Sudden hot flash

Hot flashes - Diagnosis and treatment

Diagnosis

Your doctor can usually diagnose hot flashes based on a description of your symptoms. Your doctor might suggest blood tests to check whether you're in menopausal transition.

Treatment

The most effective way to relieve the discomfort of hot flashes is to take estrogen, but taking this hormone carries risks. If estrogen is appropriate for you and you start it within 10 years of your last menstrual period or before age 60, the benefits can be greater than the risks.

Medications such as antidepressants and anti-seizure drugs also might help reduce hot flashes, although they're less effective than hormones.

Discuss the pros and cons of various treatments with your doctor. If hot flashes don't interfere with your life, you probably don't need treatment. Hot flashes subside gradually for most women, even without treatment, but it can take several years for them to stop.

Hormone therapy

Estrogen is the primary hormone used to reduce hot flashes. Most women who have had a hysterectomy can take estrogen alone. But if you still have a uterus, you should take progesterone with estrogen to protect against cancer of the lining of the uterus (endometrial cancer).

With either regimen, the therapy needs to be tailored to your needs. Guidelines suggest using the smallest effective dose for symptom control. How long you use the treatment depends on the balance of your risks and benefits from hormone therapy. The goal is to optimize your quality of life.

Some women who take progesterone with estrogen therapy experience progesterone-related side effects. For women who can't tolerate oral progesterone, a combination drug of bazedoxifene with conjugated estrogens (Duavee) is also approved for treating menopausal symptoms. Like progesterone, taking bazedoxifene with estrogen may help you avoid the increased risk of endometrial cancer from estrogen alone. Bazedoxifene might also protect your bones.

If you have had or are at risk of breast or endometrial cancer, heart disease, stroke or blood clots, talk to your doctor about whether estrogen therapy is right for you.

Antidepressants

A low-dose form of paroxetine (Brisdelle) is the only nonhormone treatment for hot flashes approved by the U.S. Food and Drug Administration. Other antidepressants that have been used to treat hot flashes include:

Venlafaxine (Effexor XR)
Paroxetine (Paxil, Pexeva)
Citalopram (Celexa)
Escitalopram (Lexapro)

These medications aren't as effective as hormone therapy for severe hot flashes, but they can be helpful to women who can't use hormones. Possible side effects include nausea, difficulty sleeping or drowsiness, weight gain, dry mouth or sexual dysfunction.

Other prescription medications

Other medications that might offer relief for some women include:

Gabapentin (Neurontin, Gralise, others). Gabapentin is an anti-seizure medication that's moderately effective in reducing hot flashes. Side effects can include drowsiness, dizziness, water retention in the limbs (edema) and fatigue.
Pregabalin (Lyrica). Pregabalin is another anti-seizure medication that can be effective in reducing hot flashes. Side effects can include dizziness, drowsiness, difficulty concentrating and weight gain.
Oxybutynin (Ditropan XL, Oxytrol). Oxybutynin is a pill or patch most often used to treat urinary conditions like overactive bladder. It may also help relieve hot flashes in some women. Side effects can include dry mouth, dry eyes, constipation, nausea and dizziness.
Clonidine (Catapres, Kapvay, others). Clonidine, a pill or patch typically used to treat high blood pressure, might provide some relief from hot flashes. Side effects include dizziness, drowsiness, dry mouth and constipation.

Nerve block procedure

A procedure known as stellate ganglian block has shown promise for treating moderate to severe hot flashes, but more research is needed. It involves injecting an anesthetic into a nerve cluster in the neck. The treatment has been used for pain management. Side effects include pain and bruising at the injection site.

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Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

If your hot flashes are mild, try managing them with these lifestyle changes:

Keep cool. Slight increases in your body's core temperature can trigger hot flashes. Dress in layers so that you can remove clothing when you feel warm.

Open windows or use a fan or air conditioner. Lower the room temperature, if you can. If you feel a hot flash coming on, sip a cold drink.
Watch what you eat and drink. Hot and spicy foods, caffeinated beverages and alcohol can trigger hot flashes. Learn to recognize your triggers and avoid them.
Practice mind-body therapies. Although evidence is inconclusive, some women find relief from mild hot flashes through mind-body therapies. Examples include meditation; slow, deep breathing; stress management techniques; and guided imagery. Even if these approaches don't help your hot flashes, they might provide other benefits, such as easing sleep disturbances that tend to occur with menopause.
Don't smoke. Smoking is linked to increased hot flashes. By not smoking, you might reduce hot flashes, as well as your risk of many serious health conditions, such as heart disease, stroke and cancer.
Lose weight. If you're overweight or obese, losing weight might help ease your hot flashes.

