Symptoms and Hormones: Fine-Tuning Atherosclerotic Risk?

  • Juan José Hidalgo-Mora
  • Darya Dudenko
  • Sandra Ruiz-Vega
  • Antonio CanoEmail author
Part of the ISGE Series book series (ISGE)


The drastic reduction in the circulating levels of estrogens along the menopausal transition triggers a list of symptoms, where hot flashes (HF) constitute a frequently reported episode. Women describe hot flashes as a sudden feeling of heat affecting the upper body, trunk, head, and neck and spreading upwards or, less frequently, downwards. The whole phenomenon is described as a heat wave, which is accompanied by sweating and reddening of the skin, and that persists for short intervals, of minutes or even seconds. HF present during day and night and, when intense enough, affect the quality of sleep and provoke frequent waking-up episodes.


  1. 1.
    Llaneza P. Clinical symptoms and quality of life: hot flashes and mood. In: Menopause, a comprehensive approach. New York, NY: Springer; 2017.Google Scholar
  2. 2.
    Archer DF, Sturdee DW, Baber R, de Villiers TJ, Pines A, Freedman RR, Gompel A, Hickey M, Hunter MS, Lobo RA, Lumsden MA, MacLennan AH, Maki P, Palacios S, Shah D, Villaseca P, Warren M. Menopausal hot flushes and night sweats: where are we now? Climacteric. 2011;14(5):515–28.CrossRefGoogle Scholar
  3. 3.
    Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999;340(2):115–26.CrossRefGoogle Scholar
  4. 4.
    Rees MC, Barlow DH. Absence of sustained reflex vasoconstriction in women with menopausal flushes. Hum Reprod. 1988;3(7):823–5.CrossRefGoogle Scholar
  5. 5.
    Brockie JA, Barlow DH, Rees MC. Menopausal flush symptomatology and sustained reflex vasoconstriction. Hum Reprod. 1991;6(4):472–4.CrossRefGoogle Scholar
  6. 6.
    Ginsburg J, Hardiman P, O’Reilly B. Peripheral blood flow in menopausal women who have hot flushes and in those who do not. BMJ. 1989;298(6686):1488–90.CrossRefGoogle Scholar
  7. 7.
    Sassarini J, Fox H, Ferrell W, Sattar N, Lumsden MA. Vascular function and cardiovascular risk factors in women with severe flushing. Clin Endocrinol (Oxf). 2011;74(1):97–103.CrossRefGoogle Scholar
  8. 8.
    Rance NE, Dacks PA, Mittelman-Smith MA, Romanovsky AA, Krajewski-Hall SJ. Modulation of body temperature and LH secretion by hypothalamic KNDy (kisspeptin, neurokinin B and dynorphin) neurons: a novel hypothesis on the mechanism of hot flushes. Front Neuroendocrinol. 2013;34(3):211–27.CrossRefGoogle Scholar
  9. 9.
    Prague JK, Roberts RE, Comninos AN, Clarke S, Jayasena CN, Nash Z, Doyle C, Papadopoulou DA, Bloom SR, Mohideen P, Panay N, Hunter MS, Veldhuis JD, Webber LC, Huson L, Dhillo WS. Neurokinin 3 receptor antagonism as a novel treatment for menopausal hot flushes: a phase 2, randomised, double-blind, placebo-controlled trial. Lancet. 2017;389(10081):1809–20.CrossRefGoogle Scholar
  10. 10.
    Thurston RC, El Khoudary SR, Sutton-Tyrrell K, Crandall CJ, Gold EB, Sternfeld B, Joffe H, Selzer F, Matthews KA. Vasomotor symptoms and lipid profiles in women transitioning through menopause. Obstet Gynecol. 2012;119(4):753–61.CrossRefGoogle Scholar
  11. 11.
    Jackson EA, El Khoudary SR, Crawford SL, Matthews K, Joffe H, Chae C, Thurston RC. Hot flash frequency and blood pressure: data from the study of women’s health across the nation. J Womens Health (Larchmt). 2016;25(12):1204–9.CrossRefGoogle Scholar
  12. 12.
    Rossouw JE, Prentice RL, Manson JE, Wu L, Barad D, Barnabei VM, Ko M, LaCroix AZ, Margolis KL, Stefanick ML. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA. 2007;297(13):1465–77.CrossRefGoogle Scholar
  13. 13.
    Huang AJ, Sawaya GF, Vittinghoff E, Lin F, Grady D. Hot flushes, coronary heart disease, and hormone therapy in postmenopausal women. Menopause. 2009;16(4):639–43.CrossRefGoogle Scholar
  14. 14.
    Lambrinoudaki I, Augoulea A, Armeni E, Rizos D, Alexandrou A, Creatsa M, Kazani M, Georgiopoulos G, Livada A, Exarchakou A, Stamatelopoulos K. Menopausal symptoms are associated with subclinical atherosclerosis in healthy recently postmenopausal women. Climacteric. 2012;15(4):350–7.CrossRefGoogle Scholar
  15. 15.
    Thurston RC. Vasomotor symptoms: natural history, physiology, and links with cardiovascular health. Climacteric. 2018;2:1–5.Google Scholar
  16. 16.
    Thurston RC, Johnson BD, Shufelt CL, Braunstein GD, Berga SL, Stanczyk FZ, Pepine CJ, Bittner V, Reis SE, Thompson DV, Kelsey SF, Sopko G, Bairey Merz CN. Menopausal symptoms and cardiovascular disease mortality in the Women’s Ischemia Syndrome Evaluation (WISE). Menopause. 2017;24(2):126–32.CrossRefGoogle Scholar
  17. 17.
    Bechlioulis A, Kalantaridou SN, Naka KK, Chatzikyriakidou A, Calis KA, Makrigiannakis A, Papanikolaou O, Kaponis A, Katsouras C, Georgiou I, Chrousos GP, Michalis LK. Endothelial function, but not carotid intima-media thickness, is affected early in menopause and is associated with severity of hot flushes. J Clin Endocrinol Metab. 2010;95(3):1199–206.CrossRefGoogle Scholar
  18. 18.
    Thurston RC, Chang Y, Barinas-Mitchell E, Jennings JR, Landsittel DP, Santoro N, von Känel R, Matthews KA. Menopausal hot flashes and carotid intima media thickness among midlife women. Stroke. 2016;47(12):2910–5.CrossRefGoogle Scholar
  19. 19.
    Matthews KA, El Khoudary SR, Brooks MM, Derby CA, Harlow SD, Barinas-Mitchell EJ, Thurston RC. Lipid changes around the final menstrual period predict carotid subclinical disease in postmenopausal women. Stroke. 2017;48(1):70–6.CrossRefGoogle Scholar
  20. 20.
    Thurston RC, Christie IC, Matthews KA. Hot flashes and cardiac vagal control: a link to cardiovascular risk? Menopause. 2010;17(3):456–61.PubMedPubMedCentralGoogle Scholar

Copyright information

© International Society of Gynecological Endocrinology 2019

Authors and Affiliations

  • Juan José Hidalgo-Mora
    • 1
  • Darya Dudenko
    • 1
  • Sandra Ruiz-Vega
    • 1
  • Antonio Cano
    • 1
    Email author
  1. 1.Service of Obstetrics and GynecologyHospital Clínico UniversitarioValenciaSpain

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