HOT FLUSHES  and the nervous system

* Featured image by Julia Yellow for The Washington Post

MenoPassage: a holistic Journey through the menopausal years

Hot flushes are perhaps the one symptom that is most classically associated with menopause. Many women wonder why they have this pesky symptom that sometimes disturbs life quite profoundly. Pesky and sometimes deeply disturbing they are, and yet there are things we may gain from having to endure them, they may well become part of the MenoPassage Journey that leads one to greater inner strength and tranquility.

There are many aspects to this enigmatic phenomenon of HOT FLUSHES. A lot of it has to do with the brain and our nervous system. Indeed, the brain has receptors for estrogen that regulate its activity. In the menopausal years, estrogen levels tend to fluctuate a lot, and the brain has to make corresponding adjustments.

Our sense of how warm it is in our environment and whether we need to do something about it (primarily by SWEATING) is regulated by a specific center in our brain that acts as our thermostat, the “thermoregulatory nucleus”, it maintains the core body temperature within a specific range, “the thermoregulatory zone”. Sweating occurs when it goes above the upper threshold, whereas chills occur when it dips below the lower threshold. Women with hot flushes seem to have a more narrow range that they can tolerate, thus more readily developing the sweats and chills for no apparent reason.

But what leads to the narrowing of the range? This question remains unanswered, it most likely has to do with the large fluctuations of hormones in the brain during menopause. The sudden withdrawal and/or great variability in estrogen levels definitely seem to be a factor, these changes seem to entrain greater variability in certain neurotransmitters including norepinephrine and serotonin.  This in turn will also lead to mood swings, depression and sleep abnormalities.

Can we take charge of these changes in our nervous system?

It does appear to be so. Researchers have found  that it is indeed possible to calm down the fluctuations in hormone levels and thereby diminish hot flushes in a study involving almost 500 women. They were able to show that a key to diminishing hot flushes is RELAXATION, specifically slow-breathing techniques, which in essence are particularly effective in reducing an adrenalized/stressed state. This seems to help widen the thermoregulatory zone, or the range of tolerated temperature. So – enjoy and RELAX, breathe deeply and slowly and watch the hot flushes diminish.

I would particularly recommend the yogic practice of alternate nostril breathing (instructions to this are widely available on YouTube). Though of course, it is easy to just be attentive to one’s breathing and simply deepen the breath, but from my experience it is a good idea to get specific instruction as they are many nuances to pay attention to that will make the experience more effective. One such set of instructions is available for a free download from  the home page of my web site on the right hand side.

Another interesting observation that came out of the same study: endorphins plummet when you have a hot flash, so if we can keep our endorphin levels even and well boosted by exercising regularly as well as other methods outlined below, we have a greater chance of moderating this symptom.

This is actually quite significant, because it shows how much the state of our nervous system, the level of tension vs. deep quiet reserves is a significant factor in hot flushes as well as other menopausal issues. Nourishing our nervous system becomes a crucial element in our approach to hot flushes.

We can accomplish this in so many ways:

  • Exercise, somewhat vigorously, 3x/week for 20 minutes at a time, preferably accompanied by music you really like to get the most enjoyment and maximize the endorphins…. This will also help diminish hormonal fluctuations and thus stabilize your whole experience of menopause.
  • Making space for deep rest, sound sleep (which tends to suffer during menopause as well, subject for another day…)
  • A meditation practice
  • Herbal remedies: here we have a variety of different approaches:
  • Tonifying the nervous system with herbs such as oat straw, the queen of the nerve tonics, hops, gemmotherapy (another blog)
  • Detox and nourish the liver, which is essential to minimize the hyperreactivity of a stressed nervous system. Dandelion, Ho Shou Wu (a Chinese herb), yellow dock, milk thistle, chicory, burdock are all examples of herbs that may work well. You can easily find liver detoxification formulas that include some of the herbs.
  • Phytoestrogenic plants, includingmotherwort, fenugreek, fermented soy products
  • Supplements, vit E, Selenium, vit B, bioflavonoids esp Hesperidin 1000 mg
  • You can also try a homeopathic, lichesis, preferably 30X, has an 80% chance of working

In essence, the more you nourish your nervous system, detoxify your liver and connect to a deep, quiet place inside, the more you will be able to moderate this symptom. This also takes us into the realm of Chinese medicine, which I intend to get more deeply into in future blogs. Chinese medicine provides an in depth understanding of how to nourish and balance one’s nervous system to bring harmony and vitality to all functions and address a variety of symptoms that arise from stress and depletion of energy. 

Taking time to nourish yourself more deeply will enhance your whole MenoPassage Journey, will give you a foundation for stepping into the full vitality and creativity of the next phase of your life. We will continue discussing this in greater depth as we go along, so please stay posted.


by Angela Ingendaay, MD

Angela Ingendaay






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