@article{660689ea8d4f4c02ac1d87cff481d117,
title = "Personal Perspective: What's in a name: Are menopausal {"}hot flashes{"} a symptom of menopause or a manifestation of neurovascular dysregulation?",
abstract = "Hot flashes have typically been classified as {"}symptoms of menopause{"} that should be tolerated or treated until they resolve. However, mounting evidence points to hot flashes as a manifestation of one or several underlying pathophysiological processes. Associations exist between the presence, timing of onset, severity, and duration of hot flashes, and the risk of several neurological (affecting sleep, mood, and cognition) and cardiovascular conditions. In addition, four consistent patterns of vasomotor disturbances have been identified across different countries, making it unlikely that these patterns are solely explained by socioeconomic or cultural factors. The changing hormonal environment of menopause may unmask differences in the autonomic neurovascular control mechanisms that put an individual woman at risk for chronic conditions of aging. These differences may have a genetic basis or may be acquired across the life span and are consistent with the variability of the clinical manifestations of aging observed in women after bilateral oophorectomy. It is time to investigate the pathophysiological mechanisms underlying the four patterns of vasomotor symptoms more closely, and to shift from describing hot flashes as symptoms to be tolerated to manifestations of an underlying autonomic neurovascular dysregulation that need to be addressed.",
keywords = "Aging, Autonomic nervous system, Estrogen, Hot flashes, Menopause, Night sweats",
author = "Miller, {Virginia M.} and Kling, {Juliana M.} and Files, {Julia A.} and Joyner, {Michael J.} and Ekta Kapoor and Moyer, {Ann M.} and Rocca, {Walter A.} and Faubion, {Stephanie S.}",
note = "Funding Information: Received October 24, 2017; revised and accepted December 18, 2017. From the 1Departments of Surgery and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN; 2Women{\textquoteright}s Health Research Center, Mayo Clinic, Rochester, MN; 3Division of Women{\textquoteright}s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ; 4Department of Anesthesiology, Mayo Clinic, Rochester, MN; 5Women{\textquoteright}s Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN; 6Division of Endocrinology, Metabolism and Nutrition, Mayo Clinic, Rochester, MN; 7Department of Laboratory Medicine and Pathology, Personalized Genomics Laboratory, Mayo Clinic, Rochester, MN; 8Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN; and 9Department of Neurology, Mayo Clinic, Rochester, MN. Funding/support: Research of authors contributing to these comments is funded through grants from the National Institutes of Health—P50 AG044170, R01 AG034676, and R01 HL83947. Financial disclosure/conflicts of interest: Dr Faubion is a consultant for Mithra Pharmaceuticals and Procter and Gamble. Address correspondence to: Virginia M. Miller, PhD, Department of Surgery, Medical Science 4-20, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. E-mail: miller.virginia@mayo.edu This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Publisher Copyright: {\textcopyright} 2018 by The North American Menopause Society. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",
year = "2018",
month = jun,
day = "1",
doi = "10.1097/GME.0000000000001065",
language = "English (US)",
volume = "25",
pages = "700--703",
journal = "Menopause",
issn = "1072-3714",
publisher = "Lippincott Williams and Wilkins",
number = "6",
}