Researchers are still unsure what causes 70 percent of menopausal women to experience the sudden and prickling heat of a hot flash. However, new research suggests that the fire fueling hot flashes can be partially extinguished through weight loss.
A University of Pittsburgh study released Monday, which the National Institutes of Health through the National Institute of Aging supported, showed that overweight women who lost weight during menopause experienced a reduction in hot flashes compared with those who did not.
“This pilot study points to the importance of doing a larger study on this topic,” said Rebecca Thurston, Ph.D., Pitt associate professor of psychiatry, psychology and epidemiology. The study is published in this month’s issue of the journal Menopause.
As part of the study 40 overweight or obese women who experienced four or more hot flashes daily were randomly assigned to a control or a weight-loss group. Women in the weight-loss group followed a low-fat and low-calorie diet and kept a food diary in addition to doing aerobic exercise for five hours a week over 16 weeks. Those women lost an average of 19 pounds and about 10.7 percent of their body weight. Those in the weight-loss group experienced fewer hot flashes than those in the control group, which saw little weight change.
“Fat acts as an extra layer of insulation, and eliminating it allows the body to release heat more easily,” said Margery Gaas, executive director for the North American Menopause Society.
“We used to think body fat actually protected women because it secretes estrogen, so we thought of it as a supplemental estrogen source,” Ms. Thurston said. “It’s really in the [past] 10 years that this kind of research has exploded.”
Hormone replacement therapy, usually started as a woman entered menopause, which occurs a year after her last menstrual cycle, was once the premier weapon in the battle against hot flashes and other menopausal symptoms. However, the Women’s Health Initiative, a landmark study on the use of combined estrogen and progestin therapy, was halted in 2002 after investigators determined that HRT could instead increase the risk of heart disease, stroke, blood clots and breast cancer.
When those results were announced, many doctors stopped prescribing HRT. This led to “a lot of hot-flashing women running around without any other options,” Ms. Thurston said.
In June 2013, the Food and Drug Administration approved the first nonhormonal drug to treat hot flashes. Developed by Noven Pharmaceuticals, the new drug Brisdelle, consists of a low dose of paroxetine, which is used at higher doses in the antidepressant Paxil. Brisdelle’s label, however, has a strong warning that the drug can increase suicidal thoughts or suicidal behavior in addition to other complications.
“We do not currently have a great alternative from a drug standpoint,” Ms. Thurston said, “That is why I wanted to develop a behavioral strategy to manage hot flashes.”
Using weight loss as a strategy to help control hot flashes can also lead to myriad of other health benefits, such an improvement in cardiovascular problems and reduction of sleep apnea.
Ms. Thurston hopes to conduct further study on the effects of weight loss on a larger group of women to confirm the benefits. She also wants to look at ways to control hot flashes among women who are of normal weight.
“Hot flashes are associated with lots of negative issues — irritability, depressed mood, sleep disturbances,” Ms. Thurston said, “At the very least, improving women’s hot flashes can help improve their quality of life.”
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