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Sweating with Purpose

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If you are going to get hot and sticky and sweaty, you might as well be doing it for a good reason. Listen, hot flashes are not under your control, and my patients agree they are one of the most annoying side effects of declining estrogen. If you’re going to get them, you’re going to get them. But as long as you are in the sweat zone, you might as well sweat with a purpose—especially if it will help you sweat more often when you choose, and less often (or less intensely) when menopausal changes are the cause, and you have absolutely no choice.

Hot flashes are an imbalance of the neurohormonal modulation system that dilates and contracts the arteries for the purposes heating and cooling the body as necessary. It’s no surprise that there has not been a ton of research on how this system goes awry with the hormonal changes of menopause (women’s health issues are notoriously under-researched), but there is a theory that the drop in estrogen and estradiol that comes with impending menopause affects the hypothalamus, which is the temperature regulator in the brain. When estrogen drops, this central thermometer goes out of whack and causes the arteries to dilate randomly. This dilation causes the sensation of intense internal heat.

While we probably can’t completely resolve the issue, we can make it a whole lot better by overriding what’s not working correctly. This change is possible because of the action of the parasympathetic nervous system— your “rest and de-stress” system. By contrast, the sympathetic nervous system is the “OMG! I am stressed out and I better fight or flee!” system. When it takes over, we are a messy ball of sweat, along with a pounding heart and shortness of breath. When the “rest” system takes charge, we are calm cool and collected.

Knowing that we can’t stop estrogen from doing its exit dance—and this is an exciting and stimulating dance that tends to activate the sympathetic nervous system—we have to focus on the parasympathetic nervous system, getting it into the game, turned on and raring to go to balance out the action of the sympathetic nervous system. If we can do that, not only do we decrease the intensity of hot flashes, but we might even prevent a few of those future sweat baths. We are also likely to sleep better, be less moody, increase focus, and generally feel more like ourselves again. Sounds like a miracle, right? Don’t you want to know where to buy the magical cure that can make this happen? Don’t you want to know who manufactures it and where you can buy some stock in it?!

Sit down, then stand up, because here’s the truth: You can’t buy, sell, industrialize, or trade it, yet it is all yours to own and to have, absolutely for free. It is exercise.

This might seem counterintuitive, because exercise seems to rev you up and make you sweat. Isn’t that the realm of the sympathetic nervous system? Au contraire. This is the magical power of vigorous movement: Yes, it stimulates all those hormones to increase your blood pressure, heart rate, and respiratory rate, but then it stimulates the parasympathetic nervous system, waking it up so it can keep all those stress reactions under control. The more you exercise regularly, the more your arteries will dilate, your blood pressure will drop, your heart rate will slow down, and (wait for it!) your hot flashes will become a distant, sweaty memory. Well, maybe not totally, but it’s the best thing we’ve got so far that is without side effects and comes with awesome cardiovascular, fat-burning, sleep-inducing, and mood-enhancing benefits.

Here’s the caveat–I’m not talking about leisurely exercise here. You can’t get all these great perks from window shopping or strolling around the block. I’m talking about hard-core, heart rate-up, can’t-carry-on-a-conversation exercise that makes you sweaty and disgusting. For 30 straight minutes. Five days a week. Every week. You will know you are exercising enough when your resting heart rate starts to go down, you start sleeping better, you feel happier, and your hot flashes are improving. If you want to be precise and have a smart watch that tracks your heartbeat or some other kind of heart rate monitor, exercise at or above your target heart rate for at least 30 minutes 5 days per week. To determine your target heart rate, take 220 and subtract your age. Multiply that number by 85%. Do that, and feel the change take place. Anything less is just a stroll. That can be pleasant and even healthful, but it is not going to activate your parasympathetic nervous system to combat those menopausal symptoms you want to arrest.

Sounds easy, right? If you are shaking your head, I get it. If it were easy, then I wouldn’t be writing this. And the pharmaceutical industry wouldn’t be making so much money off menopausal women. But why take drugs if you can get a handle on your discomfort with a lifestyle change that benefits you in so many fantastic ways?

I suggest you make a promise to yourself that getting sweaty on purpose is always better than getting sweaty because your hormones have hijacked your nervous system. I always say exercise is the best medicine, and I will probably be saying it for the rest of my days. Why not go find out on your own how much exercise can do for you? Give it a good, serious commitment for 6 weeks, and then let me know how you are feeling. That’s how long it will take to feel the change and make it a habit. Then, you are on your way. Just get up and do it, and before you know it, you’ll find your old self again. Maybe even new and improved…and significantly less overheated!

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