Q: Hello Dr. please post for me and hide my ID. Just wanted to find out when ‘hot flushes’ end.  I am 52 going on 53 years old soon.  I started having hot flushes when I was 39 years old.  I haven’t had my pees (periods) for over a year now but still have the hot flushes. It can be embarrassing at times.  If there is any remedy? Please advise. Thanking you in advance

A: Menopause is a period defined by at least 12 months of cessation of menstrual period. It occurs as a natural process of aging which can start as early as late 30s as the ovaries start making less amounts of hormones (estrogen) but typically around the 40s and 50s. Menopause can also be induced by chemotherapy or radiotherapy (treatment for cancers), surgical removal of the ovaries etc. This is called premature menopause and is likely to run in families.

Symptoms of menopause can start months or even years before the cessation of periods and may last for up to four years (and sometimes even longer) after your last period as appears to be the case here. Common symptoms include:

• Reduced sex drive
• Vaginal dryness
• Night sweats
• Difficulty with sleeping
• Anxiety
• Hot flushes, as you have described

Hot flushes are typically described as a sudden feeling of heat that seemingly appears from nowhere and spreads throughout the face and body. This may happen occasionally but some women have several episodes a day, which they find uncomfortable and embarrassing.

The real culprit here is the deficient hormone, estrogen but this can also be triggered by wearing thick clothing, a high temperature, anxiety, drinking coffee or alcohol, eating spicy foods, some medicines etc

To reduce these symptoms, focus on the related cause. Examples include reducing coffee and alcohol intake, keeping the room temperature cool, sipping on cool drinks, having lukewarm baths/showers as opposed to hot ones, reviewing medicines with doctor if you suspect the medicine you are taking etc. Other helpful tips include spraying your face with some cool water if you feel a flush coming on, wearing more of cotton fabrics and stopping smoking.

Treatment for menopausal symptoms (including hot flushes) include hormone replacement therapy, eating healthy, balanced diets, exercising and cognitive behavioral therapy for people with anxiety. Your doctor will be able to assess what will benefit you most after reviewing any other medical condition you may have.

All the best!