Hot Flashes Symptoms
Hot flashes feel as a sudden wave of mild or intense body heat caused by rushes of hormonal changes resulting from decreased levels of estrogen in female body. they are due to blood vessel opening and constricting and a symptom of menopause.
Hot flashes are episodes that are experienced by many, but not all, women undergoing menopause. a hot flash is a feeling of warmth, sometimes associated with flushing that spreads over the body and sometimes followed by perspiration. Menstruating women in their 40′s may have hot flashes, and hot flashes may last for a decade or more in some women. there is no way to predict when they will cease in a given woman. they decrease in frequency over time.
During a hot flash, sensations of heat move up your waist, chest, neck, and face. Perspiration that you exude during your hot flash will soon cool you down, causing you to experience rapid chills all over your body. Typically, a hot flash last only a couple of minutes, however, some unfortunate women can experience hot flashes lasting up to 30 minutes. Women can experience as many as 15 hot flashes in one day, but typically hot flashes occur 2 to 4 hours apart during menopause.
When you’re having a hot flash, you may experience:

• A feeling of pressure in your head as the hot flash begins
• A feeling of mild warmth to intense heat spreading through your upper body and face
• A flushed appearance with red, blotchy skin on your face, neck and upper chest
• Rapid heartbeat
• Perspiration, mostly on your upper body
• A chilled feeling as the hot flash subsides

Less common symptoms associated with hot flashes include:

• Weakness
• Fatigue
• Faintness
• Dizziness

Reasons for Hot Flashes
Exact cause of hot flashes isn’t known, but the signs and symptoms point to factors affecting the function of your body’s thermostat — the hypothalamus. This area at the base of your brain regulates body temperature and other basic processes. The estrogen reduction you experience during menopause may disrupt hypothalamic function, leading to hot flashes. So, hot flashes may have more to do with fluctuation of hormone levels as opposed to low hormone levels per se.  
Low estrogen alone doesn’t often seem to induce hot flashes, as children and women with low levels of estrogen due to medical conditions usually don’t experience hot flashes. instead, the withdrawal of estrogen, as happens during menopause, appears to be the trigger.
As estrogen and progesterone levels drop during menopause, the body produces more of a brain hormone called gonadotropin hormone (GnRH) in order to force fertility. GnRH is also responsible for regulating heat sensors in the brain. when higher levels of GnRH are present, the body mistakenly thinks that it is overheating. it attempts to cool itself down by opening blood vessels in the head and neck, which causes perspiration.
Sweaty Side Effects
The most obvious side effect of hot flashes is the sweating! The amount of sweat that your body produces during a hot flash will vary depending on your stage of menopause, your diet, and any medications that you are taking. Some women get away with just a sweaty lip while others feel like they’ve run 10 miles in a fur coat! if your transition between perimenopause and menopause is fairly quick, you can probably expect your symptoms to be a little worse.
Hot flashes can cause you to feel more than just sticky though. It’s not unusual to feel completely exhausted, as though all your energy has been zapped for as much as an hour after a hot flash. On top of that, hot flashes often occur at night, making it impossible to get a good night’s sleep.
Hot flashes leave a lot of women feeling very anxious because they are hard to predict. though you may feel embarrassed if you have a hot sweat at a restaurant, at a friend’s house, or during that big board meeting, remember: most women will go through this at some stage in their life. No one will judge you over a little sweat.

Risk Factors
Not all women who go through menopause experience hot flashes. Although it’s not clear why some women get hot flashes and others don’t, the following factors increase your risk of hot flashes:

• Smoking. Women who smoke are more likely to get hot flashes.
• Obesity. a high body mass index (BMI) is associated with a higher frequency of hot flashes.
• Physical inactivity. if you don’t exercise, you’re more likely to have hot flashes during menopause.
• Ethnicity. More African-American women report menopausal hot flashes than do women of European descent. Hot flashes are less common in women of Japanese and Chinese descent than in white European women.

