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khagihara, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 6377
Experience:  Trained in OB & GYN for many years.
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why would a 78 yr old female have extreme hot flashes, sweaty

Customer Question

why would a 78 yr old female have extreme hot flashes, sweaty hair from it, lasts about 5 minutes, getting more frequent in the night
Submitted: 5 years ago.
Category: OB GYN
Expert:  khagihara replied 5 years ago.
When did she start to have the symptoms?
When did she start to take norvasc?
Breathing problem?
Swelling of the face?
flat angiomas (little collections of dilated blood vessels) on the skin?
Low blood pressure?
Customer: replied 5 years ago.
blood pressure is now normal due to all the drugs, she has none of the other symptoms you asked about, norvasc wa started about yr 2000 which was 2 yrs after a stroke w/ full recovery, the hot flashes have been getting more frequent, maybe started about a year ago infrequently,
Expert:  khagihara replied 5 years ago.
Any problem adjusting to hot temperature? Tremor? Hair loss? Frequent bowel movements? Sleep problem? Palpitations? Voice change? Nervousness?
Customer: replied 5 years ago.
only thing is the sleeep problem bc the hot flashes wake her up, she is wet thru out the front of her hair and the forehead
Expert:  khagihara replied 5 years ago.
It could be due to normal aging processes (changes in function of the hypothalamus-a part of brain).

Low-dose antidepressants. Venlafaxine (Effexor), an antidepressant related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs), could work for her hot flashes. Other SSRIs can be helpful, including fluoxetine (Prozac, Sarafem), paroxetine (Paxil, others), citalopram (Celexa) and sertraline (Zoloft).

Gabapentin (Neurontin). This drug is approved to treat seizures, but it could also help reduce hot flashes.

Any questions?
Customer: replied 5 years ago.
if she is not in any way depressed, why would an anti depresant help her or is it just for the symptoms
Expert:  khagihara replied 5 years ago.
Hot flashes are mostly caused by the hormonal changes of menopause, but can also be affected by lifestyle and medications. A diminished level of estrogen has a direct effect on the hypothalamus, the part of the brain responsible for controlling your appetite, sleep cycles, sex hormones, and body temperature. Somehow (we don't know how), the drop in estrogen confuses the hypothalamus — which is sometimes referred to as the body's "thermostat" — and makes it read "too hot."
The brain responds to this report by broadcasting an all-out alert to the heart, blood vessels, and nervous system: "Get rid of the heat!" The message is transmitted by the nervous system's chemical messenger, epinephrine, and related compounds: norepinephrine, prostaglandin, serotonin. The message is delivered instantly. Your heart pumps faster, the blood vessels in the skin dilate to circulate more blood to radiate off the heat, and your sweat glands release sweat to cool you off even more. Antidepressants work for the transmitters such as norepinephrine, serotonin.
Before she starts to take any medications, she should try home remedies.

1. If she can identify the things that trigger her hot flashes, she has made the first step in getting the upper hand. Keep a record of when they occur and what she was eating or doing, or how she was feeling at the time. Many women find that stress tops the charts as a trigger. Was that hot flash in the boardroom a random hit, or was she feeling under pressure at the time? Was it a full day of pressure without a break?

Solution: Ease the pressure. Give yourself more time to plan her work, to rehearse her presentation, to deliver your assignments, to arrive where she is going. If she is doing a series of presentations, give herself a chance to relax and cool off between sessions. And plan her schedule so you avoid meetings or decision making when she is most likely to be in a sweat.

Other hot flash triggers:

alcohol, caffeine, diet pills, spicy food, hot food, hot tubs, saunas, hot showers, hot beds, hot rooms, hot weather smoking

2. Dress in layers, so she can peel off one layer after another as she gets warmer.
Don't wear wool, don't wear synthetics, and be wary of silk. That leaves cotton, linen, rayon, and more cotton. (Look at the bright side: She'll save on cleaning bills, and she can stop worrying about moths.)
Avoid turtlenecks. Stick to open-neck shirts.
Keep ice water at hand that she can sip to cool down your insides.
Where possible, lower the thermostat. Maybe it's time for a decent air conditioner or a ceiling fan. Or maybe she'd prefer one of those little hand-held battery-operated fans or the foldable kind she flutter in front of her face. She can find perfectly adequate paper fans for about a dollar.
Wear cotton pajamas or a nightgown. If she perspires a lot at night, your nightclothes are easier to change than the sheets.
Use cotton sheets only, not synthetics.
Get a bigger bed if she and her partner are on different heat planets but she still wants to stay in close orbit.
Take a cool shower before bed.
Try a mild medication like Tylenol
Arrive at meetings early so that she can get the coolest seat.
Use your freezer liberally. A number of women talked about opening the freezer at home (or in the supermarket) and sticking their head in when a hot flash hits.

3. Increasing your level of activity (for example, taking the stairs instead of the elevator) can reduce hot flashes

4. It isn't unusual to have trouble dealing with stress. She may finds that one of the following techniques will help her minimize the devastating effects of stress on her body:

relaxation exercises, breathing exercises, meditation, massage, hypnosis, yoga.

5. Over time, a low-fat diet helps some women with hot flashes. Losing excess weight helps, but losing too much weight, or being too thin, can worsen symptoms.

6. Acupuncture, which moves your Xi (your inner wind, energy, or spirit). For every woman who's skeptical about this approach, there's a woman who's found acupuncture helpful for hot flashes.

7. Some women find that taking vitamin E every day (800 I.U., range 400–1000) helps. Vitamin B6, 200–250 milligrams daily, and Peridin-C (containing antioxidants), two tablets taken three times daily.

There are other medications additionally.

1. Blood pressure-lowering medications such as clonidine (Catapres-TTS, 0.1–mg patch applied once weekly) and Aldomet (250 mg twice daily) can lessen the severity and frequency of hot flashes. They modify how the blood vessels respond to the brain's command to give off heat quickly. These drugs must be prescribed and adjusted carefully by her doctor. She should try it instead of norvasc or in addition to norvasc.

2. Mild sedatives
Bellergal-S simmers down overactive chemical activity in the brain. Taken occasionally, once or twice a day, it can be quite safe and effective — but not with alcohol. (It contains belladonna, phenobarbital, and an ergotamine.) Phenobarbital can cause drowsiness and, if she uses it regularly, she can develop a dependency for it.

3. Progesterone-like products
Megace (megesterol acetate) can reduce hot flashes in approximately 80% of women who take it. Megace is usually started at 40 milligrams daily, and it may take a few weeks to start to work. After a month the dose is adjusted up or down. The maximum dose is 80 milligrams per day. Those who reap its benefits and can tolerate its side effects (fluid retention and bloating) may do well on this medication.

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