Menopause: Hot Flashes and Exercise

Hot flashes are considered the tell-tale sign of menopause.

Why? What is the link between menopause and hot flashes, and as counterintuitive as it might seem, will exercise help manage hot flashes? First, let’s define a few key terms like physical activity, exercise, menopause, and hot flashes. Physical activity is not the same as exercise. Physical activity is any bodily activity that produces movement, like walking the dog, housework, etc. Exercise is any planned activity done for a specific period involving large muscle groups to accomplish a goal. The goal can be anything from running a 5K to managing stress or taming hot flashes. Hot flashes usually begin with perimenopause. Perimenopause is associated with changes in symptoms around the menstrual cycle as your hormone levels start to fluctuate. This can begin in your mid-thirties. You are perimenopausal if you start noticing bigger changes in mood fluctuations, energy levels, or other physical symptoms like menstrual pain, cramping, or gastrointestinal issues. As you get closer to menopause, your periods may become closer together, last longer or shorter, and the flow may be heavier or lighter. You will probably notice hot flashes and night sweats, which are common for many women. Menopause is defined as one year after your last menstrual period. Hot flashes may decrease for some women at this time, but for others, they may continue.

What causes hot flashes?

With the decrease in the production of estrogen that precipitates menopause, our bodies have a harder time regulating our internal temperature. The hypothalamus, the part of the brain that regulates body temperature, is sensitive to estrogen. Without sufficient amounts, the hypothalamus does not get activated as it should, and it attempts to cool the body by dilating the blood vessels that go to the skin to increase blood flow away from the core. The resulting vasomotor spasms can be accompanied by drops in BP, dizziness, nausea, and sweating. A hot flash can also be followed by a chill and accompanied by heart palpitations.

What can we do about hot flashes? Do we have to suffer?

There are medications and hormone replacement therapies that can help. You will need to talk with your physician to determine if pharmaceutical intervention is right for you. There are natural alternatives that some people say work for them, but there are no supplements currently approved by the FDA. Keep in mind that if you decide to use an over-the-counter supplement, it may interact with any medications you are currently taking, so be sure to speak with your physician or pharmacist.

How about exercise? Can exercise help manage hot flash symptoms?
The results are equivocal. Not surprisingly, there is not a lot of evidence yet. However, a systematic review of the literature, including randomized controlled trials by Witkowski et al. (2023) published in the Journal of the North American Menopause Society found “The limited available studies on acute exercise indicate that a bout of moderate-intensity exercise may decrease objectively measured and self-reported hot flashes, but acute increases in physical activity intensity above accustomed levels may influence the subjective hot flash experience.” The authors concluded that given the “available evidence, for people who experience hot flashes, engaging in regular moderate-intensity physical activity, including cardiovascular and resistance exercise, may be an effective therapy to reduce hot flashes” The authors also note that because there are so many current gaps in knowledge that exercise physiologists are unable to generate a specific exercise prescription. However! Many symptoms of menopause, such as weight gain, lack of energy, and sleep disturbances all can be improved with consistent cardiovascular and resistance training exercise. If you need help with your exercise, contact a Momentum Personal Trainer today to get the program that is right for you!

Witkowski, Sarah PhD1; Evard, Rose1; Rickson, Jacquelyn J. PhD1; White, Quinn1; Sievert, Lynnette Leidy PhD2. Physical activity and exercise for hot flashes: trigger or treatment? Menopause 30(2):p 218-224, February 2023. | DOI: 10.1097/GME.0000000000002107

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