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WHAT ARE VASOMOTOR SYMPTOMS AND WHEN DO THEY OCCUR? The commonest vasomotor symptoms are hot flushes and night sweats. The latter often results in insomnia. They are sometimes accompanied by fainting episodes, palpitation and headaches and they may arise early in the climacteric when menstruation is still regular. At this time, these symptoms tend to cluster in the premenstrual week and may then be confused with Pre-Menstrual Syndrome (PMS). However, they may also begin later, around the time of the menopause, or they may not develop until early during the postmenopausal years. AS FAR AS SYMPTOMS ARE CONCERNED, IS THERE ANY DIFFERENCE BETWEEN A NATURAL AND SURGICAL MENOPAUSE? Menopause induced by surgery or radiotherapy is associated with higher incidence and with an increased severity of symptoms, the reasons being unclear. However, it has been suggested that the climacteric allows women to adjust gradually to lower circulating oestradiol concentrations, and that those who acclimatize best have fewer hot flushes and night sweats. An abrupt menopause i.e. following surgery does not allow for a period of adjustment to the lower plasma levels and therefore, the symptoms arise abruptly and are more severe. HOW LONG DO VASOMOTOR SYMPTOMS LAST? 70% of symptomatic women have vasomotor symptoms for 2 years; 25% have vasomotor symptoms for 5 years and 5% have vasomotor symptoms ad infinitum. WHAT IS THE ASSOCIATION BETWEEN MENOPAUSE AND SLEEP? Studies have shown that night-time flushing and sweating episodes are associated with periods of wakefulness, ie normal sleep rhythm is disrupted. There is considerable variation in the frequency and the severity of night sweats. Some women find them very troublesome because sweating necessitates getting out of bed several times during the night to open a window, to take a shower, to change their clothing or occasionally to change the bed linen. This scenario can occur nightly over many weeks, months and sometime years. It is a potent cause of sleep deprivation, not only to the woman but also to her partner. |