Alternative medicine

Many women have turned to alternative medicine, including mind and body techniques and dietary supplements to help curb hot flashes. There's a shortage of well-designed studies on complementary health practices for hot flashes, but research is progressing.

Mind and body approaches

A growing body of evidence suggests that certain techniques can help ease hot flashes, including:

Cognitive behavioral therapy (CBT). CBT is a widely used type of individual or group counseling and is recommended by the North American Menopause Society as an effective treatment for hot flashes and night sweats. CBT doesn't typically reduce the frequency of hot flashes, but may reduce how much they bother you.
Hypnosis. The North American Menopause Society recommends hypnosis for the treatment of hot flashes. Research indicates that hypnosis might help reduce both the frequency and severity of hot flashes.
Mindfulness meditation. This type of meditation has you focus on what's happening from moment to moment. Although not shown to relieve hot flashes, it might reduce how much they bother you.
Acupuncture. Some studies indicate that acupuncture might reduce the frequency and severity of hot flashes, but results are conflicting, with many studies showing improvements in both active and control groups, but no difference between the two groups.

Dietary supplements

People often assume that "natural" products cause no harm. However, all supplements may have potentially harmful side effects, and supplements can also interact with medications you're taking for other medical conditions. Always review what you're taking with your doctor.

Dietary supplements commonly considered for menopause symptoms include:

Plant estrogens. Asian women, who consume soy regularly, are less likely to report hot flashes and other menopausal symptoms than are women in other parts of the world. One reason might be related to the estrogen-like compounds in soy.

However, studies have generally found little or no benefit with plant estrogens, although research is ongoing to determine whether specific components of soy, such as genistein, help hot flashes.
Black cohosh. Black cohosh has been popular among many women with menopausal symptoms. Studies of black cohosh's effectiveness have had mixed results, and the supplement might be harmful to the liver in rare circumstances.
Ginseng. While ginseng may help with mood symptoms and insomnia, it doesn't appear to reduce hot flashes.
Dong quai. Study results indicate that dong quai isn't effective for hot flashes. The supplement can increase the effectiveness of blood-thinning medications, which can cause bleeding problems.
Vitamin E. Taking a vitamin E supplement might offer some relief from mild hot flashes. In high doses, it can increase your risk of bleeding.

Preparing for your appointment

For hot flashes, you'll likely start by seeing your family doctor or gynecologist.

What you can do

Before your appointment, make a list of:

Your symptoms, including how many hot flashes you have a day and how severe they are
Medications, herbs, vitamins and supplements you take, including doses
Questions to ask your doctor

Take a family member or friend with you, if possible, to help you remember the information you get. Bring along a notepad or device to jot down information you receive.

Some basic questions to ask your doctor include:

Do I need any tests?
What treatments are available to help with my symptoms?
What else can I do to relieve my symptoms?
Are there alternative therapies I can try?
Do you have printed information I can have? What websites do you recommend?

If other questions occur to you during the appointment, don't hesitate to ask them.

What to expect from your doctor

Some questions your doctor might ask include:

Are you still having periods?

When was your last period?
How often do your symptoms bother you?
How uncomfortable do your symptoms make you?
Does anything seem to help?
Does anything make your symptoms worse?

By Mayo Clinic Staff

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Why They Happen, Treatment, Prevention

Written by WebMD Editorial Contributors

What Is a Hot Flash?

When hot flashes happen, there's a sudden feeling of heat and sometimes a red, flushed face and sweating. We don't know exactly what causes them, but they may be related a drop in estrogen levels and changes in an area of the brain that controls body temperature.

When hot flashes happen, blood vessels near the skin's surface widen to cool you off, making you break out in a sweat. Some women have a rapid heart rate or chills, too.

When they happen while you sleep, they're called night sweats. They can wake you up and may make it hard to get enough rest.

A hot flush is the redness in your face and neck that occurs during a hot flash.

How Long Will You Have Them?

That depends. About 2 in 10 women never get hot flashes. Others have hot flashes for only a very short period of time. Still others can have them for 11 years or more. On average, however, women get hot flashes or night sweats for about 7 years.

