Some of the most unpleasant symptoms of menopause, including hot flashes and night sweats, may result from changes in the brain. According to researchers, the hypothalamus and pituitary gland appear to develop a reduced sensitivity to estrogen.

"This is an important new concept. Menopause doesn't just originate in the ovary, but also in the brain," explains Laura Goldsmith, a professor of obstetrics and gynecology and women's health at the New Jersey Medical School of the University of Medicine and Dentistry of New Jersey.

If future research proves this theory, it may ultimately help doctors predict the type of menopausal transition a woman will have. It could also pave the way for the development of non-estrogen medications to reduce menopausal symptoms, says Dr. Gerson Weiss, chairman of obstetrics and gynecology and women's health at the New Jersey Medical School.

The Findings

The study stems from previous research that examined menopausal symptoms in 840 women approaching menopause. They provided daily urine samples for one full menstrual cycle or 50 days whichever came first. The urine was tested for hormone levels.

The researchers learned that 160 women did not ovulate. After further analyzing the hormone levels from the non-ovulating women, the researchers discovered that these women fell into three distinct groups…

  • The first group had an increase in their estrogen levels, and then had an appropriate surge of luteinizing hormone (LH) that should have triggered ovulation, but didn't.

According to Weiss, this lack of response indicated a problem originating in the ovary,

  • In the second group, estrogen levels peaked, but there was no correlating surge in LH, which Weiss says should be triggered by the hypothalamus and pituitary gland responding to higher estrogen levels.
  • The third group did not have an increase in estrogen as the first and second groups did. LH levels didn't surge, but were higher than the other groups for most of the cycle. In addition, this group was most likely to report menopausal symptoms, such as hot flashes and night sweats.

According to Weiss, the second and third groups showed different kinds of decreased sensitivity to estrogen in the brain, suggesting the brain is not responding to hormones.

"It appears that what's going on in menopause isn't only ovarian," says Dr. Steven Gold stein, a professor of obstetrics and gynecology at New York University School of Medicine. "We thought the pituitary responded to lower levels of estrogen, but there may be a lack of sensitivity to estrogen in the hypothalamus and pituitary."

It's important for women to know that there are "real biochemical changes occurring during menopause," says Goldsmith.

Researchers are beginning to understand how those changes start, which is the first step in trying to come up with more effective treatments.

Stay Cool During Hot Flashes

What middle-aged woman hasn't asked, W "Is it warm in here or is it me?"

Those hot flashes that seem to come over you at the most inopportune times are a natural part of life, but you can avoid them.

The first step is determining what brings them on. Triggers could include stress, alcohol, caffeine, diet pills, spicy or hot food, hot tubs, saunas, hot showers, hot beds, hot rooms, hot weather and smoking.

Even if you can't avoid hot flashes, you can survive them. Here are some suggestions from…

  • Dress in layers, so you can peel off layers as you get warmer.
  • Wear clothing made of cotton, linen and rayon. Wool, silk and synthetics are more likely to trigger hot flashes.
  • Avoid turtlenecks. Stick to open-neck shirts.
  • Keep ice water at hand that you can sip to cool down.
  • Whenever possible, lower the thermostat. Make sure you have a decent air conditioner or a ceiling fan.
  • Wear a cotton nightgown or pajamas. If you perspire a lot at night, your nightclothes are easier to change than the sheets, which should be cotton also and not synthetic.
  • Take a cool shower before bed.

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