Lifestyle Tips
Here are some tips to help dealing with hot flashes:

• Know your triggers. keep a daily record of your hot sweats, including how long they last and when they occur. certain foods often exacerbate hot sweats especially spicy foods, hot drinks, and alcohol.
• Keep cool. Slight increases in your body’s core temperature can trigger hot flashes. Dress in layers so that you can remove outer clothing when you feel too warm. Open a window or use a fan or air conditioner to keep air flowing. lower the room temperature, if you can. if you feel a hot flash coming on, sip a cold drink. Avoid hot baths, spring showers and steam baths, esp. before bedtime. Have cool showers, instead.
• Use cotton bed linens. Cotton is more breathable and absorbent than other fabrics. it will keep you cooler at night and help you get a great rest.
• Watch your diet. Drink lots of water and juice and keep a cool drink by your bed.  many foods are thought to contribute to or worsen discomfort from hot flashes. Alcohol, caffeine, excess sugar, dairy products, meat products and spicy foods rank among the top aggravators of severe hot flashes as well as mood swings.
• Relax! Learn yoga, listen to music, or engage in quiet meditation.
• Breathe deeply. Deep, slow abdominal breathing (paced respiration) may decrease hot flashes. it takes some practice to perfect the technique, but paced respiration done for 15 minutes twice daily, or at the beginning of a hot flash, can be helpful. To practice paced respiration, begin by sitting comfortably. Breathe in deeply for five seconds, pushing your stomach muscles out. Exhale for five seconds, pulling your stomach muscles in and up. Repeat this cycle of breathing deeply in and out until you feel calm and relaxed.
• Stop smoking. Smoking is linked to increased hot flashes. by not smoking, you may reduce hot flashes, as well as your risk of many serious health conditions such as heart disease, stroke and cancer.

Medications
Menopause is a natural transition. if hot flashes don’t interfere with your life, you don’t need treatment. if it’s necessary to ease your symptoms with treatment, periodically re-evaluate your need for continuing that treatment. for most women, hot flashes fade gradually within a few years.
Hormone therapy
For moderate to severe hot flashes, your doctor may recommend hormone therapy. Estrogen therapy is the most effective treatment for hot flashes, but in some instances, doctors might prescribe progesterone therapy instead.

• Estrogen therapy. if you’ve had a hysterectomy, you can take estrogen alone. But if your reproductive organs are still intact, you should take progesterone along with estrogen to protect against cancer of the lining of the uterus (endometrial cancer). With either regimen, current recommendations are to use the lowest effective dose for the shortest amount of time needed to relieve symptoms.

Before starting estrogen therapy for menopause symptoms, review your heart-disease risk factors with your doctor and weigh the benefits of symptom relief against the risk — remote but recognized — of developing heart disease as a result. It’s likely that hormone therapy interacts with other factors — timing and length of hormone use, reproductive history and family history, for example — to increase this risk, but there’s no way to know what’s safest for you individually. Your doctor can help you weigh the pros and cons.
Estrogen therapy is not a good option if you’ve ever had a blood clot or breast cancer.

• Progesterone therapy. As an alternative for women who can’t take estrogen, some doctors prescribe progesterone alone to control hot flashes. Two progesterone-like drugs, megestrol acetate and medroxyprogesterone acetate, have been found to provide some relief from hot flashes.

Other prescription medications
If you decide against estrogen or progesterone therapy, your doctor may suggest a non-hormonal medication for reducing hot flashes. These medications aren’t approved by the Food and Drug Administration specifically to treat hot flashes, but they are approved for treating other conditions.

