- What Causes a Hot Flush?
- Hot Flushes and Type 2 Diabetes
- Hot Flushes and Cardiovascular Disease
- Hot Flushes and Inflammation
- Insulin and Inflammation
- How to Combat Inflammation
Anyone who has experienced a hot flush will be familiar with the creeping sensation of heat which washes over the body, regardless of where you are or what you’re doing.
Often the butt of jokes, hot flushes are no laughing matter for those affected.
They are uncomfortable, causing embarrassment, anxiety and sleep deprivation.
Hot flushes are estimated to affect in excess of 80% of menopausal women (1).
A hot flush usually starts unannounced with a feeling of heat in the face, neck and chest accompanied by sweating, raised heartbeat and redness or blotchiness of the skin.
To some women, it feels like a rush of blood from their toes to their head.
Following a flush a woman may feel chilly.
Often hot flushes occur during the night, in which case they’re called night sweats.
Some women wake up completely drenched in sweat.
We’re dedicated to providing you with both insightful information and evidence-based content, all orientated towards the Personalised Health approach.
In this article we’ll will delve a little deeper into what may be behind hot flushes and their link with other common health conditions, including chronic inflammation, as well as actionable tips to help combat inflammation on your journey to optimal health.
Despite the fact almost every woman will experience hot flushes at some time during her menopause, scientists don’t fully understand the mechanisms which occur behind a hot flush or what causes them to happen.
It’s commonly believed hot flushes are due to rapidly changing levels in female hormones, particularly oestrogen.
Some scientists believe changes in the brain chemical serotonin (2) also play a role, along with blood vessel alterations regulated by the part of our nervous system not under our conscious control.
Interestingly, science has found a link between the severity of hot flushes experienced by a woman as she transitions through the menopause and two common twentieth-century diseases - Type 2 diabetes and cardiovascular disease.
Type 2 diabetes carries with it the risk of dangerous complications including heart disease and stroke, as well as kidney and nerve damage and eye problems.
Early signs of Type 2 diabetes include increased thirst, fatigue, frequent urination and unexplained weight loss, however scientists have now found another possible symptom - hot flushes.
In one study (4) researchers who looked at 150,000 postmenopausal women found those who experienced frequent hot flushes were 18% more likely to develop Type 2 diabetes.
Women who were troubled by night sweats had an even greater risk.
It appeared it was the number of hot flushes or night sweats which was significant, as well as their severity or duration.
These results held true even when they were adjusted for other risk factors such as obesity and ethnicity.
The study authors have hypothesised one link may be the disturbed sleep caused by hot flushes, which in itself is a risk factor for Type 2 diabetes.
This is possibly because lack of sleep causes an increase in the release of stress hormones which can interfere with insulin levels.
In another study (5), women aged between 40 and 53 years who suffered from hot flushes were found to have changes in the tissue lining their blood vessels, which are connected with the early development of cardiovascular disease.
These changes were correlated with the number and severity of the flushes.
From this, we can see that hot flushes may also predict the risk of a woman developing cardiovascular disease.
This correlation between hot flushes and cardiovascular disease has again been found when conventional risk factors such as obesity and a sedentary lifestyle have been ruled out.
A further study (6) noted a relationship between certain inflammatory markers (which are associated with inflammation of the blood vessels and typically raised in cardiovascular disease) and the severity of hot flushes experienced.
One factor underlying chronic diseases such as Type 2 diabetes and cardiovascular disease is chronic inflammation.
One study has suggested the severity of hot flushes may be associated with inflammatory changes within the body as a whole (7).
Inflammation plays a crucial role in the body.
When we suffer from an injury or infection, inflammation is the body’s defence mechanism by which white blood cells migrate to the area to clear away foreign invaders such as pathogens or damaged tissue.
It is associated with redness, heat and swelling in the affected area.
This type of inflammation is short lived, lasting from a few minutes to several days depending on the injury, and it serves a specific and useful purpose.
However, certain factors such as an overreactive immune system, poor food choices, smoking, stress or lifestyle factors like obesity can cause inflammation to become constantly elevated in the body.
If inflammation is increased long-term it may become chronic, which can cause many health problems.
This is because chronic inflammation can damage our cells and tissues, interfere with our blood sugar control and alter our stress response by increasing the release of stress hormones.
In fact uncontrolled inflammation is now known to play a role in almost every chronic disease.
