Hot Stuff!

Hot flashes are weird.  They sneak up on you, while you’re minding your own business and, “POW,” like a lightning strike, a surge of electrical hot flames billow from your core to your face until sweat is dripping from your forehead, neck and middle of your back.  Remarkably, your body temperature remains normal despite the fury inside.  Even thinking about a hot flash or the tiniest bit of exertion (such as tying one’s shoes) can cause a fire to stir inside one’s body.  Although hot flashes occur in more than 2/3 of North American women and nearly all women who have induced menopause (most commonly brought about by chemotherapy), we still know very little about what truly causes these sudden throes of fury.  We know they occur with decreases in estrogen levels, as ovarian follicles (eggs) diminish, but we’ve never connected the line to how that produces a sense of overheating.  The best explanation that I found was from an April 12, 2012 article from U.S. News and World Report, which appeared to recognize the importance of the issue since women between ages 44-65 is the largest demographic in the world.  (Maybe our politicians should take note!)

In this article, they discussed a study of peri-menopausal women with daily hot flashes.  Women wore a 24-hour heart rate monitor and recorded their hot flashes.  During the hot flashes, a decrease in the parasympathetic regulation of the heart rate occurred.  What does this mean? The parasympathetic nervous system is part of the autonomic nervous system, regulating our heart and breathing rates while our body is “at rest”.   The sympathetic nervous system provides the adrenaline or surge necessary for “fight or flight”.   In other words, our circulatory system, as it is being regulated by the nervous system, seems to be sending signals to our brain to cool our body off by increasing our blood supply to the skin, which in turn causes flushing and sweating.  Or, as Sandra Tsing Loh illustratively describes in her October 2011 article in The Atlantic, “during menopause, a woman can feel like the only way she can continue to exist for 10 more seconds inside her crawling, burning skin is to walk screaming into the sea—grandly, epically, and terrifyingly, like a 15-foot-tall Greek tragic figure…”

Despite the sleeplessness, fatigue and annoyance, I am grateful to endure this change in my life while progressing through chemotherapy.  I’d much rather deal with this nuisance while I’m already exhausted, so I can take a restorative nap or break when needed.  To assist me, Chris has happily shared his napping expertise, although I’ve not perfected his rapid onset and awakening techniques just yet.  Nonetheless, learning to fall back to sleep quickly after awakening from night sweats can make those 3-4 nighttime awakenings less evident during the day.  But, if you see the bags under my eyes or the "color" in my cheeks, you'll understand why.  

I don’t have hot flashes.  I have short, private vacations in the tropics. ~ Anonymous