• Antidepressants. low doses of certain antidepressants may decrease hot flashes. Antidepressants from classes of medications known as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) — including venlafaxine (Effexor), paroxetine (Paxil), fluoxetine (Prozac), citalopram (Celexa), desvenlafaxine (Pristiq) and others — have been found to relieve hot flashes. However, these medications aren’t as effective as hormone therapy for severe hot flashes and may cause unwanted side effects, such as nausea, dizziness, weight gain or sexual dysfunction. Talk with your doctor about whether the benefits outweigh the potential side effects for you.
• Gabapentin. Gabapentin (Neurontin) is a medication approved for treating seizures or pain associated with shingles. It’s also increasingly used to treat various other types of pain. Gabapentin may be moderately effective in reducing hot flashes, particularly for women who have symptoms at night. Side effects can include drowsiness, dizziness and headaches.
• Clonidine. Clonidine, a pill or patch typically used to treat high blood pressure, may provide some relief from hot flashes. Side effects such as dizziness, drowsiness, dry mouth and constipation are common, sometimes limiting the medication’s usefulness for treating hot flashes.

Diet, Vitamins, and Natural Remedies
Soy Products
Several researches suggest that soy may have some benefit for reducing hot flashes and other symptoms of menopause. However, it is strongly recommended that you get your soy from foods rather than from supplements. Foods that contain soy include tofu, tempeh, miso, soy milk, whole soybeans, texturized vegetable protein, and soy powder.

Vitamin E
A study published in Gynecologic and Obstetric Investigation found that Vitamin E may help reduce the occurrence and severity of hot flashes and night sweats during menopause. However, a placebo-controlled, randomized study evaluated vitamin E supplements (800 IU/day for four weeks) for 120 breast cancer survivors with hot flashes and found that vitamin E only marginally decreased hot flashes.
Black Cohosh (Actaea racemosa, Cimicifuga racemosa)
This herb has received quite a bit of scientific attention for its possible effects on hot flashes. Studies of its effectiveness in reducing hot flashes have produced mixed results. However, some women report that it has helped them. Recent research suggests that black cohosh does not act like estrogen, as once thought. This reduces concerns about its effect on hormone-sensitive tissue (eg, uterus, breast). Black cohosh has had a good safety record over a number of years. there have been some reports linking black cohosh to liver problems, but this has not been proven.
Red Clover (Trifolium pratense)
In five controlled studies, no consistent or conclusive evidence was found that red clover leaf extract reduces hot flashes. As with black cohosh, however, some women claim that red clover has helped them. Studies report few side effects and no serious health problems with use. But studies in animals have raised concerns that red clover might have harmful effects on hormone-sensitive tissue.
Chasteberry (Vitex agnus castus)
Similar to black cohosh, chasteberry appears to act like a progesterone and  has been used in Europe for many years to alleviate PMS symptoms as well as menopausal symptoms. it may help diminish both LH and FSH and appears to affect your pituitary function. Different studies have found that it reduced menopausal symptoms, particularly hot flashes and irregular bleeding. And it appears to be very helpful for breast tenderness, primarily because chasteberry suppresses prolactin production. Typically, it takes about three to four weeks notice results.  one note, however:  While chasteberry is widely used in Europe, there have been no double-blind placebo studies conducted on it.
Dong Quai (Angelica sinensis)
Dong quai has been used in Traditional Chinese Medicine to treat gynecologic conditions for more than 1,200 years. Yet only one randomized clinical study of dong quai has been conducted to determine its effects on hot flashes, and this botanical therapy was not found to be useful in reducing them. Some experts on Chinese medicine point out that the preparation studied was not the same as they use in practice. Dong quai should never be used by women with fibroids or blood-clotting problems such as hemophilia, or by women taking drugs that affect clotting such as warfarin (Coumadin) as bleeding complications can result.

Ginseng (Panax ginseng or Panax quinquefolius)

Research has shown that ginseng may help with some menopausal symptoms, such as mood symptoms and sleep disturbances, and with one’s overall sense of well-being. However, it has not been found to be helpful for hot flashes.
Kava (Piper methysticum)
Kava may decrease anxiety, but there is no evidence that it decreases hot flashes. it is important to note that kava has been associated with liver disease. The FDA has issued a warning to patients and providers about kava because of its potential to damage the liver.
Evening Primrose Oil (Oenothera biennis)
This botanical is also promoted to relieve hot flashes. However, the only randomized, placebo-controlled study (in only 56 women) found no benefit over placebo (mock medication). Reported side effects include inflammation, problems with blood clotting and the immune system, nausea, and diarrhea. it has been shown to induce seizures in patients diagnosed with schizophrenia who are taking antipsychotic medication. Evening primrose oil should not be used with anticoagulants or phenothiazines (a type of psychotherapeutic agent).