Prevention

There’s nothing you can do to avoid hot flashes around menopause. But you can stay away from triggers that may make them more frequent or more severe. Common ones include:

Stress
Caffeine
Alcohol
Spicy foods
Tight clothing
Heat
Cigarette smoke

What Can You Do

Stay cool. At night, a "chill pillow" filled with water or other cooling material might help. Use fans during the day. Wear lightweight, looser-fitting clothes made with natural fibers such as cotton.

Try deep, slow abdominal breathing (6 to 8 breaths per minute). Practice deep breathing for 15 minutes in the morning, 15 minutes in the evening, and when a hot flash starts.

Exercise daily. Walking, swimming, bicycling, and dancing are all good choices.

Plant estrogens, found in soy products, may have weak estrogen-like effects that could cut vasomotor symptoms likehot flashes. Doctors recommend you get your soy from foods like tofu and edamame rather than supplements. Some studies suggest black cohosh may be helpful for 6 months or less. Botanicals and herbs may have side effects or change how other medications work, so ask your doctor first.

Treatments

Some women can wait out hot flashes with no treatment.

If they're bothersome or causing trouble for you, talk to your doctor about taking hormone replacement therapy, or HRT, for a limited time, typically less than 5 years. This prevents hot flashes from occuring for many women. Plus, it can help other symptoms of menopause, including vaginal dryness and mood disorders.

When you stop taking HRT, the hot flashes may come back. Some short-term HRT can make you more likely to have blood clots, breast and endometrial cancers, and gallbladder inflammation.

If HRT isn't right for you, other treatments may offer relief. Prescription treatments include:

Low-dose depression drugs like fluoxetine (Prozac, Rapiflux), paroxetine (Paxil, Pexeva), or venlafaxine (Effexor)
Clonidine, a blood pressure medication
Gabapentin, an anti-seizure drug
Brisdelle, a paroxetine formula specifically for hot flashes
Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashes

B complex vitamins, vitamin E, and ibuprofen may help, too.

It’s important to talk to your doctor before you take any new medication or supplements, including over-the-counter products.

Menopause Guide

Perimenopause
Menopause
Postmenopause
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Daily Living
Resources

Lightning in the eyes - causes and treatment

Everyone knows the expression "sparks from the eyes fell." This phraseological turn means a quickly passing flicker in the eyes after a head injury. But what if such flickering and flashes of light occur against a background of complete calm, without aggressive external influence - suddenly a white flash appears in the field of view, which immediately goes out. What is this?

Let's start with the fact that this is an imaginary sensation. That is, it seems to a person that he sees these shining balls, lightning, spots. They may differ in color, intensity. But it all happens inside the eye. They are not connected to external light.

More often than not, outbreaks are short-lived and disappear quickly. But with some pathologies, they appear for a long time, having significant brightness, clear boundaries and shape. Lightning and flashes in the eyes are an important symptom, late seeking help can be a dangerous delay that reduces the chances of good vision in the future.

A patient with these complaints needs careful observation by a doctor, and in some cases, emergency hospitalization and surgical intervention in front of his eyes!

Causes.

Single and rare flashes of lightning in front of the eyes are a completely harmless phenomenon, but at the same time they can be an indicator of pathological conditions. These diseases include: posterior vitreous detachment, retinal detachment or rupture, inflammation of the retina or choroid, migraines, vascular diseases of the body, brain tumors, toxic poisoning, head injuries.

1) Posterior vitreous detachment. Our eye inside is filled with a gel-like substance, with a volume of only 3-4 ml and a mass of approximately 4 g.

The composition of the vitreous body is uneven, it consists of a loose central substance and voids filled with liquid, as well as collagen fibers, more dense in structure. The vitreous body is attached in two places (in front of the eye and in the back), in the rest of the length it simply fits closely to the inner shell of the eye - the retina.

In most cases, in the process of eye aging, its layers and fibers thicken in the body, and its volume decreases. It begins to gradually exfoliate from the inner shell, tension of the retina occurs and this causes flashes in the eyes. If the tension of the retina is small, then dynamic observation is sufficient, and no special treatment is required. But if there is a complete detachment of the vitreous body and a significant tension of the retina, then this condition becomes critical and dangerous. At any time, a rupture or detachment of the retina itself can occur, with a serious decrease in vision, often irreversible.

