[Understanding menopause. Pathophysiology of hot flashes]

Menopause is the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Although recognized since ancient time, the term "menopause" did not appear until the early 19th century. Throughout history, the perception of menopause has always had a cultural and sociological dimension, varying according to cultures and ethnic groups. From the second half of the 20th century, the demonstration of links between estrogen deficiency and a decline in quality of life, as well as an increased risk of certain diseases (such as osteoporosis and cardiovascular diseases), paved the way for the medicalization of this stage in women's lives, a topic that remains the subject of intense debate today. Vasomotor symptoms, commonly referred to as hot flashes, represent one of the main functional manifestations associated with estrogen deficiency induced by the cessation of ovarian activity. Their pathophysiology remains poorly understood, although recent advances have highlighted the role of specific neuromediators in thermoregulation, notably involving a narrowing of the thermoneutral zone under the influence of estradiol decline.