Menopause
Everything you need to know about hot flashes and nausea

About 75 per cent of women experience hot flashes but many questions remain unanswered about the nausea that comes with it. Can hot flashes cause nausea? How? What to do?
A hot flash is a sudden feeling of warmth in the upper body, which is usually most intense over the face, neck and chest.
Hot flashes are the most common of an array of indicators of menopause and perimenopause called vasomotor symptoms.
They start when blood vessels near the skin’s surface widen to cool off, making you break out in a sweat. Some women have a rapid heart rate or chills too.
Can hot flashes cause nausea?
Yes, they can.
Hot flashes that occur at night can cause drenching night swears and, sometimes, they may be so strong that they can make the individual feel nauseous.
Other symptoms of hot flashes include headaches and migraines which may also cause nausea.
A menopausal woman can feel nauseous before, during or after a hot flash.
What causes nausea?
Suddenly feeling hot and nauseous with a hot flash is believed to be due to abrupt changes in serotonin, which can stimulate the area postrema, a part of the brain that controls nausea and vomiting.
Area postrema is located right next to the hypothalamus – the part of the brain that regulates temperatures. Due to hormonal fluctuations, the hypothalamus incorrectly detects that the body is overheating, and heat loss mechanisms are triggers, provoking a hot flash.
Nausea can also be caused by a sudden dip in blood pressure, by pressure on the liver or by blood sugar levels.
How to prevent nausea?
Treatments for nausea and hot flashes may involve a combination of lifestyle or dietary changes, along with prescription medications to help address the underlying causes.
A dietary change is one of the main lifestyle changes needed to reduce the risk of nausea during menopause. Menopausal women may want to avoid or decrease the consumption of alcohol, spicy foods, hot foods, hot beverages and caffeinated drinks.
Exercise, not smoking and reduced stress are also part of these lifestyle changes.
If the symptoms do not improve with lifestyle changes after three months, a doctor may recommend medications. These include HRT, oral contraceptive and selective serotonin reuptake inhibitors (SSRIs), a type of antidepressants.
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News
Osteoporosis significantly increases risk of death in menopause, study suggests

Osteoporosis may raise the risk of death in postmenopausal women by up to 47 per cent, a new study suggests.
The findings point to an inverse relationship between femoral bone mineral density and mortality risk, especially within certain ranges.
Femoral bone mineral density is the amount of mineral in the thigh bone, which is often measured to assess bone strength and osteoporosis risk.
Dr Monica Christmas is associate medical director for The Menopause Society.
She said: “Osteoporosis often remains a silent threat after menopause, despite its profound effect on women’s lives—from loss of height, poor balance, and reduced mobility to disfigurement, pain, and even premature death.
“Early screening and preventive measures, including a calcium-rich diet (preferably from food sources), regular weight-bearing exercise, and hormone therapy when appropriate, can significantly improve bone health and reduce risks not only of fractures but also cardiovascular disease, certain cancers, and dementia.
“It’s time we bring this conversation to the forefront.”
In the study involving nearly 3,000 postmenopausal women, bone mineral density at four femoral sites was assessed using dual-energy x-ray absorptiometry, a scan commonly used to measure bone strength and fracture risk.
The analysis found that mortality risk was significantly higher when femoral bone mineral density reached the osteoporotic threshold or when osteoporotic fractures were present.
After full adjustment, osteoporosis was associated with a 47 per cent increased risk of mortality.
A stronger inverse association between increased bone mineral density and mortality risk was seen within specific ranges, suggesting bone mineral density could serve as a prognostic marker of wider health.
The relationship appeared especially notable within the range of 0.46 to 0.71 g/cm² for total femur bone mineral density.
Previous research has shown that postmenopausal women face a significantly higher risk of death within one year of hip or vertebral fractures.
Menopause
Study seeks to understand why women’s hearts become more vulnerable after menopause

