What hot flushes and night sweats mean

2012-02-10 00:00

THE other day a client, who was battling with hot flushes and night sweats, told me she’d read an article which stated that women who had these were at less risk for heart disease. She said this made her feel better about waking up drenched in the night or turning red and fanning herself with her notes at a board meeting.

Over the past few years there have been many studies about the role of menopause and hormone therapy (HT) and the risk of heart disease in women.

Research now suggests that hot flushes and night sweats may actually play a part as far as this health risk is concerned.

A new study, probably the one my client read about, suggests that women­ who have hot flushes early on in the menopausal transition are at lower risk for heart disease, and stroke than those women who only experience these symptoms later in their menopause. This might be because younger women may have healthier blood vessels than older women, but remember that each woman is an individual with her own risk profile so it’s sensible not to generalise­.

The study also showed that persistent hot flushes throughout the menopausal transition did not affect heart- disease risk. These results don’t seem to apply to night sweats, so there is a lot of discussion as to whether these different symptoms are caused by different factors, but once again the issue­ of individuality is most important.

Other research suggested that women who had any type of vasomotor symptoms (hot flushes and night sweats) seemed to have less calcification in their arteries, although these results depended on several different factors including the amount and length of time they had these flushes and night sweats, and when they started HT.

But menopause is complex and there is conflicting research about this issue, which is why dealing with midlife women’s health is so complicated, and information you read often seems to be contradictory. A different study shows that women with severe hot flushes are at risk for hardening (calcification) of the arteries. Other research indicated that women battling with night sweats may be at some risk for heart disease, although this risk doesn’t appear to be related to hot flushes.

In yet another study, it seemed that severe hot flushes didn’t affect the actual­ thickening of the lining of the arteries, but only the way in which the inner lining of the blood vessels (the endothelium) functions.

The importance of this research is that hot flushes and night sweats, depending on when, and at what stage of your menopause­ transition you get them, may be useful in predicting­ your risk of heart disease.

I believe that future research will show that hot flushes, while normal and to be expected in most women, may possibly be a red flag for heart disease in some postmenopausal women and not in others, depending on their individual health profile. So it may become important for doctors to add the information of whether you have severe or moderate hot flushes to the list of factors that could put you at risk for heart disease.

The problem is that hot flushes usually­ occur at an age when women start to be at greater risk for heart disease, so it is vital for clinicians to understand whether hot flushes and night sweats signal ageing blood vessels and underlying problems relating to early heart disease and other health issues. Because these results don’t apply to all women, as always, the individual approach is the way to go.

Regardless of your menopausal symptoms, you should work in partnership with your doctor to understand and be aware of heart-disease risk factors, having appropriate tests and treatment when necessary.

Because there is so much new research it is not yet clear what future strategies will be most effective in dealing with these issues, but it seems certain that a healthy lifestyle and giving­ up smoking, drinking moderately and exercising, as well as taking cholesterol-lowering drugs when indicated, should help keep these risk factors at bay.


 Nicole Jaff is an international menopause expert. Her most recent book, Menopause: Everything You Need to Know, is published by Pan Macmillan.

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