Opvliegers: een symptoomanalyse

The authors believe that hot flashes should be approached clinically and functionally. Nighttime flashes are more bothersome than during daytime as they are associated with a worsened sleep quality. Hot flashes and a poor sleep quality are also associated with a lowered mood. Their symptoms, and particularly any combination of symptoms, cause significant suffering. They may also increase health care costs and reduce work productivity. Few caregivers are aware of the highly variable persistence of the symptoms: in 10-15% of women, symptoms persist for more than ten years after the menopause, and 8-9% of women in their seventies still have hot flashes. Lifestyle variables such as smoking, alcohol, a poor dietary quality and overweight, and perhaps caffeine and a low habitual physical activity modulate their severity and persistence. Recent advances in pathophysiology confirm the role of the hypothalamus, and suggest a role for peptides such as neurokinin B. Yet other brain regions, such as the insula, are involved in the perception of the thermoregulatory stress and the subsequent response. The majority of hot flashes is associated with a small, but significant reduction of the brain blood flow, but there is no evidence of a more rapid cognitive decline.status: publishe