Endocrinological basis of hot flushes

Hot flushes are frequent among women during natural, surgical, or pharmacological menopause. The available data suggest the involvement of estrogens, progestins, catecholestrogens, catecholamines, dopamine, endorphins, prostaglandins, luteinizing hormone (LH) and luteinizing hormone-releasing hormone (LH-RH) in the pathogenesis of flushes. At present the estrogen withdrawal and pulsatile luteinizing hormone (LH) secretion theories are most commonly accepted for explaining the development of this symptom. The use of LH-RH agonists offers an opportunity to focus on the probable origin and region that regulate the events of this phenomena, since the administration of this drug is associated with hot flushes, in spite of low gonadotropins and normal estrogen levels. Current data may suggest that the origin of this neurovegetative symptom lies in the hypothalamus.