Sources and Additional Information:medterms.com/script/main/art.asp?articlekey=7322epigee.org/menopause/hot_flashes.htmlmayoclinic.com/health/hot-flashes/DS01143/menopause.org/hotflashes.aspxwomenshealth.about.com/cs/hotflashes/a/nomorehotflashs.htm

NEW YORK (Reuters Health) – The practice of transcendental meditation may help children with attention-deficit hyperactivity disorder manage their symptoms, research suggests.

In a pilot study, researchers found that lessons in transcendental meditation, or TM, appeared to calm the anxiety of children with ADHD, and improve their behavior and ability to think and concentrate.

TM is considered to be one of the simplest meditation techniques. Practitioners sit comfortably for 10 to 15 minutes with their eyes closed, silently repeating a mantra — a sound, word or phrase — to calm the mind and body. some researchers believe that meditation affects the nervous system in a way that can alter a range of bodily functions, including breathing, blood vessel dilation and stress-hormone regulation.

The current findings indicate that children with ADHD can not only learn the TM technique but also benefit from it, the researchers report in the online journal Current Issues in Education.

"The effect was much greater than we expected," lead researcher Sarina J. Grosswald, a cognitive learning specialist in Arlington, Virginia, said in a written statement.

"The children also showed improvements in attention, working memory, organization, and behavior regulation," she added.

The study included 10 children between the ages of 11 and 14 who were attending a school for students with language-related learning disabilities. all had been diagnosed with ADHD and, though most were taking medication, were having problems at school and home.

The students were taught the TM technique and then practiced it at school twice a day, for 10 minutes at a time.

After three months, Grosswald and her colleagues found, the students reported lower stress and anxiety levels, while their ADHD symptoms also improved, based on questionnaires given to teachers and parents.

"Teachers reported they were able to teach more," Grosswald said, "and students were able to learn more because they were less stressed and anxious."

Larger studies, she and her colleagues write, are now needed to see whether TM can be used as an ADHD therapy, either in addition to standard treatment or by itself.

"TM doesn’t require concentration, controlling the mind or disciplined focus," Grosswald noted. "The fact that these children are able to do TM, and do it easily shows us that this technique may be particularly well suited for children with ADHD."

SOURCE: Current Issues in Education, December 2008.

© Copyright (c) Reuters

By Paul G. Donohue M.D. December 17, 2010 12:00 AM

DEAR DR. DONOHUE: please write something about polycythemia. My wife was just diagnosed with it. Before she was diagnosed, she complained about severe itching and tried many different creams, lotions and ointments without any relief. Finally a doctor made the diagnosis. she has blood taken periodically. The itching has stopped. how did she get this?

“Polycythemia” (POL-ee-sigh-THEME-ee-uh) literally means “too many blood cells” — poly, many; cyt, cells; emia, blood. no one is able to say how people get it. That’s still being worked on.

All varieties of blood cells — white, red and platelets — are produced in overabundance. Platelets are tiny blood cells whose function is to form a clot when a blood vessel breaks.

Blood, packed with too many cells, becomes thick and moves sluggishly. That gives rise to symptoms such as headache, dizziness, ear ringing and a rise in systolic blood pressure (the first number of a pressure reading). Itching is another sign. A warm shower or warm bath greatly increases itchiness. another polycythemia sign sometimes seen is redness and burning pain in the feet and hands.

One of the most serious consequences is clotting. A clot in a brain artery is a stroke. Bleeding and easy bruising are other common signs. That sounds paradoxical — clotting and bleeding. And bleeding shouldn’t happen with an excess of platelets. it does because often the platelets are of inferior quality.

