Pathophysiology and treatment of menopausal hot flashes
Pathophysiology and treatment of menopausal hot flashes
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DOI：
10.1055/s-2005-869479
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发表时间：
2005-05-01
影响因子：
2.7
通讯作者：
Freedman, RR
中科院分区：
文献类型：
--
作者：
Freedman, RR
潮热是更年期最常见的症状。虽然潮热的出现与雌激素的撤退相吻合，但这并不能完全解释这种现象，因为雌激素水平在有症状和无症状的女性之间没有差异。促黄体激素脉冲不会引起潮热，内源性阿片类物质也不会发生变化。最近的研究表明，潮热是由核心体温（T。）作用于有症状的绝经后妇女的降低的热中性区。这种狭窄可能是由于中枢去甲肾上腺素能激活升高，可乐定和一些放松程序改善潮热的观察结果支持了这一论点。因为潮热是由T触发的，升高，降低T的程序，如降低环境温度，是有益的。雌激素通过增加T出汗阈值来改善潮热，尽管其潜在机制尚不清楚。最近的研究表明，在陡峭的潮热呼吁质疑他们的作用，产生睡眠障碍。
Hot flashes are the most common symptom of menopause. Although the appearance of hot flashes coincides with estrogen withdrawal, this does not entirely explain the phenomenon because estrogen levels do not differ between symptomatic and asymptomatic women. Luteinizing hormone pulses do not produce hot flashes nor do changes in endogenous opiates. Recent studies suggest that hot flashes are triggered by small elevations in core body temperature (T.) acting within a reduced thermoneutral zone in symptomatic postmenopausal women. This narrowing may be due to elevated central noradrenergic activation, a contention supported by observations that clonidine and some relaxation procedures ameliorate hot flashes. Because hot flashes are triggered by T, elevations, procedures to reduce T,, such as lowering ambient temperature, are beneficial. Estrogen ameliorates hot flashes by increasing the T, sweating threshold, although the underlying mechanism is not known. Recent studies of hot flashes during steep call into question their role in producing sleep disturbance.