A new study will investigate why women’s hearts may be affected differently by type 2 diabetes before and after menopause.
The researchers are among a cohort of leading mid-career scientists to receive a total of almost €6m, about £5.2m, through a partnership between the British Heart Foundation, the Dutch Heart Foundation, the German Centre for Cardiovascular Research and the Lefoulon-Delalande Foundation to support international research collaborations over four years.
The menopause project will be led by Dr Lisa Heather, from the University of Oxford, Dr Miranda Nabben, from Maastricht University and Dr Annie Turkieh, from the Pasteur Institute.
Professor Metin Avkiran is director of international partnerships and special programmes at the British Heart Foundation.
Avkiran said: “We’re delighted to be supporting these ambitious research programmes alongside our European partners, and to welcome CNIC and CIBER-CV to this pioneering partnership,” said
“By joining together, we can make the money donated by BHF’s generous supporters go further to drive more lifesaving research.
“By placing mid-career researchers at the heart of this scheme, we’re backing emerging leaders in cardiovascular science.
“These partnerships are designed to last well beyond the lifetime of the awards and help address the biggest unmet needs in cardiovascular research.”
Before menopause, women are largely protected from diabetic cardiomyopathy, a type of heart muscle damage linked to diabetes, yet after menopause they become more vulnerable than men and more susceptible to heart failure.
Researchers do not yet fully understand why this happens, but believe changing hormone levels after menopause may disrupt cell signals sent out by fat tissue.
This may lead to diabetic cardiomyopathy and trigger damage to the heart.
The study will examine how the hearts and fat tissue of women with type 2 diabetes differ before and after menopause, using animal models, human cells, computer modelling and patient data.
The team says this could lead to a blood test for earlier diagnosis and better treatments for women living with type 2 diabetes.
Menopause
CBT shows promise for menopause insomnia and hot flashes

Cognitive behavioural therapy (CBT) may offer short-term relief for menopause insomnia and night-time hot flushes, a pilot study suggests.
CBT is a structured, short-term talking treatment that helps people change thoughts and behaviours that can worsen sleep problems.
Researchers found the intervention was linked to meaningful short-term improvements in insomnia severity, hot flush interference, sleep self-efficacy, or confidence around sleep, and depressive symptoms.
The Menopause Society said insomnia affects an estimated 20 to 60 per cent of perimenopausal and postmenopausal women in the US.
Ongoing research is focusing on effective treatments because insomnia can have serious physical and psychological effects.
Dr Monica Christmas, associate medical director for The Menopause Society, said: “Nocturnal hot flushes (night sweats) and sleep disruption can have a significant effect on the quality of life with many women claiming extreme impairment due to symptoms that often start in early perimenopause and last 10 or more years.”
“Sleep disturbances can persist even in those using pharmacological therapy to manage hot flushes.
“The study’s findings highlight the utility of cognitive-behavioural therapy as a standalone treatment for insomnia and hot flushes, offering women an alternative or adjunct to pharmacological treatments.”
Insomnia is defined as disturbed sleep associated with distress or impaired daily functioning and is one of the most common complaints in perimenopause and postmenopause.
It can reduce quality of life and is linked to higher healthcare use and costs, disability, depression and cardiovascular disease.
Hot flushes occur in 60 to 80 per cent of women during the menopause transition and can persist for four to five years on average.
Night-time hot flushes are linked to sleep disruption, and women may respond by napping or spending longer in bed, which can help keep insomnia going.
Previous studies have shown that cognitive behavioural therapy is an effective treatment for insomnia and may also help women cope with hot flushes and other menopause symptoms.
However, few trials have looked at both insomnia and hot flushes together.
Insomnia during and after the menopause transition is complex and can have many causes, including ageing, hormone fluctuation, hot flushes, other sleep disorders, psychiatric and medical conditions and psychosocial stressors.
Because women with acute and sustained insomnia can experience greater negative health effects, effective treatment is important.
The pilot study concluded that CBT was feasible and may be a promising approach for menopause-related insomnia and nocturnal hot flushes, although the benefits appeared to lessen after three months.
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