“…Explanations for cross-cultural variation in the frequency of hot flashes include the medicalization of menopause (Obermeyer, 2000), smoking habits (Dennerstein et al, 1993), parity (Beyene, 1989), breast-feeding patterns (Austad, 1994;Lancaster and King, 1992), the amount and type of phytoestrogens in the diet (Knight et al, 1996;Nagata et al, 1999), attitudes toward menstruation, menopause, and aging (Lock, 1993), and climate (Agoestina and van Keep, 1984;Martin et al, 1993;Okonofua et al, 1990;Oldenhave and Jaszmann, 1991;Rizk et al, 1998). Boulet et al (1994, p. 171) reviewed a variety of reasons for variation in menopausal symptoms, including thermoregulatory changes that might be recognized more clearly "in colder climates where more women have a greater awareness of body temperature variations.…”