More Frequent Overnight Hot Flashes Linked with Brain Scan Changes, New Pitt Study Finds

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Women who had more hot flashes during sleep had a greater number of brain scan changes.

"These findings suggest there is a relationship between menopausal hot flashes and blood vessel changes in the brain."

Women who experience more hot flashes, particularly while sleeping, during the menopause transition are more likely to have brain changes reflecting a higher risk for cerebrovascular disease, such as stroke and other brain blood flow problems, according to a pilot study led by researchers at the University of Pittsburgh School of Medicine published online today in Menopause and funded by the National Institutes of Health.

More than 70 percent of women have hot flashes – a sudden feeling of intense warmth and sweatiness – while transitioning into menopause, said principal investigator Rebecca Thurston, Ph.D., associate professor of psychiatry, Pitt School of Medicine. While recent research has shown that hot flashes can be linked to signs of subclinical heart disease, such as changes in the blood vessels, as well as high blood pressure and elevated cholesterol levels, Dr. Thurston and colleagues examined the possible connection between hot flashes and brain health.

The research team recruited 20 women in midlife who were not taking hormone therapy and, using a device that measures skin conductance, biologically monitored their hot flashes for 24 hours. They also conducted MRI brain imaging on participants to detect white matter hyperintensities, which are bright spots on the scan that are thought to develop due to disease of the brain’s small blood vessels. Participants also kept electronic hot flash diaries.

The women reported an average of three hot flashes per day, but the monitoring showed greater frequency, at an average of eight per day as some were likely not self-reported because they occurred during sleep, Dr. Thurston said. Women who had more monitor-detected hot flashes, particularly during sleep, also had a greater number of white matter hyperintensities on their brain scans.

“Other factors like age and cardiovascular risk factors did not explain this effect, so these findings suggest there is a relationship between menopausal hot flashes and blood vessel changes in the brain,” Dr. Thurston said. “Further work is needed to understand whether one causes the other, or if hot flashers are a signal of some other vascular process that impacts brain health.”

Dr. Thurston notes that it might be particularly important for women who are experiencing numerous hot flashes to consider modifying cardiovascular risk factors by quitting smoking and treating high blood pressure.

The research team included Howard J. Aizenstein, M.D., Ph.D., and Ervin Sejdic, Ph.D., of the University of Pittsburgh; Carol A. Derby, Ph.D., of Albert Einstein College of Medicine, and Pauline M. Maki, Ph.D., of the University of Illinois. The project was funded by National Institutes of Health National Heart, Lung, and Blood Institute grants R01HL105647 and K24HL123565; and the Department of Psychiatry, University of Pittsburgh.

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About the University of Pittsburgh School of Medicine
As one of the nation’s leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In rankings recently released by the National Science Foundation, Pitt ranked fifth among all American universities in total federal science and engineering research and development support.

Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region’s economy. For more information about the School of Medicine, see

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