Nonneural Mediation of Digital Vasodilation during Menopausal Hot Flushes

Abstract

Menopausal hot flushes are accompanied by profuse sweating, decreased skin resistance, modest tachycardia and cutaneous vasodilation. With the exception of the last effect, these events are consistent with an abrupt increase in sympathetic outflow. Blood flow in the human finger is controlled through sympathetic vasoconstricting nerves, and increased sympathetic activation results in digital vasoconstriction. We therefore sought to determine if digital vasodilation during hot flushes was mediated through efferent sympathetic nerves. Bilateral finger temperature and blood flow were recorded after the digital nerves on one hand had been blocked with a local injection of lidocaine. The effectiveness of the nerve blocks was verified by a reflex vasoconstriction test. Hot flushes were objectively defined using skin conductance responses recorded from the sternum. Fifteen hot flushes occurred in 8 women. Significant elevations in finger temperature and blood flow occurred during the flushes, in nerve-blocked and intact fingers. These findings suggest that digital vasodilation during hot flushes is due to a circulating vasodilating substance.

Cutaneous and hemodynamic responses during hot flashes in symptomatic postmenopausal women

“…On average, hot flashes resulted in an approximately twofold increase in sternal and forearm skin blood flow, confirming earlier speculations of increases in skin blood flow during hot flashes.17 -19 , 26 , 27 The mechanism( s) of increases in skin blood flow during a hot flash are unknown. Increases in skin blood flow of nonglabrous (ie, hairy) skin of this magnitude during a hot flash could be achieved through the withdrawal of sympathetic vasoconstrictor activity, increases in sympathetic cholinergic vasodilator activity, or a combination of both neural mechanisms and nonneural factors, as proposed by Freedman et al 27 and Wilkin.28 Hot flashes typically have been subjectively described by symptomatic women as beginning in the chest and radiating to the face, head, and arms. 1 , 4 , 7 ,8 In the present study the start of the increase in sternal and forearm skin blood flow occurred at the same time during the hot flash episodes (15-30 s before the hot flash), which is in contrast to the subjective descriptions of hot flashes reported previously.…”

Prevalência de distúrbios do sono na pós-menopausa

“…Outros estudos sugerem que as mudanças de humor que se verificam na pós-menopausa seriam resultantes de distúrbios no sono decorrentes dos fogachos que ocorrem durante esse período 19,21 . Os distúrbios do sono e as alterações de humor em mulheres na peri e na pré-menopausa foram analisados por alguns autores 12 por meio de questionários subjetivos e monitor actinográfico.…”

“…Não está claro, porém, na literatura, se essas alterações decorrem do estado hormonal alterado nesse período ou do próprio envelhecimento. Além disso, fatores que ocorrem na pós-menopausa, como ondas de calor [16][17][18][19] , nictúria 19 e alterações de humor 13,[19][20][21] , poderiam ter papel mais relevante nos distúrbios do sono do que o estado hormonal per si.…”

Is acupuncture effective in treatment of hot flashes?

“…Więk-szość kobiet zgłaszających się do ginekologa w okresie okołomenopauzalnym podaje uderzenia gorąca i/lub nadmierne pocenie się jako najbardziej dokuczliwy objaw, który jest jednocześnie głównym powodem ich wizyty u lekarza. Etiopatogeneza uderzeń gorąca jest ściśle związana z nagłym zmniejszeniem stężenia estrogenów, w wyniku czego dochodzi do zaburzeń regulacji neurotransmiterów i neuromodulatorów (serotoniny, dopaminy, noradrenaliny, endorfiny) i na skutek tego prowadzi do zaburzeń ośrodka termoregulacji w podwzgórzu oraz zaburzeń równowagi w autonomicznym układzie nerwowym [10][11][12].…”