Hot Flashes and Heart Disease

Introduction 

People assigned female at birth (AFAB) are more susceptible to certain health conditions such as cardiovascular disease and mental health challenges; due to their periods, childbirth and menopause. Here, we discuss the connection between the menopausal symptom of hot flashes and heart disease, and look at the ways to manage this. 

Hot Flashes

Hot flashes occur in people AFAB during menopause and in perimenopause. It is a feeling of heat that results in sweating and redness in the face. 

According to Hopkins Medicine, menopause causes hormonal changes. In particular, the levels of oestrogen and progesterone diminish from pre-menopausal levels. People AFAB begin to suffer from hot flashes around the time of their last period. As this is a biological indication of decreasing levels of oestrogen, it is extremely common: 75% of people AFAB experience hot flashes, and many suffer from it for a minimum of 2 years. Other symptoms associated with hot flashes include dizziness and heart palpitations.¹ 

Menopause and Cardiovascular Health

According to heart.org, menopause does not cause heart disease. However, it is associated with higher risks of heart failure and other heart diseases.² For example, endothelial dysfunction, a constriction of the blood vessels, is a key biomarker of heart attacks and strokes and has been shown to be associated with hot flashes.³ Other factors, such as having a high-fat diet or smoking, also increase this risk. Postmenopausal women also have a higher risk of heart disease and heart attack ten years after the onset of this symptom. 

The levels of oestrogen in the body also contribute to cardiovascular health. Oestrogen is a sex hormone produced in people AFAB and is responsible for female characteristics and the menstrual cycle. This hormone also helps blood flow by relaxing and expanding the blood vessels, as well as regulating cholesterol levels. It also has anti-inflammatory properties.⁴ 

When people AFAB enter menopause, their levels of oestrogen drop, making them more susceptible to heart disease in the future. Studies suggest that persistent hot flashes (a result of reduced oestrogen levels) are risk factors for cardiovascular disease.³ One such study, conducted by the North American Menopause Society (NAMS), points to increased risks of heart attack and stroke in menopausal and post-menopausal women experiencing frequent hot flashes.³ 

If you are experiencing hot flashes, it might be worth meeting with your GP to discuss any increased risk of heart disease and potential treatment. Hormone replacement therapy (HRT) is a type of treatment that can help lessen the effects of ageing on the body’s oestrogen levels.⁵ This in turn provides cardiovascular benefits when given in the early stages of menopause.⁴ Other preventative actions include eating a balanced diet, partaking in exercise often, maintaining a healthy weight and engaging in other activities that promote a heart-healthy lifestyle.⁶

Managing Hot flashes

Stop Smoking

Smoking puts women at a higher risk of entering menopause earlier than they normally would.⁷ According to WebMD, smokers also experience more frequent and more severe hot flashes.⁸ Cutting down on smoking can therefore reduce the occurrence of hot flashes and also reduce your risk of heart disease.

Maintain a Healthy Weight

Physical activity and a balanced diet are very important factors for deciding when a woman enters menopause.⁹ Additionally, not regularly participating in physical activity may increase the chances of nighttime hot flashes in menopausal, perimenopausal and postmenopausal women.⁹ This increases the risk of cardiovascular disease. 

Foods and Beverages to Avoid 

Alcohol is a major trigger for hot flashes. Alcohol causes blood vessels to dilate, causing blood to rush to the surface of the skin, which in turn can result in a hot flash.¹⁰

The same is true of spicy foods. This is due to the chemical capsaicin, which is found in chillies.¹⁰

Caffeine also contributes to hot flashes by raising your heart rate and getting the blood pumping, making you hotter in the process.¹⁰

If you have been suffering from hot flashes for a while and nothing seems to be working, it might be worth finding substitutes for these three triggers.

Mindfulness

Emotions often trigger bodily responses, and hot flashes can be one of them. Feeling really stressed out or intensely emotional has been shown to increase the likelihood of getting a hot flash, so practising mindfulness techniques - like deep breathing or yoga - may help. ¹⁰

Hormone Therapies 

Hormone replacement therapy (HRT) may be used to reduce hot flashes. There are two different types of HRT available for women suffering from menopausual symptoms: combined HRT (a mix of oestrogen and progestogen hormones) or oestrogen-only HRT.

There are benefits and risks of taking HRT. A main benefit is that HRT eases most menopause symptoms. Yet, using some types of HRT can cause an increased risk of breast cancer. However, the NHS states that the benefits of HRT mostly outweigh the risks.  Nevertheless, since everybody’s different, the doctor will have to personalise your dosage and duration of treatment.¹¹

Summary 

Heart disease is one of the major medical conditions that affect women's health. Entering menopause signals a time when ovaries age and produce less oestrogen than before. This causes menopausal symptoms like hot flashes. With hot flashes comes an increased risk of experiencing strokes, panic attacks, heart attacks and other cardiovascular diseases.

Reducing stress, practising relaxation techniques, and maintaining a healthy and active lifestyle are proactive ways to reduce your chances of getting hot flashes or make your symptoms more bearable.