Q: I am a 50-year-old healthy and active woman pursuing a good career as a school principal. All my medical tests are normal. Lately, I have started getting up in the middle of my sleep with a very rapid heart beat and a severe headache. I have a feeling of insecurity and rather than feeling cold in this weather, I feel like throwing away my clothes. My husband is very caring and he shares the stressful moments with me in the middle of the night. This situation lasts for a couple of hours after which I feel normal.

A:The first thing that comes to mind is menopause, which is common at your age and especially known to cause attacks with feeling of warmth. You might also be experiencing anxiety, which need not have a specific cause such as trouble in the family and might also be related to menopause. There are other, much rarer causes of warmth, headache, and palpitation but if there are no other symptoms and the doctors have done basic tests which are normal, these other causes seem very unlikely. The main reason to remember that there are unusual causes is that they should be considered in greater depth if the symptoms persist and something new comes up. But common things are the usual explanation and menopause seems most likely.