Perspiration and Hormonal Effects

Perspiration is your body's normal way of cooling itself. On average you have 2.6 million sweat glands in your skin. Sweat glands are distributed over your entire body - except for the lips, nipples and external genital organs. Sweat glands are your dermis (the middle layer of your skin). Each sweat gland is comprised of a long, coiled, hollow tube of cells. The coiled part in is the dermis is where sweat is produced, and the long duct connects the gland to a pore on your epidermis (the skin's outer surface). There are two types of sweat glands:

• Eccrine - the most common type, these are found all over the body, particularly on the palms of the hands, soles of the feet and forehead
• Apocrine - mostly found in the armpits and the anal-genital area. They typically end in hair follicles rather than pores.

Eccrine glands are smaller than apocrine glands, are active from birth (Apocrine glands become active only at puberty) and produce a sweat that is free of proteins and fatty acids. You are always perspiring even though you may not notice. This is how your body regulates your temperature. The amount of sweat produced depends upon our states of emotion and physical activity. Sweat can be made in response to nerve stimulation, hot air temperature, and/or exercise.

Hormones and Perspiration

Hot flashes affect three fourths of women. Most women have hot flashes for more than a year and up to one half of women have them for more than 5 years. What causes hot flashes is unknown, but they may be related to fluctuations in hormone levels. Hot flashes seem to result in the widening (dilating) of blood vessels near the skin's surface. As a result, blood flow increases, causing the skin, especially on the head and neck, to become red and warm (flushed). Perspiration may be profuse. Hot flashes are sometimes called hot flushes because of this warming effect. A hot flash lasts from 30 seconds to 5 minutes and may be followed by chills. Saliva testing identifies the degree to which the specific hormones associated with hot flashes are out-of-whack. Using test results as a guideline, lifestyle improvement and natural hormone supplements can be prescribed as needed to restore balance and cool the hot flashes.

Excessive Perspiration

Some women perspire excessively (a condition known as hyperhidrosis) even without overheating. Usually this sweating happens for little or no reason and can be so profuse as to dominate the sufferer's life because of the amount of wetness produced. The problem is usually most noticeable in young adults although most sufferers report that they were first affected during their childhood. Young women are affected almost three times more commonly than young men. Once established it can last for the rest of people's lives. Although it does occasionally seem to affect several members of one family, it is not recognized as a hereditary condition and it is even possible for only one of identical twins to be affected. There seems to be no racial difference in incidence.

Treatment for Hyperhidrosis

The initial treatment for hyperhidrosis is usually medical and does not involve surgery. There are ointments and salves available (i.e., Drysol) that are astringents that tend to dry up the sweat glands. Another treatment is iontopheresis. This consists of a treatment of electrical stimulation, usually in the hands. Patients place their hands in a bath through which an electrical current is passed. This treatment tends to "stun" the sweat glands and can decrease the secretion of sweat for periods of 6 hours to one week. Surgery is done using general anaesthesia. Two or three small incisions are made below the armpit. Through these holes, a tiny telescope is passed which is attached to a miniature video camera. This allows the surgeon to locate the nerves that stimulate the sweat glands. Through the remaining one or two incisions, instruments are placed to allow the surgeon to cut the nerves that affect the areas where the patient experiences excessive sweating.