Related Topics: Advice, Hot Flushes, Nutrition

Menopause Turns You Red

The menopause may turn you red in the face, but what’s out there to help manage those annoying flushes?

Dr Nina Bailey

Hot flushes are generally the most characteristic, and often the most distressing, symptom for the menopausal woman. About 75% of women are thought to experience hot flushes, on average around 2 years before their periods actually cease. Of those women who do suffer, around 85% will continue to experience hot flushes for more than 1 year and up to 50% for as long as 5 years.

Those who do suffer are more likely to experience disturbed sleep, depressive symptoms and significant reductions in quality of life as compared to asymptomatic women. A typical hot flush is caused by the dilation of skin blood vessels, resulting in a sudden sensation of heat that concentrates in the neck and face or, in some cases, over the entire body and can last anything from a few seconds to as much as 10 minutes in extreme cases, but on average around 4 minutes.

The frequency of flushes is influenced by factors such as being overweight and smoking, and may occur anywhere from every hour to just a couple of times a week. However, the overall consensus is that the body’s inability to regulate its internal thermometer at these moments is vastly unpleasant.

Thermoregulation, or the process by which body heat is maintained, is a complex mechanism that is influenced by many factors, of which sex hormone levels are one. The cause of hot flushes is not generally a lack of the hormone oestrogen, but more to do with a sudden drop of oestrogen through ovarian failure. As oestrogen levels fall, there are corresponding alterations in neurotransmitter levels, and this leads to a disturbance of the temperature regulating mechanism situated in the hypothalamus within the brain.

The most effective conventional form of treatment for hot flushes is hormone replacement therapy (HRT), but findings from two large cohort studies, the Women’s Health Initiative and the MillionWomen Study conducted in the early 2000’s, have subsequently raised concerns over its long term safety. The concerns revolve around two main areas: that the extended use of HRT may increase the risk of breast cancer and heart disease.

Since these findings were published there has been a significant fall in HRT prescription in general practice as women seek more natural alternatives for their symptoms. Of these, the most popular natural alternatives include evening primrose oil (EPO), soya foods, soya supplements, black cohosh and red clover.

During the past 20 years there has been an array of interest into the health benefits attributed to the consumption of soya. The soybean is rich in isoflavones, chemicals that first came to the attention of the scientific community in the 1940s because of fertility problems observed in sheep grazing on a type of isoflavone-rich clover.

In the 1950s, it was shown that these isoflavones function as antioestrogens, competitively binding to oestrogen receptors but without any oestrogenic effect, and are hence better known as phytoestrogens.  Whilst many women use phytoestrogen rich products very effectively, there have been many concerns with its use, and the corresponding advice has been to avoid their use in women with hormonally responsive cancers such as breast and ovarian cancer.

Hot flushes not only cause discomfort, but the inflammatory process that occurs depletes our bodies of several essential vitamins and minerals involved in the production of specific polyunsaturated fatty acids such as the omega-6, gamma linolenic acid (GLA), and the omega-3, eicosapentaenoic acid (EPA). The use of EPO is a well established treatment for hot flushes that has been used successfully by generations of women. EPO works because it is rich in GLA, which influences the production of hormone like substances called prostaglandins that are involved in the dilation or constriction of blood vessels.

More recently, it has been shown that EPA can produce on average a 55% reduction in hot flushes in menopausal women. Results from the first double-blind, placebo-controlled randomized clinical trial of ethyl-EPA published last year found that ethyl-EPA is very effective when compared to the placebo. EPA, like GLA, is the precursor to a family of anti-inflammatory prostaglandins and works, therefore, in a similar way to GLA.

Given that the body may have a compromised ability to produce both EPA and GLA from natural precursors through micronutrient deficiencies caused by the symptoms of menopause, it should not be too surprising that direct supplementation not only provides relief but also provides a reservoir of these essential fatty acids for other beneficial physiological purposes.

Vegepa ( is a unique synergistic formulation which combines ultra-pure EPA and organic virgin evening primrose oil, providing a highly concentrated source of omega-3 & omega-6 fatty acids and botanical triterpenes offering a unique method of managing menopausal symptoms, either on its own or in combination with other approaches.

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