Hot flashes. You know that feeling; you’re either in the middle of an important meeting, or cooking dinner, or perhaps you’re fast asleep, when suddenly, a rush of heat starts to spread through your body. You find yourself sweating, your skin flushed and red, and your heart racing.
For some people this sudden uncontrollable change in body temperature can cause more than just discomfort⸺it can create embarrassment, stress, and sleepless nights.
In this article, we’ll look at how menopause causes hot flashes, your management options, how to avoid triggers, and when to see a doctor.
We’ll also look at other causes of hot flashes in both men and women.
What are hot flashes?
Hot flashes happen when your internal thermostat is out of alignment. Your brain believes you’re overheating, even when you’re not, and tries to cool you down.
Your hypothalamus is the area of the brain that perceives and regulates your body temperature. During menopause the amount of estrogen your body produces drops. It’s thought that these hormonal changes affect the way your hypothalamus perceives, and responds to heat.
Think of your body at its ideal temperature. We call this the ‘neutral zone’. Before menopause, this zone is quite wide and forgiving. If the ambient temperature goes up or down a few degrees, you won’t notice it too much and your body won’t have a strong physical reaction to the change.
As you begin the transition to menopause this zone narrows. Your hypothalamus becomes more sensitive and may believe you’re overheating, when you’re not. The slightest change in your environment can kick off your cooling mechanisms (sweating, flushing, and a racing heart) and you have a hot flash.
Who can get hot flashes?
Around 80% of women experience hot flashes during menopause. For many it may be the first obvious sign that they are entering this stage of life. Many others experience hot flashes when they receive hormone suppression treatment for breast cancer, regardless of their age.
Men can experience hot flashes too
Up to 80% of men with a history of prostate cancer have experienced hot flashes due to androgen deprivation therapy that reduces the level of the male hormone, testosterone. Studies show that men who experience hot flashes due to prostate cancer experience them more frequently and for longer than menopausal hot flashes.
Hot flashes may also be a side effect of certain medications or a sign of underlying health conditions such as:
- Hormone imbalances (unrelated to menopause)
- Neurological disorders
If you’re concerned about hot flashes being a sign of something more serious, make an appointment with your doctor to talk about your symptoms. They can help you find the right diagnosis.
What triggers hot flashes?
Often, hot flashes seem to occur spontaneously, but you may notice that at other times they can be triggered by a food, a place, or an emotion.
Common hot flash triggers can include a change in the temperature, eating spicy food, drinking alcohol, or even having a cup of coffee.
Or, you may notice that some activities trigger a hot flash, such as walking into your office, driving in peak hour traffic, or planning dinner.
The way you’re feeling may also have an impact on your hot flashes. A 14-year study found that anxiety was a reliable predictor of hot flashes. Women who reported high anxiety levels were five times more likely to have hot flashes than those who had low levels of anxiety.
The good news is that by building awareness of when and where you have your hot flashes, you may be able to avoid some of your more common triggers.
When you should see a doctor
Hot flashes are not dangerous in themselves, but they can impact your daily life and your quality of sleep. Feeling anxious, embarrassed, tired, and frustrated is completely normal when dealing with hot flashes, but that doesn’t mean you have to put up with them.
Hot flashes may also be a sign of something other than menopause. It's always good to check in with your doctor to hear your options if you are experiencing symptoms that are concerning, or that interfere with your normal functioning.
How can you treat hot flashes?
When hot flashes occur, we immediately feel the need to cool down, fan ourselves, have a cold drink and find some relief. Unfortunately, because our internal thermostat is out of alignment, we are cooling down a body that doesn’t actually need to be cooled down, no matter what it is telling you. During a hot flash, the body goes through a bunch of physiological changes that can make you feel hot mostly due to vasodilation (expansion) of the blood vessels in the skin. This rush of blood does make you feel warmer, but the body is already ‘on it’ to start the cooling process, so adding things like ice, water and fans may make the following chill more extreme.
Keeping cool, unfortunately, is not the way to beat hot flashes. The reality is that women experience hot flashes all around the world, whether they live in hot or cold climates.
The key to managing your hot flashes is to find a treatment that can reduce them and their severity before they are triggered. Once a hot flash has been triggered, there is nothing that can be done.
Some common treatments for hot flashes include:
1. Hormone Replacement Therapy
Hormone Replacement Therapy (HRT) is one of the best known treatments for a variety of menopause related symptoms, including hot flashes. HRT adds estrogen back into your body through pills, patches, creams or gels, depending on your symptoms.
While HRT is currently the most effective treatment available, many women are not good candidates, depending on their cancer history and age.
Side effects can range from breast tenderness and mood swings to more serious things like blood clots, strokes, and certain types of cancer. Your doctor will be able to discuss the options with you and whether HRT is appropriate for your situation.
Don’t be tempted to buy any HRT or estrogen-based treatments online without your doctor’s OK. Online pharmaceuticals aren’t well regulated, and you may be purchasing a very convincing counterfeit that will do you more harm than good.
2. Hypnotherapy for hot flashes
Hypnotherapy is the only non-prescription treatment that has been clinically proven to reduce hot flashes. In one recent study, participants saw on average an 80% reduction in their hot flashes. They also reported feeling calmer, more in control, and having improved sleep.
One of the great benefits of hypnotherapy for hot flashes is that there are no negative side effects. It’s a great option for women who want to avoid prescription treatments, and it is safe for people who can’t take HRT. Many providers also encourage their patients using HRT to wean off estrogen therapies, and hypnotherapy can help during this process.
While hypnotherapy for hot flashes is quite a specialized service, it is possible to access at home options through apps. These apps give you access to hypnotherapy sessions developed by world-leading specialists, in your own time and in your own space.
3. Herbal supplements for hot flashes
While many over-the-counter herbal supplements make claims about their effectiveness at managing hot flashes, it’s important to know that the clinical evidence is so far largely inconclusive.
Some commonly used herbal supplements for hot flashes include:
- Black cohosh (Cimicifuga racemosa)
- Dong Quai (Angelica Sinensis)
- Evening primrose oil (EPO)
- Phytoestrogens such as soy isoflavones
Be mindful that although these supplements are ‘natural’, they may still have potentially dangerous interactions with other medications. If you are taking a herbal supplement, it’s important to mention this to your doctor so they can advise you on any potential risks.
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4. Lifestyle changes
At this time, food and exercise have not been shown to have an effect on the occurrence of hot flashes, but a healthy body can help improve your overall well-being and decrease risk of menopause related health complications like osteoporosis and heart disease.
Be sure to watch for any pattern to your hot flashes, you may find you can manage them well if you avoid particular foods, drinks, or alcohol.
As stress has also been shown to contribute to hot flashes, now is a good time to say ‘No’ to extra commitments, and take more time to relax and care for yourself.
The Wrap Up
Hot flashes are a common symptom of menopause, affecting up to 80% of women. Men and women who have undergone hormone suppression therapies for cancer may also experience hot flashes. If you’re experiencing hot flashes, there are things you can do. Clinically proven treatments such as hypnotherapy and HRT have been shown to reduce hot flashes by up to 80%. If you are concerned about the severity of your hot flashes, don’t suffer in silence, be sure to talk to your doctor and ask for help and discuss your options.