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Menopausal hot flashes

Authors
Richard J Santen, MD
Charles L Loprinzi, MD
Robert F Casper, MD
Section Editors
Robert L Barbieri, MD
William F Crowley, Jr, MD
Deputy Editor
Kathryn A Martin, MD

INTRODUCTION

Hot flashes occur in about 75 to 80 percent of menopausal women in the United States. The flashes most often begin in the perimenopausal period, although in some women they do not begin until after menopause. Hot flashes are almost always due to menopause. Other causes, including carcinoid syndrome, are uncommon (table 1).

The prevalence, pathophysiology, and treatment of hot flashes will be reviewed here. Other menopausal symptoms and the risks, benefits, and practical aspects of menopausal hormone therapy (MHT) are reviewed separately. (See "Clinical manifestations and diagnosis of menopause" and "Menopausal hormone therapy: Benefits and risks" and "Treatment of menopausal symptoms with hormone therapy" and "Treatment of vaginal atrophy".)

EPIDEMIOLOGY

Symptoms become far more common during the menopausal transition, with a frequency of approximately 40 percent in the early transition and increasing to 60 to 80 percent in the late menopausal transition and early postmenopausal stage (figure 1) [1-5].

Prevalence — Vasomotor symptoms (VMS) or “hot flashes” are the most common complaint during the menopausal transition, occurring in up to 80 percent of women [2,6-8], although the frequency appears to vary by culture and ethnicity [9,10] (see 'Risk factors' below). Many to most women describe their symptoms as severe, but only about 20 to 30 percent of women seek medical attention for treatment [1,11,12]. Some women first develop hot flashes that cluster around menses during their late reproductive years, but symptoms are typically mild and do not require treatment.

Symptoms become far more common during the menopausal transition, with a frequency of approximately 40 percent in the early transition and increasing to 60 to 80 percent in the late menopausal transition and early postmenopausal stage (figure 1) [1-5].

                                    

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Literature review current through: Jul 2015. | This topic last updated: Mar 27, 2015.
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