog ambulatory recorder, with hot flashes flagged by published norms and each skin conductance track evaluated by a trained expert verifying that events matched published norms for vasomotor events.
“Based on published norms,10–13 hot flashes were flagged if there was an increase in sternal skin conductance of at least 2 μmho within a 30 second period, with a 15-minute post-event lock-out. Each skin conductance track was evaluated by a trained expert, verifying that each skin conductance event matched published norms for vasomotor events.”
From Clinical hypnosis in the treatment of postmenopausal hot flashes (2013) · cites this paper as [12]
Physiological hot flashes were measured by sternal skin conductance using the Biolog ambulatory recorder, with hot flashes flagged by published norms and each skin conductance track evaluated by a trained expert verifying that events matched published norms for vasomotor events.
“Based on published norms,10–13 hot flashes were flagged if there was an increase in sternal skin conductance of at least 2 μmho within a 30 second period, with a 15-minute post-event lock-out. Each skin conductance track was evaluated by a trained expert, verifying that each skin conductance event matched published norms for vasomotor events.”
From Clinical hypnosis in the treatment of postmenopausal hot flashes (2013) · cites this paper as [11]
A very small increase in core temperature was detected before the onset of 65% to 76% of flushes.
“Using an ingestible thermometer (radio-telemetry pill), a very small increase in core temperature was detected before the onset of 65% to 76% of flushes (Fig. 3) (Freedman, 1998, 2001).”
From Modulation of body temperature and LH secretion by hypothalamic KNDy (kisspeptin, neurokinin B and dynorphin) neurons: A novel hypothesis on the mechanism of hot flushes (2013) · cites this paper as Freedman, 1998
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References 23 · Cited by 232
- Authors
- Freedman, R. R.
- Affiliations
- Wayne State University (US)
- Corresponding author
- Freedman, Robert R
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1998-08
- Volume
- 70
- Issue
- 2
- Pages
- 332-337
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2169078759
- Cited by
- 232
- References
- 23
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 2 · 2019: 4 · 2018: 5 · 2017: 6 · 2016: 9 · 2015: 4 · 2014: 3 · 2013: 17 · 2012: 14
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG-05233)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
- Keywords
- menopausal hot flashes, core body temperature, metabolic rate, peripheral vasoconstriction, MHPG, vanillylmandelic acid, norepinephrine, skin conductance, respiratory exchange ratio, postmenopausal women
- MeSH terms
- Analysis of Variance, Body Temperature Regulation, Female, Galvanic Skin Response, Humans, Menopause, Middle Aged, Norepinephrine, Vasoconstriction, Hot Flashes
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