Hot flashes

Hot flashes are among the most common symptoms of the first stage of menopause.

What is a hot flash?

A hot flash is the sudden sensation of heat in the face, neck and chest—and occasionally throughout the rest of the body—caused by a sudden enlargement of blood vessels near the surface of the skin. Hot flashes can be very mild (feeling a little warmth in the face) or very severe (becoming red in the face and sweating excessively). The most severe hot flashes may include symptoms similar to a panic attack, including dizziness, fear of loss of control, rapid heartbeat, sweating and trembling. Some women will experience a cold chill after a hot flash, while a few women report feeling only the chill. Some women with severe hot flashes also report experiencing a headache after other hot flash symptoms subside.

Lifestyle tips

Following are some ways to help you ease hot flashes.

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  • Avoid caffeine, alcohol and hot, spicy foods that can cause your internal temperature to spike.
  • Avoid sweets, simple carbohydrates and sugary drinks. Sugar (in all forms) is a major hot flash trigger.
  • Drink 60 to 80 ounces of water per day. A drink of cold water can help cool your body’s core and shorten a hot flash.
  • Increase your soy intake. Bean paste, edamame, soy milk, soy sauce, tempeh and tofu all contain isoflavones which convert into phytoestrogens during digestion.
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Get plenty of sleep. If hot flashes are keeping you up at night:

  • Eliminate excess bedding and use low-thread-count sheets
  • Go to bed barefoot
  • Reduce the temperature in your bedroom (but not too cold, as you will then have the shivers)
  • Take a cold shower right before bed to help lower your core temperature
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If you smoke, quit. Smoking interferes with circulation and inhibits the body’s ability to warm and cool itself. Women who smoke are more likely to get hot flashes.

Stress management
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Reduce or eliminate stress. Strategies include:

  • Journal; consider listing five things to be grateful for every day
  • Practice deep breathing or mindfulness meditation
  • Do tai chi or yoga
Weight management
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Maintain a healthy weight. Fat adds insulation, making it harder for your body to adjust to temperature swings. Every woman’s body is different, but for some, losing even as little as 5 pounds can help reduce the frequency and duration of hot flashes.

Treatment options

There are many effective medications for hot flashes, including:

  • Hormone therapy (HT), including patches, pills, gels and vaginal rings – Stabilizes estrogen levels in your body; symptoms usually improve within 10 days of starting therapy
  • Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) – Are used to treat depression and anxiety, but also been shown to relieve menopause symptoms
  • Gabapentin – Approved by the FDA treat epilepsy and nerve pain; can also help with hot flashes and has a sedative effect
  • Clonidine – Lowers blood pressure by modifying how blood vessels respond to the body’s instructions to release heat quickly; can help alleviate hot flashes

Frequently asked questions

What are the risk factors for hot flashes?
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You may be more likely to experience severe hot flashes if you are:

  • Black or Latina
  • Overweight
  • Smoker
What causes hot flashes?
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Hot flashes are caused by changing levels of estrogen and, to a lesser extent, progesterone. These fluctuations affect the hypothalamus—the part of the brain responsible for regulating body temperature, appetite, sex hormones and sleep.

How long does a hot flash last?
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Most hot flashes last 30 seconds to five minutes. Severe hot flashes can last up to 15 minutes.

Can hot flashes damage my long-term health?
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On their own, hot flashes are not damaging—they are just instances of the body’s natural response to an increase in internal temperature. However, hot flashes may impact relationships, work, sleep and even cognition. Some research indicates that women with severe hot flashes may be at higher risk for heart disease and bone density loss than women without hot flashes.

How long will I have to deal with hot flashes?
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Most women experience hot flashes for two and seven years. About 10% of women may have hot flashes for 10 to 15 years. Typically, the earlier women start having hot flashes, the longer they last.

Should I be worried if I don’t have hot flashes during menopause?
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No. Up to 25% of women report having no hot flashes or such mild hot flashes that the symptoms are hardly noticeable.

Contact us

Talk to a care navigator or schedule an appointment at the Women’s Health & Wellness Center.