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[Petra]

I've been on and off HRT for the past 12 years, mostly on, currently trialing coming off.

I've spent a bit of time over the years while off HRT, i.e. while suffering from hot flashes and night sweats, really focusing on the trajectory/anatomy of these flashes. I'll describe what I notice and wonder if other women have noticed this, or have other insights:

About 10-15 second before the actual heat/sweat symptoms start to spread and become apparent, I feel a strange, almost imperceptible jolt, usuallly in the chest region. It's hard to describe. It's a bit like a 'gasp', and sometimes it even makes me take a big breath or an extra breath.

I also notice it while running...like a tiny falter, or weakness, or need to gasp or pause. And though I don't notice the heat as much when running, I learned that, oh, yeah, this is what happens just before the heat/sweat. As I said, it's hard to describe and is almost imperceptible.

Have any others really focused on the anatomy / trajectory of a hot flash and noticed anything like this? (I meditate regularly, and I especially notice this then, when my attention is less disbursed.)

[Taz2]

Hi Petra. Yes I have similar feelings before a hot flush/sweat hits. I would describe it as more of a lurch in my chest and upper abdomen swiftly followed by a feeling of total doom and panic. I have to take a big gasp of air. Then my heart rate rises making me feel slightly nauseous and as if I might need to rush to the loo (bowel) before the flushing/sweating then begins.I always thought the feelings were attributed to a sudden rise in adrenaline.

Once I got used to knowing that these sensations meant that a flush was on the way it wasn't so frightening but after a year they were happening every 20 minutes day and night and this was the main reason I began HRT.

Taz x

[VanillaLover]

Yes to the doom and panic feeling beforehand. Also like a lightheaded/floaty feeling and a bit dizzy. Feel my heart rate speed up. Want to run off and escape! Then the heat starts. Mainly in my hands (never face for some reason). Bad ones feel the heat in my chest/neck badly. At the moment triggered by exercise (can be vigorous, can be hoovering). Or sometimes going into a warm place after being outdoors etc.

Don’t really want to increase my HRT so I’m hoping I’ll get used to the exercise ones (martial art so when it happens I just have to stand there and deal with it!). Before HRT used to have them all the time (though more like mini ones. Getting into a car, eating, drinking, walking, anything would set them off)

[Fruitcake]

I also experience the same panic/anxious feeling about 10-15 seconds before a hot flush.  They start in the middle of the chest somewhere then radiate upwards. With a really intense flush I feel irritated and annoyed as well, not at the fact it is happening, just at 'the world'.

It is hard to describe to anyone else.  I've tried to explain to hubby numerous times the feelings and he has a very blank expression on his face. I sometimes get a head tilt of 'the things women go through!'

[VanillaLover]

Ha yes ….try to explain to people that a hot flush isn’t just ….feeling hot! People who haven’t had them don’t get it.

[Petra]

From the replies so far, I think I'm lucky that so far this pre heat feeling has been almost entirely physical for me, as in, I haven't felt the doom, though maybe a little bit of the panic, now I think about it.

Really interesting to read these accounts. Does anyone know if any researchers have made attempts to describe or understand this particular aspect of sweats/flashes, what is actually going on in body?  (Edited to ad: @Taz2, re this being adrenaline, that makes sense...is that something you worked out and/or is there a medical theory on that as well?)

Once I finally became aware of what this was, and became more alert to it, I think it helped a bit, in the sense I could gird for what was coming next.

Thanks all!!

[VanillaLover]

I believe that the erroneous signal from the hypothalamus that the body is too hot put you into a state of emergency …. hence the fight or flight type feelings. Blood rushes to the skin surface (and away from brain and other organs, giving nausea, dizziness etc), adrenaline is released as the body is in “danger” hence panicky type feelings. Heart rate speeds up to try and cool the blood diverted to the skin.

I know what you mean about “just” the hot feelings …..I used to get those where I would just feel warm and my hands were hot to touch ….but now over the last couple of years they have developed into full scale sweating heart racing jobs.

[Taz2]

I believe that the erroneous signal from the hypothalamus that the body is too hot put you into a state of emergency …. hence the fight or flight type feelings. Blood rushes to the skin surface (and away from brain and other organs, giving nausea, dizziness etc), adrenaline is released as the body is in “danger” hence panicky type feelings. Heart rate speeds up to try and cool the blood diverted to the skin.

My feelings of panic etc start before the hot flush though rather than in response to an increase in heat 

[DottyD68]

Hi Petra,

Thank you for posting this thread.

I can totally relate to a sudden feeling of doom that comes unexpectedly from nowhere, followed quickly by increased heart rate and a total sense of panic as I don't know what is happening to me. It sounds really dramatic but on occasions I've actually felt that I'm about to die - not nice.

Surprisingly until now I had never really considered this a flush but rather an adrenaline surge caused by fluctuating hormones but maybe it is a kind of "flush". I had always put any facial flushing/heat that sometimes follows down to my body's response to the adrenaline rather than being a flush itself. As Taz2 said  "my feelings of panic etc start before the hot flush though rather than in response to an increase in heat". Personally, in terms of "heat", I have suffered over the years more from night sweats rather than the regular facial flushes that my friends visibly have.

Fortunately these doom/surge sensations don't happen very often but when they do they always knock me for six and it takes me a while to settle afterwards as I can feel quite wobbly. The first time it happened the only way I could describe it was like a fast surging sensation through my body - like being injected with a treble espresso into my blood stream 

Occasionally it happens when I'm asleep and I wake up sat bolt upright, heart racing and I have no idea what's going on. The first time was terrifying but I now know it's been a "surge". I get my breathing under control and it passes within a few minutes.

Although it is not a pleasant experience, knowing what it is and that it will pass helps me deal with it better. 

[Petra]

Occasionally it happens when I'm asleep and I wake up sat bolt upright, heart racing and I have no idea what's going on. The first time was terrifying but I now know it's been a "surge". I get my breathing under control and it passes within a few minutes.

Yes! I realised not that long ago that it's the pre-heat jolt/weird feeling (doom, panic, etc. others describe) that wakes me up, not the actual sweating. (It's so easy to confound the two, and think the sweating is what wakes you up, but, nooo...for me anyway.)

And that is also why it's even harder to go back to sleep than if one were just woken up by some sweating...because you've just had an injection of ... whatever ... adrenalin ... into your system, of course you're going to be awake.

[VanillaLover]

Hi yes, my feeling of panic/adrenaline rush arrives before the heat too.

I assume that the hypothalamus sensing “danger” and giving adrenaline rush happens faster than the actual cooling responses of the body can kick in. That’s all just a guess though!

Whatever they are horrible and I’d love them to stop….one day….!