Understanding Vasomotor Symptoms: What They Are and How Hormones Help

If you've ever heard someone mention hot flashes or night sweats during menopause, they were talking about vasomotor symptoms—one of the most common and often frustrating symptoms of hormonal changes in midlife. But what exactly are vasomotor symptoms, and why are hormones like estrogen and progesterone used to treat them?

Let’s break it down.

What Are Vasomotor Symptoms?

Vasomotor symptoms (VMS) refer to episodes of:

• Hot flashes: sudden feelings of warmth, usually over the face, neck, and chest, often accompanied by sweating and sometimes a rapid heartbeat.

• Night sweats: hot flashes that occur at night and can disrupt sleep.

These symptoms are caused by dysregulation of the body’s temperature control system, which is influenced by hormonal changes—especially the drop in estrogen levels during perimenopause and menopause.

Why Do Vasomotor Symptoms Happen?

During menopause, the ovaries gradually stop producing estrogen and progesterone. Estrogen, in particular, plays a critical role in maintaining the brain's temperature regulation. When estrogen levels decline, the hypothalamus—the part of the brain responsible for controlling body temperature—becomes more sensitive to slight changes. It misfires, thinking your body is overheating, and triggers a hot flash to "cool things down."

How Hormones Help: Estrogen and Progesterone

1. Estrogen: The Primary Treatment

Estrogen is the most effective therapy for moderate to severe vasomotor symptoms.

How it works:

• Replenishes the body's natural estrogen levels.

• Stabilizes the hypothalamus’s temperature regulation.

• Reduces the frequency and severity of hot flashes and night sweats—often within weeks of starting treatment.

Forms:

• Oral tablets

• Transdermal patches, gels, or sprays

• Vaginal rings (though these are usually for local symptoms like dryness, not VMS)

2. Progesterone: The Balancing Hormone

For women who still have a uterus, estrogen therapy is almost always combined with progesterone (or a progestin, its synthetic version). Why?

Because estrogen alone can stimulate the uterine lining (endometrium), potentially increasing the risk of endometrial cancer. Progesterone counterbalances this effect by thinning the uterine lining.

Additionally, micronized progesterone (bioidentical progesterone) may have sedative effects, which can help with sleep disturbances caused by night sweats.

The Bottom Line

Vasomotor symptoms are a natural but often disruptive part of the menopausal transition. Thankfully, hormone therapy, estrogen, supported by progesterone, can offer significant relief and restore quality of life for many women.

As with any treatment, it’s essential to talk with us to create a personalized plan that fits your symptoms, health history, and goals.

Want to learn more about menopause and hormonal health? Schedule an appointment to meet with a specialist to discuss all treatment options!

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