The physiology and measurement of hot flushes.

Hot flushes occur in the vast majority of women at menopause or after bilateral oophorectomy. Yet only in the last decade have the physiologic changes associated with hot flushes been identified. It is now clear that hot flushes occur together with pulsatile release of luteinizing hormone. Available data implicate the anterior hypothalamus in the pathogenesis of the hot flush and suggest involvement of catecholamines and endogenous opiates. Estrogen withdrawal appears to be the stimulus to the development of hot flushes in susceptible women, and likewise estrogen is the most effective agent in reducing the frequency and intensity of the hot flush.