Hot flashes can signal heart disease

I always wondered how my mother’s generation dealt with hot flashes. My mother never mentioned having one and neither did any of the women in her age group that I knew. It was only with our generation (by that I mean 40-plus) that hot flashes made their grand entrance into the common consciousness to a larger degree – despite the fact that the effects of menopause have been treated with estrogen since the late 1800s.

I became a physician in the 1970s and my training did not cover preventive medicine, menopause or specifically the use of hormones either to aid in menopause or prevent disease. It’s only in the past decade that true prevention, a topic covered mostly by the media, is starting to penetrate our health care system.

In the process, research – such as the work of scientists who have studied hot flashes and heart disease for decades and presented their findings at a meeting of the International Menopause Society in Rome in 2011– has demonstrated that hot flashes may be warning signs of heart disease when they are persistent and extremely frequent.

Heart disease is the biggest killer of women in the U.S. More than 350,000 women die of heart disease every year, while around 28,000 die of complications from therapies for breast cancer or the disease itself.

While I don’t want to minimize the need of a cure for breast cancer, I want to stress the possible connection between hot flashes and heart disease since most women die of heart disease.

Hot flashes – which can also occur before your period, pre-menopause and after childbirth – are caused by pulses of hormones released by the pituitary gland as we age, asking our ovaries to produce the hormones of youth, which are estrogen, progesterone and testosterone. At menopause and even before, the production of these much-needed hormones decreases, resulting in hot flashes.

Thus hot flashes are not just a nuisance and we are best advised to do something to get rid of them rather than grin and bear them. We can eliminate them easily and safely with bioidenticals (human identical hormones made from plant extracts) – estradiol, progesterone, testosterone and thyroid. With the exception of testosterone, all these hormones are available in FDA-approved creams, tablets and/or patches by prescription at your pharmacy. But make sure your doctor knows how to use hormones in wellness and disease-prevention or else you will continue to suffer and risk chronic illness.

Supplements like oil of evening primrose, used occasionally for short periods of time; black cohosh; vitamin E; omega-3 and -6 fish oils; and vitamin B complex support hormone balance. But they won’t help prevent heart disease, even if they can get rid of the hot flashes for a while.

But what about the link between hormones and breast cancer? That fear dates from the Women’s Health Initiative, an eight-year study that looked only at Premarin, an estrogen made from the urine of pregnant mares, which is not identical to the human hormones.

If you take bioidentical hormones, change your diet to a more natural, vegetable-based one; minimize alcohol, caffeine, processed foods and sugar; do more exercises that improve and maintain your cardiac status and keep your bones strong; sleep eight hours a night; and take some of the supplements I mentioned above, hot flashes will quickly disappear.

You will feel better, continue contributing to society and be an active participant in preventing the chronic illnesses of aging like heart disease from robbing you of a life of high quality.

It’s your choice after all. Live in fear and discomfort, accepting hot flashes, night sweats, insomnia and other symptoms of menopause, or do something about it. Take control of your life and find the doctor who cares and knows enough about you, bioidentical hormones and prevention to help you feel better.

For more, email Dr. Erika at

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