What Really Causes Hot Flashes?

Hot flashes, also known as hot flushes, are a common symptom experienced primarily by women during perimenopause, although they can also occur in men and may be associated with certain medical conditions. 

While the exact cause of hot flashes is not fully understood, the leading theory suggests that they are triggered by hormonal changes in the body.

When Do Most People Start Experiencing Hot Flashes?

Hot flashes can begin before menopause during a phase known as perimenopause, which is the transitional period leading up to menopause. 

Perimenopause can start in a woman's 40s or even earlier, and during this phase, hormonal fluctuations can lead to irregular periods, changes in menstrual flow, and symptoms like hot flashes and night sweats.

Hot flashes can continue during menopause, which is a natural stage in a woman's life when her menstrual periods cease permanently. Menopause typically occurs between the ages of 45 and 55, with the average age of onset being around 51. 

However, it's important to note that menopause is a highly individual experience, and hot flashes vary widely among women.

Night Sweats & Other Common Symptoms of Perimenopause

It's important to note that not all women will experience all of these symptoms, and some women may not experience any at all. Additionally, the severity and duration of symptoms can vary widely from woman to woman. Here are some of the other symptoms of perimenopause:

Night Sweats

Night sweats, also known as nocturnal hyperhidrosis, are episodes of excessive sweating that occur during sleep. They are similar to hot flashes but specifically happen at night. Indeed many think of them as nighttime hot flashes. Night sweats can be super annoying, as they can disrupt sleep, soaking through bedding and nightclothes, and leading to discomfort and fatigue. 

Skipped or Irregular Periods

During perimenopause, menstrual cycles may change drastically due to fluctuating hormone levels. Some women may experience irregular or less frequent periods, while others may experience spotting or heavier bleeding. It's important to track these changes to better understand the stage you're in and to seek medical advice if needed. Excessive bleeding may be a symptom of something else, such as anemia.

Other Symptoms

The list of other menopausal symptoms is quite long. The good news is not all perimenopausal women experience these symptoms. And they may be less intense for some. The list includes:

• Nausea: Fluctuating estrogen levels can result in feelings of nausea.
• Mood swings & anxiety: Any fluctuation in hormones can have a knock-on effect on your mood. Many report feeling more anxious or having sudden flashes of rage.
• Weight gain: Sudden changes in weight or digestion can also point to perimenopause. If your diet, nutrition, and exercise levels are fairly stable and you find yourself experiencing weight gain, that may be a symptom of perimenopause.
• Vaginal dryness: Vaginal or endometrial atrophy occurs in some women after menopause. The body produces less estrogen after menopause, which can lead to the thinning, drying, and inflammation of the vaginal walls. During perimenopause this process can begin, resulting in dryness.
• Changes in sexual desire or satisfaction: Some women report changes in sexual desire and arousal due to fluctuating hormones.
• Insomnia and sleep troubles: Apart from night sweats, general sleep can become unpredictable during perimenopause and beyond. It can also be hard to fall asleep, with some experiencing insomnia.
• Bone loss: With declining estrogen levels, your bone density may decrease as you start to lose bone more quickly than you replace it. For some, this can increase the risk of osteoporosis — a disease that causes fragile bones in women.
• Bladder problems: Low estrogen levels may also make you more vulnerable to urinary or vaginal infections. Loss of tissue strength may contribute to urinary incontinence.
• Memory problems or difficulty concentrating: Memory problems or difficulty concentrating are common symptoms caused by hormonal changes. Other factors like stress, sleep disturbances, and mental health conditions can contribute to these symptoms. 
• Joint and muscle pain: Estrogen plays an important role in maintaining joint and bone health. As estrogen levels decline during perimenopause, women may experience a loss of bone density and joint cartilage, leading to joint and muscle pain
• Headaches or migraines: The exact cause of headaches during menopause is not fully understood, but hormonal changes are believed to play a role. As levels of estrogen and progesterone fluctuate during menopause, some women may experience changes in blood vessels that can lead to headaches. Other factors, such as stress, lack of sleep, and certain foods or drinks, can also trigger headaches during menopause.
• Changes in skin and hair, such as dryness or thinning: Estrogen plays a key role in maintaining skin and hair health. It promotes collagen production, which helps keep skin elastic and firm, and also helps maintain healthy hair follicles. As estrogen levels decline during menopause, collagen production decreases, and hair follicles may become less active, leading to thinner, less elastic skin and hair.

If you're experiencing symptoms that are interfering with your daily life, talk to your healthcare provider about your options for managing them. Most of these symptoms will subside in postmenopausal women.

Take Our Perimenopause Quiz

The symptoms of menopause and perimenopause - including cold flashes - are numerous. But they can also be easily confused with other things going on in our bodies. Perimenopausal women may also wonder:

• Am I just stressed (work, world events, family life, etc.)
• Am I just run down?
• Maybe I’m coming down with the flu/cold/COVID?
• Maybe my body is just a little out of whack?

This means it can be difficult to say decisively if one is experiencing perimenopause or something else. To help you navigate these uncertainties, we’ve devised a little quiz. Check it out here…

Can Hot Flashes Be Caused By Something Other Than Perimenopause/Menopause?

During menopause, a woman's estrogen levels decline, which can affect the hypothalamus, a part of the brain that regulates body temperature. The hypothalamus may become more sensitive to small changes in temperature and send signals to the body to cool down. As a result, blood vessels near the skin's surface dilate, leading to a sudden sensation of heat and flushing of the skin.

