By Amy Medling, founder of PCOS Diva
It’s happening again.
Your face and neck are bright red, your heart is racing, and your body is breaking out in a sweat.
You feel powerless and even a little embarrassed.
Sometimes, these bursts of heat jolt you awake at night, drenching you in an uncomfortable sweat, causing fatigue, forgetfulness, and irritability the following day.
But you are too young for menopausal hot flashes.
Did you know that a woman who is still menstruating can also experience hot flashes?
When these symptoms appear earlier, they often go untreated because the woman is not yet thinking about menopause.
However, it is essential to take these symptoms seriously and consider that they might be due to estrogen dominance, thyroid dysfunction, a sign of poor cardiovascular health, or primary ovarian insufficiency (POI).
What is Estrogen Dominance?
Estrogen dominance is one of the most common hormonal balances women with PCOS experience.
The theory associated with the mechanics of estrogen dominance is that it happens during the perimenopause transition. It is a condition where estrogen levels are abnormal relative to progesterone levels. In this stage, the body produces less progesterone but still secretes the same levels of estrogen. This imbalance then causes a variety of unpleasant symptoms including hot flashes, night sweats, infertility, fluid retention, mood swings, and hypothyroidism.
If hot flashes start at a younger age while you still have periods, they could last up to ten years, but if they begin later in life as you approach menopause, they most likely will only last a year or two.
In perimenopause, hot flashes seem to occur before or during periods.
Causes of Estrogen Dominance
Experts attribute estrogen dominance to four main causes: environmental, dietary, medicine, and lifestyle factors.
Man-made chemicals found in pesticides and plastic containers contain xenoestrogens which can mimic naturally occurring estrogen in our bodies and act as endocrine disruptors which can play havoc with our hormones.
Solution: Learn how to clean up your toxicity levels here.
The average diet is loaded with refined flour sugar, simple carbohydrates, and artificial ingredients which lead to inflammation and disrupt the natural flow of hormones. In fact, inflammation is the root cause of many PCOS symptoms.
Solution: Eating an anti-inflammatory,high-fiber diet is often recommended for those with high estrogen levels. High fiber diets, in particular, have been shown to reduce estrogen absorption in the colon and increase fecal estrogen excretion. This would explain why high fiber diets are linked with low estrogen levels and lower risks of certain cancers. Blood sugar fluctuations seem to make hot flashes (and PCOS symptoms) worse. Diet modifications improve blood sugar levels, hot flashes, and night sweats.
Eliminating and/or reducing caffeine as well as inflammatory foods can be helpful too, especially if you are managing PCOS. Alcohol and spicy foods may also be a factor.
High levels of estrogen can happen due to specific medications and treatments, especially those that seek to boost estrogen levels, such as estrogen replacement therapy.
Solution: Doctors can change their treatment plans to help achieve a healthier hormone balance.
Topical progesterone can help, especially with hot flashes in perimenopause.
#4 Lifestyle Factors
Finally, high stress levels and lack of exercise can cause your adrenal gland to produce extra cortisol throwing off the delicate hormone balance, sparking hot flashes, and worsening PCOS symptoms.
Solution: Learn how to manage your adrenal response here.
Thyroid dysfunction can also cause hot flashes, especially high TSH or hypothyroid.
The thyroid is responsible for maintaining hormonal balance, and any fluctuations in its functions will translate to “out of the ordinary” sensations, one of them being hot flashes. When the thyroid gland produces too much thyroid hormone, it causes the body to be uncomfortably warm and even brings about early menopause.
Poor Cardiovascular Health
Hot flashes may be a cause of poor cardiovascular health or at least a sign of it.
Chronic, persistent, low-grade inflammation is an essential underlying factor in poor cardiovascular health and is a contributing factor to PCOS.
A study in 2015 concluded that women who experience hot flashes before their 40s or before they get to their menopausal years are at higher risk for cardiovascular disease.
The study monitored 189 peri and post-menopausal women for 24 hours. The results were telling. The women who experienced multiple hot flashes in 24 hours were likely to have poor endothelial function, specifically with blood flow.
Researchers in one study concluded that:
“Endothelial function is very important to vascular health, and it’s often the first thing to go in the atherosclerotic process, so it’s an early marker of cardiovascular risk.”
Primary Ovarian Insufficiency
Primary Ovarian Insufficiency (POI) is when a woman’s ovaries no longer function normally before they reach 40. POI is not the same as PCOS. A woman with POI cannot produce typical amounts of estrogen or have regular menstruation, leading to infertility.
Other than hot flashes, symptoms of Primary Ovarian Insufficiency include:
- Difficulty getting pregnant
- Night sweats
- Dry eyes
- Low libido
- Vaginal dryness
Women with POI are also at risk of developing osteoporosis due to low estrogen levels.
Causes of Primary Ovarian Insufficiency
The exact cause of POI is still up for debate. Research suggests that only 10% of cases can be traced to autoimmunity or genetic conditions. Other possible causes include:
- Chromosome abnormalities or defects
- Toxins such as those you get from chemotherapy or radiation therapy
- Cigarette smoke, pesticides, and viruses
- Autoimmune disease, where the body attacks ovarian tissue, harms the egg-containing follicles and damages the egg.
Solutions: Estrogen Therapy: Estrogen therapy is primarily recommended to help prevent osteoporosis while also relieving hot flashes and other symptoms. This therapy might help women get their period back, but it will unlikely restore ovarian function.
Calcium and Vitamin D supplements: Both calcium and vitamin D are essential for healthy bones. This is especially important for those who have POI as they are prone to osteoporosis.
There is no need for younger women to live with hot flashes. Take control of your symptoms, beginning with small lifestyle changes which have a big impact.
Learn more with PCOS Diva Jumpstart
Jumpstart is NOT a diet. Jumpstart is a 7-Day program of diet and lifestyle changes that will transform the way you look, feel, and think about PCOS. It is a natural solution to mindful eating, self-care, and self-compassion.
Amy Medling, the best-selling author of Healing PCOS and certified health coach, specializes in working with women with Polycystic Ovary Syndrome (PCOS), who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill, and live with their symptoms. In response, Amy founded PCOS Diva and developed a proven protocol of supplements, diet, and lifestyle programs that offer women tools to help them gain control of their PCOS and regain their fertility, femininity, health, and happiness.
Wein, H. Too Young for Hot Flashes. NIH (News In Health). June 2010.
Rose, D. P., Goldman, M., Connolly, J. M., & Strong, L. E. High-fiber diet reduces serum estrogen concentrations in premenopausal women. The American journal of clinical nutrition, 54(3), 520–525. September 1991.
Casteel, B. Hot flashes at younger age may signal greater cardiovascular risk. American College of Cardiology. March 2015.