Menopausal hot flash frequency changes in response to experimental manipulation of blood glucose.
OBJECTIVE
Although a majority of women (80%) at menopause experience hot flashes, the symptoms' physiological trigger has yet to be identified. To determine the relationship between glucose availability and hot flashes in menopausal women, hot flash frequency was compared between intervals while the subjects were fasting and/or infusing in a sample of menopausal women (38-55 years of age).


METHODS
An experimental study was conducted in 10 postmenopausal women taking hormone therapy (HT) between the ages of 38 and 55. Following a clinic visit to screen for general health and absence of diabetes, HT participants were asked to stop the medication for 7 to 10 days and to maintain a diary of hot flash frequency. When hot flashes were experienced at least four times per day in a consecutive 3-day period, participants were admitted to the General Clinical Research Center for a 30-hour experimental protocol, including frequent blood sampling and two experimental periods of intravenous infusion of glucose or normal saline. Blood glucose levels were manipulated to provide conditions of postprandial versus fasting states.


RESULTS
There was a significant reduction in the incidence of hot flashes during the experimental elevation of glucose concentrations (130 to 140 mg/dl) compared to the fasting state (<110 mg/dl) (t= -2.4, df= 9, p=.04).


CONCLUSIONS
Conditions of fasting may stimulate the trigger mechanism for menopausal hot flashes.
D000328:Adult; D001786:Blood Glucose / Q000032:analysis / Q000502:physiology*; D001812:Blood-Brain Barrier / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology; D004967:Estrogens / Q000502:physiology; D005215:Fasting / Q000502:physiology*; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D005947:Glucose / Q000494:pharmacology; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D019584:Hot Flashes / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology; D015994:Incidence; D007262:Infusions, Intravenous; D008875:Middle Aged; D009004:Monosaccharide Transport Proteins / Q000502:physiology; D009638:Norepinephrine / Q000502:physiology; D017698:Postmenopause / Q000502:physiology*; D012965:Sodium Chloride / Q000494:pharmacology; D014666:Vasomotor System / Q000503:physiopathology
D001786:Blood Glucose; D004967:Estrogens; D009004:Monosaccharide Transport Proteins; D012965:Sodium Chloride; D005947:Glucose; D009638:Norepinephrine