Menopausal hot flushes and night sweats: where are we now?
Abstract
OBJECTIVE: An overview of the current knowledge on the etiology and treatment of vasomotor symptoms in postmenopausal women. MATERIALS AND METHODS: Acknowledged experts in the field contributed a brief assessment of their areas of interest which were combined and edited into the final manuscript. RESULTS: Women around the world experience vasomotor symptoms as they enter and complete the menopause transition. Vasomotor symptoms, specifically hot flushes, are caused by a narrowing of the thermoneutral zone in the brain. This effect, although related to estrogen withdrawal, is most likely related to changes in central nervous system neurotransmitters. Peripheral vascular reactivity is also altered in symptomatic women. Estrogen replacement therapy is the most effective treatment for hot flushes. Of the other interventions investigated, selective serotonin and selective norepinephrine reuptake inhibitors and gabapentin show efficacy greater than placebo. Objective monitoring of hot flushes indicates a robust improvement with hormone replacement therapy but little to no change with placebo. These data suggest that the subjective assessment of responses to therapy for vasomotor symptom results in inaccurate data. Hot flushes have recently been associated with increased cardiovascular risks and a lower incidence of breast cancer, but these data require confirmation. CONCLUSIONS: Vasomotor symptoms are experienced by women of all ethnic groups. They are caused by changes in the central nervous system associated with estrogen withdrawal and are best treated with estrogen replacement therapy. Objective monitoring of hot flushes indicates that placebo has little to no effect on their improvement. Subjective assessments of hot flushes in clinical trials may be inaccurate based on objective measurement of the frequency of hot flushes. Based on preliminary reports, women experiencing hot flushes have an increased risk of cardiovascular disease and a reduced incidence of breast cancer.
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Soy isoflavones show selectivity toward ER-β over ER-α.
“First, soy isoflavones show selectivity toward ER-ß over ER-α [168-175].”
From Soy, Red Clover, and Isoflavones and Breast Cancer: A Systematic Review (2013) · cites this paper as [172]
Hot flushes can be triggered by thermal, chemical, or other stimuli including increased ambient temperature, hot beverages, caffeine, spicy food, stress or anxiety.
“Hot flushes can be triggered by a variety of stimuli including thermal (increased ambient temperature or hot beverages), chemical (caffeine or spicy food) or other (stress or anxiety) (Archer et al., 2011; Freedman, 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 Archer et al., 2011
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- Authors
- Archer, D. F., Sturdee, D. W., Baber, R., de Villiers, T. J., Pines, A., Freedman, R. R., Gompel, A., Hickey, M., Hunter, M. S., Lobo, R. A., Lumsden, M. A., MacLennan, A. H., Maki, P., Palacios, S., Shah, D., Villaseca, P., & Warren, M.
- Affiliations
- Eastern Virginia Medical School (US)
- Solihull Hospital (GB)
- The University of Sydney (AU)
- Tel Aviv Sourasky Medical Center (IL)
- Wayne State University (US)
- Assistance Publique – Hôpitaux de Paris (FR)
- Royal Women's Hospital (AU)
- King's College London (GB)
- University of Glasgow (GB)
- The University of Adelaide (AU)
- University of Illinois Chicago (US)
- Instituto Palacios (ES)
- Pontificia Universidad Católica de Chile (CL)
- Columbia University (US)
- ORCID
- Venue
- Climacteric
- Publisher
- Informa UK Limited
- Published
- 2011-08-18
- Volume
- 14
- Issue
- 5
- Pages
- 515-528
- ISSN
- 1369-7137 (ISSN-L)
- 1473-0804
- OpenAlex
- W2025638598
- Cited by
- 185
- References
- 131
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 8 · 2023: 11 · 2022: 12 · 2021: 9 · 2020: 11 · 2019: 16 · 2018: 16 · 2017: 12 · 2016: 18 · 2015: 13 · 2014: 15 · 2013: 18 · 2012: 8
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Climacteric (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- hot flashes, night sweats, vasomotor symptoms, menopause, perimenopause, estrogen withdrawal, thermoneutral zone, peripheral vascular reactivity, hormone replacement therapy, selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors, gabapentin, cardiovascular risk, breast cancer risk
- MeSH terms
- Adult, Body Temperature Regulation, Brain, Breast Neoplasms, Cardiovascular Diseases, Estrogens, Female, Humans, Menopause, Middle Aged, Risk Factors, Sweating, Vasomotor System, Estrogen Replacement Therapy, Randomized Controlled Trials as Topic, Neurotransmitter Agents, Hot Flashes
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