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  • Tania Elfersy

Hot, sweaty and just fine in perimenopause and menopause

There was a woman sweating at the airport.

It was me, about to board a plane.

I wasn’t fearing the flight itself, but I was getting caught up in some thoughts about flying away from my kids for the first time.

Almost 16 years on from becoming a mom, the time had finally felt right to book a trip abroad. A trip just for me – a long weekend to celebrate a dear friend’s 50th and connect with other dear friends who live far away.

I’d been feeling so grateful that I could make this trip and that my kids were at the age where their own busy lives filled their days. And yet sitting at the departure gate felt like hanging out at the edge of the scary unknown.

How would this trip play out and how would things be back home? What if….

I was teary.

I began to sweat.

And then I smiled.

My warning system had kicked in and helped me remember.

Just because a thought comes into my head, doesn’t mean I have to believe it.

And although I can view a departure gate as THE gate to the scary unknown, but for my thinking about it, a departure gate is actually no different to my front door. Both lead me to the unknown because every future moment is unknown.

In an interconnected world of infinite possibilities, we don’t ever know with absolute certainty what will happen in an hour’s time, what we’ll be thinking and how we’ll feel. It’s just in our day-to-day we don’t realize we’re always on the edge of the unknown and in that moment, on the edge, we’re okay, and we always have been.

I calmed down. The sweating ceased and I boarded the plane.

We're all blessed with warning systems that are designed to help us wake up and remember.

During perimenopause and menopause, we develop extra sensitive warning systems and heat is just one popular one!

In the West, up to 85% of women will experience hot flashes and night sweats during midlife change, yet ask a doctor why they happen and the answer is a little unclear.

I’m sure you’ve heard that falling levels of estrogen cause hot flashes and night sweats. This explanation falls in line with the still dominant theories of menopause that emerged from mid last century, when menopause became known as an estrogen deficiency disease. However, ask why falling levels of estrogen appear to throw our internal thermostats out the window, and no-one has a definitive answer.

Dr Christiane Northrup points out that vasomotor symptoms (the medical term for flashes and sweats) can occur not only when a woman has low estrogen levels, but also when a woman has low progesterone and normal estrogen levels; when women (or men) have low testosterone levels; when a woman has high FSH (follicle stimulating hormone) or surges of LH (luteinizing hormone); when women and men have increased cortisol, increased stress hormones and low beta–endorphin levels.

The sweating, red-faced menopausal woman has become a classic image of menopause in the West. But if you’ve spent any time around teenagers, you’ve probably noticed that there comes a time when they keep on wearing shorts and t-shirts when everyone else has moved on to warmer layers, and then you’ll have to argue with them to wear a coat.

“I’m hot!” they’ll declare, and parents everywhere can’t decide if that could be true, or if their kids are just being stubborn.

It seems, they’re hot. And they’re not alone.

Pregnant women throw off the covers at night as a furnace burns within, and during the day they discover that they probably didn’t need to buy those super warm maternity clothes after all.

Postpartum women can often find themselves in a pool of sweat as they breastfeed or comfort their newborn, but with everything else going on, who has time to notice?

It seems it would be more accurate to say that at times of hormonal change our bodies need heat.

Looking at a woman’s body as it functions throughout her life-cycle (rather than viewing a menopausal woman as somehow defective or malfunctioning as modern medicine has chosen to) we can discover a body brilliance within the heat we experience.

When the body is busy putting energy into CHANGE (during adolescence, pregnancy, postpartum or perimenopause and menopause) it makes sense that to keep us healthy in all other areas it will need to make some adjustments – compensate for where there is less energy to spare. The body uses heat to detox and combat infections. If less energy is available for the immune system to work as usual during times of hormonal change, perhaps the body can use heat to keep the immune system just a little bit ahead of the game.

So does this mean that vasomotor symptoms are inevitable during perimenopause and menopause? No! While many women will feel hotter at midlife, flashes and sweats will be more likely to occur when in addition to the underlying hormonal changes (which create a sensitive period) other areas of a woman’s life are out of balance.

Rather than measuring hormones and supplementing a woman’s estrogen (which essentially desensitizes the body and delays change), we should be looking at a woman’s diet, exercise, sleep and I would argue, most importantly, her levels of stress.

When a woman’s body is out of balance in these areas at midlife, the body can use the underlying heat to create vasomotor symptoms and communicate with us that we need to make shifts to bring us back into balance. At the airport, as my stress was multiplying through me getting caught up in a thought storm, my body was quick to get my attention that I was moving off balance. Returning to wellbeing and harmony can be easier than we think.

As I’ve seen in my life and with the women I work with, when we make shifts to healthier paths, vasomotor symptoms can and do disappear.

Interestingly, when the 12th century German abbess, mystic and healer, Hildegard of Bingen wrote about menopause in her medical handbook Cause et Cure, she stated: “From her fiftieth and sometimes from her sixtieth year, a woman begins to feel irritation and dries around the openings of her body.”

Dryness around the openings of the body can be attributed to heat, yet Hildergard, who is considered to have been an expert observer of women’s experiences during their life-cycles, makes no mention of flashes or sweats.

We know that in cultures where aging is viewed more positively, change at midlife is more accepted, and women face less pressure to conform with unrealistic ideals, women experience fewer hot flashes and night sweats.

In the West, we enter midlife stressed and exhausted, with diets that are far from ideal and with less natural movement than it appears we are designed for, and then we think there must be something wrong with women who are experiencing hot flashes and sweats.

And yet, it might just be that our bodies are working perfectly, and using the heat generated at midlife to wake us up.

UPDATE as per a reader's request :-) My trip was amazing and everyone managed just fine back home!

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