Although hot flushes are the most common characteristic during menopause but underlying physiopathological mechanisms has not yet been clarified. Trials of drugs that selectively inhibit the re-uptake of serotonin and noradrenalin have shown some beneficial effects which provides new insight into the pathophysiology of hot flushes.A variety of chemical pathways have been proposed involving estrogen,serotonin,endorphin,noradrenalin and dopamine. Flushing occurs as a result of disturbance of the temperature regulating system situated in the hypothalamus on low estrogen conditions, and probably a reduction in the thermoneutral zone, within which fluctuations of basal body temperature do not provoke compensatory vascular responses. Many factors have been implicated, including hormone factors, serotonin, gonadotrophins and multip neurohumoral mechanisms.%潮热是围绝经期女性常见症状,但其内在病理生理学机制尚未阐明.近年临床发现,5-羟色胺及去甲肾上腺素再摄取抑制剂对潮热有一定疗效,开拓了研究潮热的多种思路及治疗方向,包括雌激素、5-羟色胺、内啡肽、去甲肾上腺素及多巴胺等化学分子机制假说相继出现.潮热可能是雌激素低落导致5-羟色胺、β-内啡肽、促性腺激素释放激素等多种神经介质代谢异常,同时下丘脑体温调定点范围变窄,体温调节紊乱,基础体温的波动不能通过血管舒缩代偿,多因素多环节作用的结果.
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