Freedman · The Journal of steroid biochemistry and molecular biology 2014 · narrative review · n=?

Menopausal hot flashes: mechanisms, endocrinology, treatment.

Cited 307 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of mechanisms and treatments without systematic methodology.

PubMed 24012626 · doi:10.1016/j.jsbmb.2013.08.010 · record verified 2026-08-29

What was done

This narrative review summarizes the physiological mechanisms, endocrinology, and management strategies for menopausal hot flashes based on existing literature.

What was found

The abstract reports no numerical data or statistical findings. It describes hot flashes as exaggerated heat dissipation responses (sweating, peripheral vasodilation, intense internal heat) triggered by small elevations in core body temperature acting within a narrowed thermoneutral zone. This narrowing is attributed partly to estrogen depletion and elevated central sympathetic activation mediated by alpha-2-adrenergic receptors. Interventions reducing sympathetic activation (such as clonidine and paced respiration) and peripheral cooling ameliorate hot flashes. Hot flashes contribute to some menopausal sleep disturbance, and the abstract notes recent work questioning the role of serotonin.

Why it matters

The paper synthesizes the thermoregulatory basis of hot flashes, providing a mechanistic rationale for non-hormonal treatments targeting sympathetic tone.

Limits

As a narrative review, it lacks systematic search methodology, quantitative effect sizes, and specific sample size details in the abstract.

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