Why Do I Get Hot Flashes On My Period

Overview

Hot flashes are a common and bothersome symptom experienced by menopausal women, but when should you worry and what treatment options are available? In this article, we will explore the causes of hot flashes during perimenopause, available management and treatment options, and when to seek medical advice

Causes of hot flashes during or on my period

Perimenopause, also known as the menopausal transition, is the time leading up to a woman’s final menstrual period, characterised by menstrual irregularities and associated symptoms such as hot flashes and vaginal dryness. There are two stages of perimenopause: The first involves irregularities in menstruation while the second latter stage is defined by amenorrhea. In essence, perimenopause is a process that typically takes place towards the end of a woman's reproductive life, before menopause.

Hot flashes, also known as hot flushes or vasomotor symptoms, are experienced by both premenopausaland menopausal women, with prevalence and severity increasing as a woman progresses through perimenopause. 

Other factors affecting variations in prevalencen include ethnicity, BMI, FSH levels, smoking, anxiety and depression.

Women experiencing hot flashes during perimenopause are likely to continue experiencing them after menopause, with 20% of women in their 50s, 10% in their 60s, and 5% of women in their 70s reporting persitent symptoms. Though the prevalence of hot flashes typically decreases with age, a critical minority of women present with ongoing symptoms and thus will require lifelong treatment. Treatment is necessary to reduce discomfort and decrease the risk of life-threatening diseases such as cardiovascular disease, which has been linked to higher incidences of hot flashes. 

Although incidences of hot flashes in women typically decline over time, other symptoms, such as vaginal dryness only improve with prolonged treatment. Vaginal dryness occurs primarily in response to declining estrogen levels. The estrogen hormone in women helps to promote optimal sexual health by protecting women from certain reproductive diseases, including breast cancer. 

Management and treatment

• Menopausal hormone therapy preparations (low-dose) such as Cenestin and Evamist
• Simultaneous use of estrogen with levonorgestrel intrauterine system: This is also contraception and protects the endometrium
• Paroxetine mesylate, 5mg, effectively treats vasomotor symptoms 
• Ospemifene, 60mg, is a selective estrogen receptor modulator that treats vaginal dryness 
• Gabapentin, 100-300 mg doses, for hot flashes that only cause nightly discomfort - small doses may be taken at night
• Clonidine and progesterone are pharmacological agents that are highly efficient at treating menopause-associated hot flashes

Botanical remedies such as yoga, omega-3 fatty acid supplements and black cohosh have proven ineffective. 

When to see a doctor

Please consult your doctor if: 

1. You experience hot flashes while still in your first stage of perimenopause. Your clinician may be able to determine if and what pharmacological therapies are required
2. You experience hot flashes during sleeping hours. Your clinician may recommend an MRI scan as a precaution to assess potential underlying illnesses

Summary

Menopause-associated hot flashes vary in prevalence between women, depending on an array of both environmental and biological factors as detailed earlier in this article. Though effective pharmacological treatments are available, it is advisable to seek consultation with a clinician if you feel your hot flashes are severely affecting your quality of life.