You probably experienced the first one some time in your late 40s or early 50s. It's a sudden and intense wave of heat that can sneak up on you at almost any time: when you're in the middle of a business meeting, at a restaurant or even when you're sleeping. When that happens, you've experienced the most common symptom of menopause: a hot flash.
More than two-thirds of North American women report having hot flashes at menopause. Most experience them only sporadically and only for a few years around the time of the menopause transition, when you stop getting periods. But some unfortunate women get them for years - and no one really knows why.
When I wrote The Menopause Book, I was surprised to learn that scientists still don't really understand the cause of such a common and distressing symptom. I hate to say this, but I am convinced that if men got hot flashes with such frequency and severity, we could have a cure by now!
Some new research has given me some reason for hope, however. A study by researchers at the University of Pittsburgh that was published in the journal Menopause found that heart rates changes during hot flashes, which reinforced early work that suggested a link between heart disease and hot flashes.
This is important because until recently, scientists have said that hot flashes were essentially benign and didn't signal any underlying disease. Now, researchers are beginning to think that women who experience many hot flashes - especially those who have hot flashes long after their periods have ended - may be at higher risk of heart disease.
Another recent study, this one by researchers at Penn State, examined the role of exercise in hot flashes. They found that there are two groups of women - those who experience more hot flashes after exercise and those who have fewer hot flashes.
The interesting thing about this study is that an individual woman's attitude toward hot flashes appeared to be significant. Women who felt they had control over their hot flashes were less likely to experience them after vigorous exercise while those who felt they had little control had more hot flashes.
If hot flashes are troubling you, medication isn't the only answer. Consider some of these lifestyle changes that could help.