Treatment is blood removal. once the blood count has been lowered and symptoms have gone, removal can be done less frequently, every three months or so.

If blood removal does not achieve control, medicines can be added to the regimen.

DEAR DR. DONOHUE: I read what you had to say about gallstones for the woman who didn’t want to have her gallbladder removed. I have gallstones too, and want them out. My doctor insists I don’t need an operation. what if I were to have an attack at some inopportune time? I’d rather plan for surgery. is this a rational approach?

Yes, your approach is a good argument for surgery. however, the odds are that you will never need an operation. You have what is called incidental gallstones, gallstones not kicking up any trouble, discovered by chance. The percentage of people with silent gallstones in the years from 50 to 59 is 12 percent for women and 7 percent for men. between the ages of 60 and 69, the percentages are 16 for women and 17 for men. Most of those gallstones are discovered when people happen to have an ultrasound of their abdomen for some unrelated reason. Only a few of these people will ever have a gallbladder attack. Surgery for silent stones isn’t recommended.

Readers may write to Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando FL 32853-6475.

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Dementia treatments can only be assessed once a person is diagnosed with dementia. it is termed as dementia when a person suffers from loss of cognitive functions as a result of the loss of brain cells. This disease is typically characterized by memory loss and may even encompass the inability to function at work or on a social level, difficulty with speech and limited movement. This progressive disease may even bring a person to the point where they cannot take care of themselves properly. They may end up needing aid to get dressed, eat and to get around. Some typical dementia symptoms are listed below:

Dementia is not referred to as one of the normal aging processes even though it is more prevalent in older persons. There are even types of vascular dementia that are mistaken for Alzheimer’s disease.

Other dementia symptoms:

• The blockage of a blood vessel to the brain
• A brain injury
• Huntington’s or Parkinson’s disease
• A brain tumor
• Vitamin B deficiencies
• Contact with certain medications, toxic matter, and drug abuse or alcohol
• Hypoglycemic episodes

If a person is thought to be suffering from dementia symptoms they are brought in to the doctor that will confirm a diagnosis by relying more on the interviews that he conducts with the affected person and family members as there is nothing specific that can be done. it may be that the patient is depressed so that has to be eliminated. if the doctor feels that the condition may be as a result of damage to the brain he will order a computer tomography scan (CT scan) or magnetic resonance imaging (MRI) to examine the brain.

Dementia treatment options:

There are medications currently available that will slow down the progression of the disease even though there is no direct cure. some behavioral or psychiatric therapies may also be involved. it will also take a strong support system to help the afflicted person to deal with the emotional challenges that they will face. Dementia treatments are aimed at lessening the symptoms experienced and slowing down the advance of the disease.

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If you think you might be having a stroke, don’t hesitate. get to the hospital.

That’s the message from Dr. Hemant Pandey, director of the new stroke program at Chandler Regional Medical Center.

A patient who arrives at Chandler Regional with stroke symptoms will be seen by an ER physician within 10 minutes.

A CT scan will be read within 25 minutes, and, if doctors decide clot-buster drugs are needed, the patient will get them within an hour.

“These are strict guidelines,” Pandey said. “This changes the outcome significantly in the patient.”

Stroke symptoms include the abrupt onset of slurred speech or other difficulty talking, difficulty with balance, inability to lift an arm or a leg or loss of sensation in an arm or a leg.

In a stroke, a small clot appears in a blood vessel, preventing blood flow to that part of the brain.

A clot buster, called tPA or tissue plasminogen activator, “acts like Drano,” Pandey said. it dissolves the clot and opens the blood supply to that part of the brain.

“Timing is so critical because if they wait six or eight hours, part of the tissue cannot be saved,” Pandey said.

“If a patient goes to a hospital that’s stroke certified, they have a higher chance of getting clot-buster medication,” he said.

