A recent analysis of a study involving 60,000 women has found that those with hot flashes early on in menopause are 11% less likely to have a heart attack and 17% less likely to have a stroke. In contrast, those who develop hot flashes later in life after menopause are at a 29% increased risk of heart attack.

No one is quite sure why hot flashes may be protective. However, hot flashes occur as a response to dropping estrogen levels. Those with early responsiveness in menopause may have healthier vascular systems. Those who develop them later in life may have unhealthy vessels.

These findings are interesting when one looks at the results of the Womens Health Initiative Study (WHI) that looked at the health consequences of taking hormone replacement therapy. The study found that women on Premarin (estrogen from pregnant mare urine) and Provera (progestin) were at higher risk of having a heart attack or a stroke. However, women for this study were chosen specifically because they did not have hot flashes. They were also on average 63 years old. This potentially puts them at risk of stroke and heart attack regardless of hormone therapy.

Knowing that lack of hot flashes may increase the risk of heart disease, I think it is important to take another view of the results of the WHI study. In addition, we are in need of clinical trials looking at the use of bio-identical hormones and evaluating the treatments for women with hot flashes. Whether women choose to use hormone replacement therapy or not, it is important that we learn as much as possible on the true risks and benefits to help women make an educated decision for themselves.