Other potential factors that can contribute to hot flashes include:

• Hormonal imbalances: Fluctuations in hormones, such as estrogen and progesterone, can disrupt the body's temperature regulation system.
• Genetics: Some studies suggest that there may be a genetic predisposition to experiencing hot flashes.
• Lifestyle and environmental factors: Certain triggers, such as stress, spicy foods, caffeine, alcohol, and hot environments, can exacerbate hot flashes.
• Medications and medical conditions: Some medications, like certain antidepressants and opioids, can cause hot flashes as a side effect. Certain medical conditions, such as thyroid problems, diabetes, and certain cancers, can also be associated with hot flashes.

It's important to note that while hot flashes are typically associated with menopause, they can occur in other situations as well. For example, some women may experience hot flashes during perimenopause, the transitional phase leading up to menopause. Also: Certain medical treatments, such as hormone therapy for prostate cancer or breast cancer, can induce hot flashes in men or women, respectively.

If you experience bothersome hot flashes that impact your quality of life, we recommend consulting with a healthcare professional. 

9 Tips for Managing Hot Flashes During Perimenopause and Menopause

Managing hot flashes during perimenopause and menopause can involve a combination of lifestyle changes, self-care strategies, and, in some cases, medical interventions. Here are some tips that may help treat hot flashes:

1. Dress in Layers

Wear lightweight, breathable clothing and dress in layers so you can easily remove or add clothing as needed when a hot flash occurs. Leakproof underwear and clothing can also help absorb excess sweat and moisture.

2. Keep Cool

Use fans or air conditioning to keep your environment cool. Keep a portable fan or hand-held fan with you to use when needed.

3. Manage Stress

Hot flashes happen more often when you're stressed, so incorporating stress management techniques into your daily routine can be helpful. Try relaxation exercises, deep breathing, meditation, or activities like yoga or tai chi.

Practicing relaxation techniques like deep breathing exercises, guided imagery, or progressive muscle relaxation may help reduce the frequency and severity of hot flashes.

4. Stay Hydrated

Drink plenty of cool fluids to stay hydrated. Cold water or herbal iced teas can be refreshing during hot flashes.

5. Consider Your Diet

Some women find hot flashes occur more when they consume certain food or beverages. Common triggers include spicy foods, caffeine, alcohol, and hot beverages. Keep a diary to track your symptoms and identify any specific triggers.

6. Maintain a Healthy Weight

Some research suggests that being overweight or obese may increase the frequency and intensity of hot flashes. Maintaining a healthy weight through regular exercise and a balanced diet may help reduce hot flashes.

7. Quit Smoking

Smoking has been associated with increased hot flashes. Quitting smoking can have multiple health benefits, including a potential reduction in hot flashes.

8. Consider Herbal Remedies

Some herbal supplements, such as black cohosh, evening primrose oil, and red clover, have been suggested to alleviate menopausal symptoms, including hot flashes. However, it's important to consult with a healthcare professional before trying any herbal remedies, as they may interact with other medications or have potential side effects.

9. Discuss Medical interventions With Your Doctor

In cases where hot flashes are significantly impacting the quality of life, hormone therapy (HT) may be an option for treating hot flashes. HT involves taking estrogen alone or a combination of estrogen and progesterone to help balance hormone levels. 

However, hormone therapy is not suitable for everyone, and the decision should be made in consultation with a healthcare provider, considering individual health history and risk factors.

Remember that every individual is unique, and what works for one person may not work for another. It's important to discuss options with your doctor and experiment with different strategies to find what works best for you.

Did You Know: Cold Flashes Are Also a Thing!

They may be less common than hot flashes, but at the other end of the spectrum, some women report experiencing cold flashes. 

Cold flashes often happen at night and might be underreported because sometimes we just think a room is chilly or there’s a draught. We’ll tend to reach for an extra blanket or a robe. Or we may think the temperature outdoors has dropped suddenly around sunset and attribute our sense of cold to that and simply raise the thermostat a bit.

They may be perceived as less disruptive than hot flashes (though of course, it can be hard to sleep if you’re shivering and can’t seem to get warm, so they’re not exactly a breeze either.) Tips for managing cold flashes include:

• Add layers: Reach for an extra blanket, and pull on a pair of socks. If you find you’re susceptible to cold flashes, carry an extra layer (sweater, jacket) even on warm nights.
• Get moving: You may also find that movement helps to increase blood flow. So go for a walk or do some gentle stretching. 
• Change damp clothing or nightwear: If your cold flashes tend to follow night sweats or hot flashes, make sure you’re not sitting or lying around in damp clothing. Have a change of clothes or nightwear handy to prevent this.
• A warm shower or bath: Whenever I have that deep-in-my-bones chill, a hot shower usually works wonders (beware of intense heat that might scald this skin.) It may seem counter-intuitive (and a little masochistic), but I also find a final blast of cold water helps my temperature regulate. 
• Snuggle your hot water bottle: A hot water bottle against your feet may also help chase away those chills. 

Do Hot Flashes Stop After Menopause?

Hot flashes typically diminish and eventually stop after menopause. Menopause is defined as the absence of menstrual periods for 12 consecutive months. As women go through menopause, the hormonal fluctuations that trigger hot flashes become less frequent and eventually stabilize.

However, it's important to note that the duration and intensity of hot flashes can vary among individuals. For some women, hot flashes may continue for a few years after menopause, while others may experience them for a shorter or longer duration. Factors such as genetics, overall health, and lifestyle can also influence the duration and severity of hot flashes.

If severe hot flashes persist or significantly impact your daily life and you find yourself unable to treat hot flashes, we recommend consulting your healthcare professional. They can assess your specific situation, provide guidance, and discuss potential treatment options or lifestyle modifications to manage the symptoms effectively.

We hope you found this post informative — but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.