An Overview of Hot Flashes

Most women experience hot flashes before, during, and after menopause. These are brief episodes characterized by a sudden feeling of being uncomfortably hot.

Hot flashes that are associated with menopause are caused by hormonal changes, and sometimes the symptoms can be managed with simple approaches, such as using a fan, drinking cold fluids, and dressing in layers. Many women benefit from hormone therapy and the best treatment for you depends on the severity of your symptoms and which treatment approach is most helpful for you.

Symptoms

While they are entirely normal, hot flashes can be disruptive for you. Some women average one hot flash a day, and others have them frequently, with episodes coming on all day and night.

Hot flashes typically last for around two to four minutes. The episodes can occur at any time, but they can be worse when the temperature is warm or when you are feeling anxious or stressed.

Associated Symptoms

Hot flashes usually start suddenly, with a feeling of warmth that begins around the upper chest and face, and then spreads. Some women describe the warmth as a burning sensation.

The warmth of a hot flash is often accompanied by flushing, which is redness of the affected areas. You may also experience heavy sweating, tingling of your fingers, and palpitations. As these effects begin to resolve, some women experience chills, shivers, and a feeling of anxiety.

Hot flashes are uncomfortable and can be distracting when you are trying to take care of things during the day. These episodes can also disturb your sleep when they occur at night. 

Hot Flashes May Occur For Years

You may experience intermittent hot flashes for five to seven years, but sometimes these episodes continue for up to 10 to 15 years or even longer.

They usually start during the premenopausal years (before menopause) and stop shortly after menopause occurs (when you have stopped having your period for a year), but they can continue into the postmenopausal years (after menopause has occurred).

Causes

Some women notice that certain things trigger hot flashes—like spicy foods, caffeine, or cigarette smoke. But hot flashes occur due to hormonal changes associated with menopause, and while some situations may make them more frequent or uncomfortable, you can experience hot flashes even in the absence of triggers.

Estrogen

Hot flashes are caused by a drop in estrogen, a hormone that regulates womens' menstrual cycles and helps support fertility and pregnancy. There are several types of estrogen made by the ovaries, and the body's production of estrogen hormones begins to decline substantially in the years before menopause. The decline in estrogen before and after menopause occurs gradually and at irregular intervals.

Estrogen and Body Temperature

In addition to its effects on women's reproduction, estrogen also helps regulate body temperature by interacting with the hypothalamus, a region in the brain that monitors and adjusts your temperature. Fluctuating estrogen levels makes it difficult for the hypothalamus to regulate temperature.

The altered body temperature causes minor changes in the blood vessels that are located near the skin.

Vascular Changes

The warm feeling and skin flushing that occurs during a hot flash are caused by the sudden dilation (widening) of the blood vessels close to the skin. With vasodilation, a mild increase in blood flow occurs, resulting in a warm feeling and a red, flushed appearance.

Sweating occurs as the body attempts to cool off. Sweating lowers the core body temperature, leading to chills and shivering right after a hot flash.

Treatment

There are a number of ways to manage hot flashes. Because they generally last for only minutes at a time, it helps to try to figure out when you tend to experience them. Some lifestyle adjustments can help you adapt, and several prescription medications can prevent hot flashes.

Lifestyle Strategies

You can adopt some habits to help you feel more comfortable when your hot flashes occur.

Drink Fluids

Drinking something cold is a fast and effective way to cool your body. If you tend to feel hot, keeping a cool drink nearby can help you quickly cool off. It may take some planning to make sure that your drink stays at just the right temperature for you, but the extra effort is worth it.

Also, keep in mind that staying hydrated is important too. That means that it is important to drink plenty of water and other drinks that are low in sugar, caffeine, and alcohol.

Dress to Stay Cool

Dressing in layers is important if hot flashes sneak up on you. Dressing for comfort also requires planning, especially if you are used to wearing certain outfits for work. For example, if you wear an attractive and professional blouse under your blazer, you can take off your jacket when you feel too hot.

And remember that you don't have to compromise your style or professional look during menopause! You can find fabrics that will wick the perspiration away from your skin, and it is important to try them on, instead of buying them online or from a catalog.

Deep Breathing

Deep breathing techniques can shorten hot flashes and make them milder. Teach yourself to start slow, deep breaths as soon as you feel a hot flash coming on. Take as deep a breath as you can, and hold it a moment before letting it out slowly. Expanding your rib cage can help trigger the parasympathetic nervous system, which calms you down and helps regulate temperature.

If you practice deep breathing techniques, like yoga breathing or Pilates breathing, they will come more naturally when you need to use them.

Cool the Room

Turn down the thermostat, open the windows, or use the air conditioner or fan. Keeping your indoor temperature below 70 degrees Fahrenheit during the day and about 65 degrees Fahrenheit at night will help keep your body temperature more comfortable.

Try sleeping with several light covers so you can choose how many you need.

Avoid the Heat

A hot environment can make you more prone to hot flashes and may make the episodes more uncomfortable when you do experience them. Sunbathing, hot tubs, and sitting in an uncovered sunny spot for too long can make you very uncomfortable.

Skip the Spice

Some women notice that spicy foods cause flushing and a feeling of warmth. Pay attention to your own food triggers, and avoid eating or drinking anything that triggers a hot flash.

Medication

Prescription medications can help prevent hot flashes. If your symptoms are persistent or very bothersome, you may benefit from medications that prevent your hot flashes and/or medication to reduce your symptoms.

Hormone Therapy

Hormone therapy is often used to control hot flashes. Hormone therapy includes estrogen replacement therapy or estrogen/progesterone combination therapy. Some women who are at a high risk of breast, ovarian, or uterine cancer might not be able to use estrogen replacement therapy.

Symptomatic Treatment

If you are also experiencing depression, hypertension, or insomnia related to your hot flashes, your doctor might prescribe a medication to manage your associated symptoms. This has been shown to ease hot flashes for some women.

Complementary and Alternative Medicine (CAM)

You may also hear about CAM therapies in the management of hot flashes. Some women experience improvement with aerobic exercise or yoga, while some get worse. When it comes to CAM therapy, as long as it is safe, you can use whatever works for you.

Herbal Remedies

Most herbs are sold over-the-counter, without a doctor's prescription. Be sure to verify that any herbal remedy is safe before you start using it.

Flaxseed is a natural supplement that can also be used as an ingredient in food. It has been promoted as a way to relieve some symptoms of menopause, but there is not strong evidence to back up its effects.

There are many vitamin, plant, and herbal remedies with a reputation for helping hot flashes. Vitamin E, yam phytoestrogens, black cohosh, and Er-xian have all been used for many years as menopause treatments.

While people may share their positive experiences with natural remedies, these approaches have not been proven effective in scientific studies

Acupuncture

Acupuncture has been shown to improve hot flashes but research shows that, while women report a positive effect in response to this therapy, it is not better than placebo.

A Word From Verywell

Hot flashes are very common, but that does not mean that you have to just put up with them. It is difficult to predict how many years you will continue to experience hot flashes, so it is important to try to relieve the discomfort that they cause.

You can make some adjustments in your day to help relieve some of the effects of these episodes. You can also use prescription medication to relieve your hot flashes or associated symptoms, and some women experience benefits from using lifestyle adjustments along with prescription medication.

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