Hot Flashes and Their Causes

Hot flashes before, during, and after menopause are brief episodes characterized by a sudden feeling of being uncomfortably hot. They are sometimes called vasomotor symptoms.

Hot flashes associated with menopause are caused by hormonal changes, though there can be other causes. Sometimes the symptoms can be managed with simple approaches, such as using a fan, drinking cold fluids, and dressing in layers. Many people benefit from hormone therapy.

This article explains what hot flashes feel like and their causes. It presents some of the lifestyle and treatment options you can discuss with a healthcare provider in order to treat your hot flashes.

What Does a Hot Flash Feel Like?

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

Hot flashes start suddenly and 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 include symptoms such as sweating on the face, neck, and chest, as well 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 people experience chills, shivers, and a feeling of anxiety.

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).

What Causes Hot Flashes?

Hot flashes and their precise causes remain under study and are not entirely understood. A decrease in estrogen and changes in the body related to hypothalamus gland activity appear to be at work. There's also some evidence that inflammation, oxidative stress, and even genetics play a role.

Estrogen

Hot flashes are caused by a drop in estrogen, a hormone that regulates 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 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 can affect how the hypothalamus works to regulate temperature.

The altered body temperature causes minor changes in the blood vessels that are located near the skin, which contributes to symptoms and the way that hot flashes feel.

Vascular Changes

Sudden dilation (widening) of the blood vessels close to the skin during hot flashes results in a warm feeling and a red, flushed appearance.

Sweating occurs as the body attempts to cool off. The release of fluid on your skin due to sweating lowers your core body temperature, leading to chills and shivering right after a hot flash.

Medications

Hot flashes can be a side effect of some medications taken for high blood pressure or other conditions.

These drugs can include antidepressants, steroids, and calcium channel blockers used for heart-related care.

How Do You Get Rid of Hot Flashes?

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.

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.

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.

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. Sunbathing, hot tubs, and sitting in an uncovered sunny spot for too long can make you very uncomfortable.

Skip the Spice

Some people 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.

For example, Paxil (paroxetine), a selective serotonin reuptake inhibitor (SSRI) antidepressant, can be used to treat hot flashes.

Hormone Therapy

Hormone therapy is often used to control hot flashes. Hormone therapy includes estrogen replacement therapy or estrogen/progesterone combination therapy. People 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 healthcare provider might prescribe a medication to manage your associated symptoms.

Complementary and Alternative Medicine (CAM)

You may also hear about CAM therapies in the management of hot flashes. Some people experience improvement with aerobic exercise or yoga, while others do not. 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 healthcare provider'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.

Acupuncture

Acupuncture has been shown to improve hot flashes but research suggests that, while people report a positive effect in response to this therapy, it is not better than a placebo (no treatment during research, though participants don't know that).

Stellate Ganglion Block

A procedure called stellate ganglion block may offer benefits in treating symptoms of hot flashes. This involves injecting an anesthetic into spinal regions and is often used for pain management. Some studies have shown improvement after treatment.

Summary

Hot flashes are a common symptom for people during menopause, although the sudden rush of warmth, sweating, and other changes affect some people more than others. They also can be signs of an underlying health condition or a side effect of medication.

While these vasomotor symptoms are typical, they can be treated through medication and lifestyle changes. Talk to your healthcare provider about the interventions that may work best for you.