Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

heat-strokeThis May was the hottest on record since temperature measurements began to be taken during the mid-1880s. This broad problem of rising world temperatures has persisted into June. The most well-documented case of the effects is the heat wave in Pakistan where more than 1,000 lives have already been lost from heatstroke as temperatures move above 112 degrees.

“Heatstroke” is a colloquial term used to describe two distinct entities: (1) severe non-exertional hyperthermia (overheating of the body), which generally affects  the very young, the disabled, the poor, those who are isolated because of mental illness, or the elderly; and (2) exertional heat illness, which mostly affects otherwise healthy adults and adolescents. These two groups are linked due to underlying causes and effects (too much heat or sun exposure and a lack of hydration) and the eventual health impact (extreme elevations of body temperature leading to bodily dysfunction).

Heat exhaustion sometimes occurs when a person exercises and works in a hot environment and the body cannot cool itself adequately. Dehydration occurs with water loss from excessive sweating, which causes muscle cramps and weakness, along with nausea and vomiting. This makes it difficult to drink enough fluid to replenish the body’s water supply, and the lack of body water impairs further sweating, evaporation and cooling.  If the humidity is too high, sweat on the skin cannot evaporate into the surrounding air and body temperature cooling fails.

Heat exhaustion and heatstroke are caused by environmental conditions. As outside temperatures rise, the body reacts by sweating. This evaporation of water from the skin and respiratory tract is the most effective way of ridding the body of excess heat. Less effective reduction in heat occurs from the direct radiation of heat into the environment, the transfer of heat to air or liquids moving over the body.  These normal cooling mechanisms become ineffective when humidity rises above 75% and  air temperature rises above normal body temperature.

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