Insulin is secreted by the pancreas in order to lower our blood glucose levels after we have eaten.
It does this by encouraging the body to shunt glucose inside the cells where it’s used for energy, which means less glucose remains in the blood.
Type 2 diabetes often develops after the body’s cells become resistant to the message of insulin, which means glucose isn’t taken on board inside the cells and remains high in the blood.
Too much glucose in the blood can damage tissues, so the pancreas secretes more insulin to try and encourage the cells to take it in.
So insulin levels remain high. High insulin can be a symptom of insulin resistance.
It’s well established that sugar promotes inflammation. Insulin on the other hand lowers glucose levels. It also has anti-inflammatory effects in its own right.
So, insulin can actually be instrumental in lowering inflammation (8).
It would appear the culprit may not so much be the high insulin but underlying inflammation.
As ever, as science progresses, sometimes it’s hard to tease out the symptoms from the cause.
Going back to hot flushes, it’s clear inflammation plays a crucial role.
However, is the inflammation caused by the hot flushes or does an inflammatory state in the body predispose it to hot flushes?
It is becoming obvious that chronic inflammation may predispose women to more flushes, while their effects, such as disturbed sleep and increased stress themselves promote yet more inflammation in a vicious cycle.
Science has not yet demonstrated a clear link to show how inflammation can cause hot flushes, but as we’ve seen above, it seems likely that it plays a role. In order to understand how to reduce inflammation, we need to appreciate what causes it.
Blood sugar levels which are not properly controlled predispose us to release certain inflammatory chemicals.
It’s worth remembering fluctuating blood sugar levels are also connected to increased incidence of hot flushes.
The key to balancing blood sugar levels is avoiding sugar and processed carbohydrates and ensuring you are eating sufficient good quality protein from legumes, pulses, oily fish and occasional lean meat.
Good quality sleep and managing stress are also crucial to our blood sugar control mechanisms.
Prolonged stress leads to an increase in the release of our stress hormone cortisol. If this is permanently elevated, it can bring about the release of inflammatory molecules in the body.
Many women find stress increases the likelihood of a hot flush.
Try stress reduction techniques such as yoga, meditation or deep breathing exercises. A massage can be a great stress-buster.
The functioning of the digestive system is closely linked to chronic inflammation. Our microbiome – the population of many different varieties of bacteria living in our digestive system - has an important role in the proper functioning of the immune system, and its importance in regulating inflammation is becoming clear.
Keep your gut happy by eating plenty of foods rich in natural fibre which provide a food source for our digestive bacteria. These include garlic, onions, Jerusalem artichoke, asparagus and apples. Fermented food such as sauerkraut, kimchi, kombucha and kefir can also be useful.
Eating high amounts of processed foods, sugar, alcohol and saturated fats can encourage inflammation. On the other hand eating plenty of fresh fruit and vegetables, especially leafy green vegetables, and healthy fats such as omega-3 from oily fish, nuts and seeds can lower inflammation levels.
Even a few nights of disturbed sleep, or too little sleep, can raise levels of inflammation in the body. Poor sleep can in turn affect blood glucose levels. Unfortunately, if women suffer from night sweats, this can disrupt sleep in itself.
Avoiding alcohol and caffeine, minimising screen time in the evening, establishing a regular bedtime and taking a warm bath with Epsom salts can all help to improve your sleep quantity and quality.
An increase in the number of fat cells in the body results in more inflammatory molecules being produced. Regular exercise, apart from being a stress buster and playing a role in weight loss and bone health after the menopause, has been linked to lower levels of inflammation.
Choose an exercise you enjoy, start slowly and congratulate yourself when you exercise - don’t beat yourself up when you don’t.
Even walking in the open air is great exercise, with the added bonus of helping you sleep better.
Emerging knowledge of the role of inflammation as well as the close relationship between health conditions such as hot flushes, cardiovascular disease and diabetes serves to remind us the body operates as a complex whole, with no organ or system working in isolation.
A consultation with an experienced Amchara practitioner can help guide you towards nutritional and lifestyle interventions to address levels of inflammation in your body which may not only be linked to your hot flushes but may also be contributing to other health problems.
We believe sharing knowledge and experience is an important part of achieving optimal health and would love to hear your views and experiences. With your comments we can continue the conversation.
Let us know your top tips to help manage hot flushes.
By Cathy Robinson BScDipNutMed
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