Speaking of Psychology Hot flashes, heart health and hormones: Rethinking menopause, with Rebecca Thurston, PhD
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Sep 3, 2025 In this enlightening discussion, clinical health psychologist Rebecca Thurston, PhD, dissects the complexities of menopause and its impact on women's health. She reveals how hormonal shifts can lead to troubling symptoms like hot flashes and mood changes. Thurston also uncovers the links between these symptoms and long-term risks for cardiovascular disease and Alzheimer’s. Plus, she explores empowering aspects of midlife, alongside evolving treatment options, including the role of trauma in shaping menopause experiences.
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Hormone Fluctuations Define Menopause Timing
- Estradiol declines sharply around the perimenopause and early postmenopause years, while FSH rises and stabilizes at high levels.
- Single hormone tests during perimenopause are usually unhelpful because hormones fluctuate month-to-month.
Hot Flashes Are Common And Long-Lasting
- About 70–75% of women experience hot flashes, which often begin in perimenopause and can last 7–10 years for moderate to severe cases.
- Hot flash prevalence and duration vary by race, with higher rates reported among Black women and substantial rates among Asian women.
A Narrowed Thermostat Explains Hot Flashes
- Hot flashes stem from a narrowed thermoneutral zone causing exaggerated heat-dissipation responses to small temperature changes.
- Naomi Rance's neurobiology work locates the mechanism in hypothalamic KNDy (neurokinin) neurons linking thermoregulation and reproductive control.