2) Retinal detachment is a pathological condition in which a thin inner layer of light-perceiving photoreceptors peels off from subsequent layers, and the space between them is filled with fluid. At the same time, the nutrition of these layers is disrupted, which leads to a rapid loss of vision. The beginning of this pathological process is manifested by lightning and flashes before the eyes, the sensation of a curtain from above or below.

Retinal tears are the result of thinning of this membrane on the periphery (the so-called peripheral dystrophies or retinal degeneration), pulling (traction) effects from the vitreous body, weakening of the connection of the photoreceptor layer with neighboring retinal layers. Also, a rupture can occur due to direct trauma to the eye - a penetrating wound or a blunt blow, bruise.

Particular attention should be paid to flashes before the eyes or lightning that occurred after intense physical exertion or stress. This can cause detachment of the inner shell.

Prevention of retinal detachment is the early detection of peripheral dystrophies and timely preventive intervention. To do this, laser photocoagulation is most often used, when dangerous zones are limited by the action of laser beams, preventing their spread.

If detachment has already occurred or if the retina is ruptured, the timeliness of surgical treatment is very important, since the prolonged existence of detachment leads to the death of photoreceptors. In such cases, pathological phenomena may already be irreversible!

3) Inflammation of the retina - retinitis . They may also present with symptoms of flashes before the eyes. Inflammation rarely occurs in isolation, it is usually the result of a systemic disease. Since the retina and choroid ( choroid ) are located nearby, the process very quickly involves these two layers, and it is difficult to say where the inflammation first began. Treatment is usually long, includes a conservative method (systemic and local antiviral, antibacterial, antiviral, anti-inflammatory therapy) and surgical treatment.

4) Migraines. In a number of cases, before the onset of a headache, bright spots, lines, circles appear before the eyes, which can remain for quite a long time. At the same time, they look like flickering uneven or wavy lines.

This is the aura of migraine.

Immediately after it, a long attack of severe pain begins in one half of the head. Sometimes the patient sees only a flash without pain. This condition is called ocular migraine, it occurs with neurological disorders. More often the disease affects women older than 30 years. Due to cervical osteochondrosis, a certain part of the brain malfunctions and a decrease in the normal blood supply to the occipital lobes of the brain responsible for vision occurs. A sudden change in weather, overwork, disturbed sleep patterns, strong odors, depressive states, bad habits (smoking, drinking alcohol), and taking psychoactive substances can provoke a migraine. Residents of the metropolis are at risk due to increased stress, malnutrition and excessive psychophysical stress. Such conditions require a comprehensive examination by an ophthalmologist and a neurologist, lifestyle correction and treatment of concomitant diseases.

5) Vascular diseases of the body . In chronic diseases such as hypertension or diabetes mellitus, short-term spasms of blood vessels (including retinal vessels) may occur. Then patients note short-term flashes and flickering dots in front of the eyes, more noticeable in the dark. Correction of blood sugar levels and normalization of blood pressure reduces these symptoms.

6) Brain tumors . With the development of a neoplasm in the occipital lobe of the brain, luminous spots of various colors and shapes may appear before the eyes. This pathology is very serious and requires the supervision of neurosurgeons and oncologists.

7) Poisoning with toxic substances or taking drugs can cause lightning and flashes before the eyes. For example, moderate carbon monoxide poisoning disrupts visual perception, which manifests itself in a similar way. The use of psychoactive substances can provoke hallucinations accompanied by flashes. In case of any poisoning, the help of a specialist is required, since prolonged intoxication can lead to disruption of the heart and even death.

8) Head or eye injury . At the time of injury, there may be short-term flashes and lightning, up to a short-term loss of vision. Trauma to the eye often results in retinal changes requiring emergency ophthalmic care.

Blunt injuries of the occipital region are especially dangerous, since there are not only visual centers, but also areas responsible for the vital activity of the body (respiratory, cardiovascular).

The first specialist a patient should see is an ophthalmologist. Since lightning and flashes before the gaze in most cases are a manifestation of the pathology of the internal structures of the eye. With the long-term existence of such conditions, a complete cure may not be possible, which is why treatment should be immediate. The main thing is to exclude emergency conditions, such as detachment of the retina, vitreous body, or ruptures of the inner membranes. In other cases, the supervision of doctors of other specialties may also be required: therapist, endocrinologist, neurologist.

Take care of your eyesight and be healthy!