The hospital, which adopted the new faster-acting stroke-treatment plan in September, has a team of physicians trained and certified in stroke management.

“The entire care becomes very aggressive and very urgent,” he said. “We were doing it before, but not in a manner as cohesive and efficient as now.”

Since Sept. 7 when the formal program began, the hospital has had about 214 patients with acute neurological symptoms, and 25 received clot busters.

Nationally, such patients who receive clot busters are 2.5 percent.

Pandey speculates that patients receiving clot busters in Chandler are higher because the hospital sees a population that’s older, including residents of Sun Lakes, and that perhaps Chandler’s patients are more educated and know to arrive quickly after symptoms appear.

Clot busters do come with a slight risk of causing bleeding, but if they are given within the first hour of symptoms, there’s less chance of bleeding than if they’re administered in the third or fourth hour, the physician said.

“We had only one patient bleeding, so we are at 0.04percent,” the doctor said. “We believe it’s because we follow the protocols to the ‘T’ and do not deviate.”

He said the hospital is still getting a lot of patients arriving later than 4? hours after symptoms begin.

“We want them to come earlier so they can be a candidate for a clot buster,” he said.

“We would like the community to know if you recognize the symptoms, don’t wait. Come to the hospital.”

Staff from the Chicago-based Joint Commission, an accrediting agency, are visiting Chandler Regional this month, and Pandey expects the visit will result in the hospital’s stroke program being certified by the Joint Commission.

Chandler Regional is partnered with Barrow Neurological Institute in Phoenix, so if Chandler receives a patient late, such as six or eight hours after the onset of symptoms and doctors feel the person is not a candidate for clot busters, the patient is sent to Barrow, which can perform other procedures.

Dear Dr. Donohue — Please write something about polycythemia. Mywife was just diagnosed with it. Before she was diagnosed, shecomplained about severe itching and tried many different creams,lotions and ointments without any relief. Finally a doctor made thediagnosis. She has blood taken periodically. the itching hasstopped. how did she get this? — R.T.

Answer — “Polycythemia” (POL-ee-sigh-THEME-ee-uh) literallymeans “too many blood cells” — poly, many; cyt, cells; emia, blood.no one is able to say how people get it. That’s still being workedon.

All varieties of blood cells — white, red and platelets — areproduced in overabundance. Platelets are tiny blood cells whosefunction is to form a clot when a blood vessel breaks.

Blood, packed with too many cells, becomes thick and movessluggishly. That gives rise to symptoms such as headache,dizziness, ear ringing and a rise in systolic blood pressure (thefirst number of a pressure reading). Itching is another sign. Awarm shower or warm bath greatly increases itchiness.

One of the most serious consequences is clotting. A clot in abrain artery is a stroke. Bleeding and easy bruising are othercommon signs. That sounds paradoxical — clotting and bleeding. Andbleeding shouldn’t happen with an excess of platelets. It doesbecause often the platelets are of inferior quality.

Treatment is blood removal. Once the blood count has beenlowered and symptoms have gone, removal can be done lessfrequently, every three months or so.

If blood removal does not achieve control, medicines can beadded to the regimen.

Dear Dr. Donohue — I read what you had to say about gallstonesfor the woman who didn’t want to have her gallbladder removed. Ihave gallstones too, and want them out. my doctor insists I don’tneed an operation. what if I were to have an attack at someinopportune time? I’d rather plan for surgery. is this a rationalapproach? — W.B.

Answer — yes, your approach is a good argument for surgery.However, the odds are that you will never need an operation. Youhave what is called incidental gallstones, gallstones not kickingup any trouble, discovered by chance. the percentage of people withsilent gallstones in the years from 50 to 59 is 12 percent forwomen and 7 percent for men. between the ages of 60 and 69, thepercentages are 16 for women and 17 for men. Only a few of thesepeople will ever have a gallbladder attack. Surgery for silentstones isn’t recommended.

Write Dr. Donohue at P.O. Box 536475, Orlando, Fla.32853-6475.