We hope you find this information helpful. It is important to Dr. Goodman that you expand your knowledge during this new phase of your life. But please note that Dr. Goodman is no longer accepting new menopausal medicine patients. He is, however, accepting new patients for difficult/chronic GYN issues (ask staff for details*) and genital plastic and cosmetic procedures.
Whenever the topic of menopause comes up, there are several specific symptoms that draw most of the attention. Sleeplessness and weight gain are always mentioned, and so is lack of energy, vaginal dryness, and overwhelming emotion. Still, out of all those common complaints, the one that all women seem to experience and want a solution to is the unpredictable, overwhelming experience of having Hot Flashes.
Though I’ve never had a hot flash myself, I definitely say I understand. Perhaps more importantly, I can help. One of the most simple and straightforward ways to address the problem of hot flashes is through effective use of breathing exercises. Not only can these exercises alleviate the worst of the symptoms, but they may also be able to provide you some relief from some of your other symptoms as well.
Why these symptoms occur, and how breathing exercises can help.
Menopausal distresses such as hot flashes and their companion night sweats, poor sleep with resulting fatigue and memory/anxiety issues all lead to STRESS. STRESS happens to be a major evidence-based “trigger” for hot flashes, or (as they are known medically) vaso-motor symptoms. The genesis of all these symptoms is sudden severe fluctuations in estrogen (estradiol) levels, and the best (and safest) long-term therapy is judicious transdermal estradiol replacement. Still, you can find relief with or without supplement hormones. One way is by using botanical substances, and another is through stress-reducing and seratonin-enhancing habits such as vigorous exercise (nature’s Prozac) and paced breathing exercises. Both of these techniques produce relaxation and are a form of MBSR, or Mindfulness Based Stress Reduction.
It is important to remember how hot flashes work in order to understand how stress relieving exercise can help. There are neurochemicals released by the stress that act in the brain to narrow the temperature-neutral zone. This make hot flashes more common, so reducing them is an important goal. Add to this the fact that the neurochemicals released by stress increase the body’s core temperature. This, along with a narrowed “temperature-neutral zone” are strong triggers for hot flashes.
Breathing Exercises to Try
The paced breathing examples briefly outlined below are among my favorites for producing relaxation and reduction of stress. Done regularly, they can provide a measurable reduction of the levels of excitatory neurochemicals produced by stress.
Paced respiration exercise:
This exercise takes from 2 to 4 minutes, and no one will know you’re doing it. Place your tongue at the roof of your mouth, touching the ridge between your teeth and palate. Breathe in through your nose, then out through pursed lips. Fill and empty your lungs as if filling and emptying a wine carafe or old-fashioned milk bottle, using a “1-2-3-4” count to slowly fill the base/bottom of your lungs with air (abdominal breathing), then count “5-6-7-8” as you slowly fill the top of your lungs with air. Hold the breath for a “1-2-3-4-5-6” count, then slowly empty your lungs through pursed lips, counting “1-2-3-4” and emptying the top of your lungs, then “5-6-7-8” as you empty or pour the air from the base of your lungs. Imagine that you’re emptying a milk bottle or wine carafe. Hold your breath out for a “1-2-3-4-5” count. Remember that the tip of your tongue should be at the roof of your mouth. Repeat for a minimum of 4 and maximum of 8 repetitions. This exercise will take no more than 2-4 minutes. The trick lies in keeping track of the breathing, the counting, using the right form and keeping the tip of your tongue where it belongs. It is impossible for you to spend time thinking about other things while doing this exercise, and that is at the heart of mindfulness-based stress reduction. The less stress you feel, the lower the chance of a hot flash trigger!
This is an ancient Buddhist meditation. As with the meditation above, it involves 4-5 minutes of breath meditation. In this case, one’s entire attention is placed on the triangle formed by the nose, the epicanthal fold between your nostrils and upper lip, and your upper lip. Keep all of your attention focused on this small area of your body. Breathe normally, in and out of your nose, paying close attention to every sensation in this small area. Feel the breath passing, perhaps stirring your nose hairs. Pay attention to the changes in sensation – perhaps it is a bit cooler going in, and warmer while exiting. Feel the touch of the breath passing over your upper lip. Feel any twinges or tickles on your skin in the area, noticing and watching it pass away. All you need to do is breathe and take note of any and all sensations in the area, taking not of the impermanence of the breath. If you find that your attention is wandering, chuckle at yourself (“…monkey mind..!”) and return your attention to the triangle. Do this for a minimum of 5 minutes. This exercise can be done anywhere, with no one knowing that you are meditating. Continue for as long as you wish, or until you feel relaxation. The principal is the same as above: by quieting your mind and distracting yourself mindfully from stressful, trigger-inducing thoughts/worries/anxieties, you reduce the incidence of hot flashes.