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Fire! I'm on Fire!

Hot flush. Hot flash. Power surge. Whatever you want to call them, the sudden onset of intense heat resulting in a flushed red face, perspiration, the urge to tear clothes off or throw bedclothes off, are the commonest symptom of perimenopause and menopause that many women experience. It's the butt of so many old (and bad) menopause jokes, and if you've ever experienced one (hot flush that is), they aren't that funny. Actually, neither are the jokes!

Like so many of the symptoms of peri and menopause, every woman will have her own unique experience. I will share my experience with hot flushes however, your experience could be quite different. The thing is, the more we share and learn, we can at least be better prepared and also feel less alone through the transition.

My first hot flush was somewhat subtle compared to my usual hot flushes that I would come to experience 10-20 times a day for about 7 years. I remember being at home on the couch watching television and suddenly my face felt like I was blushing with embarrassment but with a bit more heat. At the time, I thought I was just feeling hot due to the weather. Slowly over time, I started having more of these hot flushes and they changed in intensity, when they would occur, and how they occurred. I would get a growing intense heat sensation that would start at the top of my chest and move up the front of my neck to my whole face and head. Thankfully, I wouldn't go red in the face, although it sure felt like it was. The feeling of heat would last anywhere from 30 seconds to a minute, but during a hot flush it feels like a lot longer. Once it was over, I would break out in a sweat, and it often felt like the sweat was being dumped from the top of my head down my face. Boom! It wasn't a significant amount of sweat, but enough to wipe away with a hand or tissue or whatever was suitably handy at the time. And yes, even in cold temperatures or air conditioning this would be the scenario. Cool environments helped to lessen the intense heat feeling, but the hot flush would still happen, and the sweat would still result. There was no escaping it.

After a few months of hot flushes, I started keeping track of when they occurred and for how long. I then noted foods or activities to see if there was any correlation. Of course, I was also Googling the hell out of hot flushes and how to prevent them or lessen the intensity of them. There are a lot of herbs and "natural remedies" that claim to stop or reduce hot flushes, but for me it was cutting down on sugar, highly processed foods, alcohol, coffee, and spicy foods that seemed to help.

So, what is a hot flush and why do they occur? Time for some science. According to the Mayo Clinic, hot flushes are most commonly caused by changing hormone levels before, during and after menopause. It's not clear exactly how hormonal changes cause hot flushes. But most research suggests that hot flushes occur when decreased estrogen levels cause your body's thermostat (hypothalamus) to become more sensitive to slight changes in body temperature. When the hypothalamus thinks your body is too warm, it starts a chain of events — a hot flush — to cool you down. This heat-releasing mechanism is how your body keeps you from overheating in the summer, but when the process is triggered instead by a drop in oestrogen, your brain's confused response can make you very uncomfortable. Some women's skin temperature can rise six degrees Celsius during a hot flush. Your body works to cool itself down when it shouldn’t, and you are miserable: soaking wet in the middle of a work meeting or in the middle of a good night’s sleep.

Not all women experience hot flushes as part of peri or menopause, but they are quite rare. If you are one of these lucky women, I am envious. For most of us however, we will have some hot flushes or even a lot of hot flushes. The good news is that over time you will find your own strategies to cope, and there is a possibility that they will lessen and may even cease. The not so good news for some women is that they may not ever cease. Lately I have been having one hot flush about once a week, but it has been very mild, and I don't break a sweat. My mother, who is in her 70s, tells me that she has the odd hot flush every now and then and they are quite mild too.

Okay, so how do we deal with these hot flushes if and when they come? That will depend on you and the severity/intensity of the flushes. At the peak (or worst) of my hot flushes, I made sure I was wearing layers of clothing, even in summer, so I could strip down when needed while still looking professional at work or out in public. Breathable fabrics are your friend. Linen, polyester blends, bamboo, and micro modal fabrics are my favourites. I also found fanning myself during and after a hot flush to be a good way to cool down quickly, but you will attract attention. I recommend talking to your work colleagues about your peri/meno and symptoms so they understand why you're tearing your clothes off, complaining about being hot all the time, fanning yourself, and turning the air conditioning down to 16 degrees while everyone else is freezing. Talk to your family and friends too. You may find, like I did, that they have noticed changes in your mood or behaviour that you may not have been aware of. In my experience, people are very understanding, especially those who are close to you. The more you talk about what you are experiencing and are comfortable doing so, people you work with and those in your life will feel more comfortable too. Believe me, even the young Gen Zs and older Boomer men will start to listen and even sympathise if you share your personal experience in an honest and candid way. You don't need to over-share but go with what you feel comfortable with to start. "Hey team, I just wanted to let you all know that I am going through perimenopause and after seeing my doctor, it has been confirmed. You may notice that I might be a bit grumpier (than usual LOL) sometimes, I get hot flushes out of the blue so will be fanning myself or complaining about the heat, and sometimes I get a bit emotional due to my hormones. I'm giving you all a heads-up because I don't want to offend anyone if I have a grumpy moment. And if I do say or do something out of line, please let me know. My perimenopause is not an excuse for poor behaviour, but I want you all to know so you can understand." This is pretty much what I said to my work team, which was a group of 4 women and 1 man, and they were really great. Often my colleagues would go on walks with me to the local cafe if I was "having a moment" or they sensed I could do with a break. Now I know not all workplaces are so accommodating or friendly, but I do believe that informing someone in your workplace is key to feeling comfortable (or as comfortable as you can be) during this time in life.

One of the best treatments for hot flushes is Menopausal Hormone Treatment or MHT. You may have heard of HRT or hormone replacement therapy from back in our mother's and grandmother's days, well MHT is the new and improved version if you like (more on this later). I was unable to use MHT do to a pre-existing medical condition, however if I could have, I would have! Talk to your medical professional or GP about MHT and any other treatment options that they may suggest that could be right for you. If, like me, it isn't right for you, don't worry. I survived without hormonal treatment and there are a lot of useful tools and products out there that can help you though the worst of hot flushes.

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