I am almost 64 years old and I am still getting hot flushes and night-sweats. They are frequent and sometimes so bad that I have palpitations too! The thing that I am confused about is that the flushes always occur at the same time as I need to pass water. I get an urgent need to go straight away. Sometimes the flush comes first, other times it comes immediately after. I have mentioned this issue to two of my GP's and they both looked at me as if I was mad. Can you please help?

Firstly, this sounds quite rational to me.

The physical changes that sweep over the body when a flush is brewing can trigger all sorts of nerve reactions (literally, reactions within the nerve pathways), and an emptying of the bladder is governed by nerve messages.

Also, it can happen the other way - the nervous messaging connected to urination can trigger a flush in someone quite sensitive (as many women are during the menopause).

The thinning of membranes that happens during the menopause means that what happens in one area of the body can affect other areas more easily.

Also, (presumably your doctors didn't take any of this into account), if you are slightly dehydrated, you will need to urinate more frequently (concentrated urine irritates the bladder lining more than dilute urine), and you will also flush more easily, as palpitations and flushes are symptoms of dehydration.

Given all that, I very much doubt you are mad.

My advice would be to focus strongly on your hydration. Drink at least 3 pints of still, plain water daily, keeping it at least 20 minutes away from food to avoid bloating.

Minimise caffeine intake, and don't drink fizzy drinks either. Lots of water and herbal teas. Do this for 2 weeks and see how things improve. Don't worry if you urinate a lot in the first few days - this will balance out.

Also, you may find a sage extract helpful in calming down the flushes.

Eileen Durward