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Pharmacy Links

THE MENOPAUSE: HOT FLUSHES AND NIGHT SWEATS (PART 2)

May 8, 2009

Hot flushes and night sweats are, therefore, an obvious case for treatment with hormone replacement therapy, and in fact relief from these distressing symptoms is the commonest reason for women wanting to take it. As the problem is caused by falling levels of oestrogen, the flushes cease when these levels are topped up to their normal level. Once oestrogen therapy is started, the situation can be dramatically improved within a few days, and the flushes have usually ceased completely within a few weeks. If you are still troubled with them after three months of therapy, ask your doctor if he will change your dosage of oestrogen; he should be able to find one eventually that relieves your symptoms without causing unpleasant side-effects. Once things have stabilised, the relief will usually continue for as long as you remain on the therapy. However, they may return if you stop the treatment suddenly, move to a hot climate (if you go abroad on holiday, for example), take a course of antibiotics, or come under additional stress. If this happens, ask your doctor’s advice.

Taking HRT will eliminate night sweats, dramatically improving the quality of your sleep, and with it your level of fatigue and irritability. Sadly, some general practitioners still prescribe tranquillisers and anti-depressants to women who complain of hot flushes and night sweats, and the insomnia and emotional upsets that they cause. This is difficult to justify, as the problem is due to falling oestrogen, and nothing else. Replace the oestrogen with HRT and the flushes and sweats will disappear, and with them the sleep disturbance they cause and its accompanying fatigue, irritability and lack of wellbeing. If you are on tranquillisers or anti-depressants for these particular menopausal problems, talk to your doctor about the possibility of changing to hormone replacement therapy. (If he ‘doesn’t believe in it’, see page 90 for other suggestions.)

Many women feel they want to ‘die of embarrassment’ or ‘disappear into the floor’ when a hot flush strikes them at work or in mixed company. This is largely due to other people’s perception of hot flushes; some men and young women may laugh and make unkind remarks. Perhaps we could bring up our sons in such a way that they become men who will not diminish a female colleague’s self-esteem at work, but will show kindness and sympathy during what is a very uncomfortable few minutes. Once our daughters know more about the menopause and its causes and effects, perhaps they will help to develop a culture that will ensure attitudes have changed by the time their turn comes.

Flushes have been described as ‘something like adolescent acne – an outward sign of natural hormonal changes’. They may be troublesome and embarrassing but (unless you are one of the unfortunate 5 per cent) they do decrease in number and strength, and they will eventually pass as the body adjusts to its lower level of oestrogen. However, just because the menopause is ‘natural’ doesn’t mean you have to put up with its distressing symptoms for months or years, and we are lucky that HRT is now available to relieve them.