The riddle of solar flares. Line crossing

Gordon Holman
In the World of Science #7, 2006

What heats a gas?
Line crossing
Until I see, I will not believe

Line crossing

To understand what happens during magnetic reconnection, we must first understand how in the solar atmosphere, invisible magnetic loops trap hot gas, which is better called plasma, since it is mainly composed of individual electrons and protons, and therefore is a good conductor of electricity. Therefore, the electric field easily moves charged particles, creating an electric current. The magnetic field also acts on charged particles.

Although electrons and protons are forced to revolve around the magnetic field lines, they can move freely along them, because if they move along converging magnetic field lines, the charged particles will be decelerated. For example, going down from the top of the loop to its base, the particle, having reached one of the so-called reference points of the loop, where the lines of force converge and the magnetic field becomes more intense, will slow down its movement. The increasing field gradually causes the electron or proton to stop, and then pushes it back up. Charged particles in the Sun do not transfer their energy to the magnetic field. The energy of their downward movement changes into another form, increasing the frequency of rotation of the particles around the magnetic field lines. Thus, the two reference points of the magnetic loop act as mirrors, reflecting protons and electrons from one point to another, thus creating a trap for charged particles.

Plasma can also affect the magnetic lines of force that hold it, because there is a sea of charged particles in which electric currents can appear whenever there is a potential difference. In ordinary electrical circuits, such as a flashlight, the voltage is provided by a battery. It does not exist on the Sun, but moving magnetic fields create a potential difference (according to the same laws of physics that an electric generator uses), and an electric current arises, creating new magnetic fields. This effect, together with the tendency of magnetic reference points to move erratically, results in an ever-changing pattern of curved magnetic fields in the solar atmosphere, sustaining significant magnetic field energy—the source of solar flares.

Now let's look at some of the physical mechanisms that scientists have been trying to understand for many decades. Difficulties arise when we try to explain how all the energy of the magnetic field is converted into heat, into the energy of accelerated particles and ejected matter. It may be appropriate to consider an ordinary electric circuit, in which there is not only a current of charged particles and a voltage that causes it, but also an electrical resistance. For example, a filament in a light bulb resists the current flowing through it, dissipates its energy and turns it into light and heat. The solar atmosphere has electrical resistance, because the charged particles that form the electric current sometimes collide with each other, slow down and heat everything around. The potential difference that maintains the current creates a sufficiently strong electric field in which electrons and ions are accelerated and leave the hot plasma. Thus, we have obtained the main components of the flash - heating and high-energy particles.

Upon closer examination, the elegant explanation proposed above was not confirmed. It turned out that the electrical resistance in the corona is usually too small to explain the explosive nature of solar flares. And even if the resistance were great, it is still difficult to explain how the required amount of magnetic energy can be concentrated in one place and released in the form of an explosion. Decades ago, researchers came to the conclusion that the occurrence of a potential difference that creates a simple current cannot rapidly heat the solar atmosphere or accelerate the flow of particles sufficient for a flash.

Previously, astrophysicists considered the flare as the result of a merging of various currents or a multitude of turbulent plasma waves and associated chaotic electric fields. A special selection of conditions makes it possible to explain the flare, but not all the phenomena accompanying it, in particular, coronal mass ejections accompanying large flares. A theory that takes into account the dynamics of not only electric but also magnetic fields looks more promising. Therefore, we should become more familiar with their physics.

Magnetic fields have a certain direction. For example, in a bar magnet, the lines of force are located from the north pole to the south. If two parallel but oppositely directed magnetic fields are placed in a plasma, then an electric current will appear between them in the form of a flat layer. The energy contained in these oppositely directed magnetic fields will decrease as the resistance dissipates the electric current in the layer.

At the end of 1956, Peter Sweet ( Peter Alan Sweet ), working at the London University Observatory, came to the conclusion that the energy of a magnetic field would decrease much faster if the oppositely directed field lines were broken and then re-closed (reconnected) in the current sheet that arose between them. As a result, two opposite fields would annihilate each other in the form of a powerful flash, just as matter and antimatter annihilate. Neighboring magnetic fields and the plasma associated with them can flow into the layer from both sides. New magnetic lines of force, arising from the connection of previously separated lines of force, are ejected along with the plasma from other sides of the layer. In the late 1950s and early 1960s, Eugene Parker ( Eugene N. Parker ) of the University of Chicago gave a mathematical description of a process called Sweet-Parker magnetic reconnection.

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