Overview

Hot flashes are a common symptom experienced by many, typically associated with the menopausal transition in women, yet not exclusively confined to this period. This sudden feeling of warmth that seems to spread through the body, targeting the face, neck, and chest, can range from mild to severe enough to disrupt daily activities.

Understanding Hot Flashes - What Are Its Causes, Symptoms & Prevention?

While often linked to hormonal changes in the body, specifically reductions in estrogen, hot flashes can also be influenced by lifestyle and environmental factors. [1]

Understanding their causes, recognizing the symptoms, and exploring effective management strategies are crucial steps in navigating this often uncomfortable condition. In this comprehensive guide, we will explore the science behind hot flashes, the various triggers and symptoms, and the most effective methods for prevention and management, aiming to provide insight and relief to those affected.

What are Hot Flashes?

Hot flashes are probably the most widely experienced menopausal symptom in the western world, with up to 75% of women experiencing it. Hot flashes are most commonly experienced as an intense feeling of heat throughout the body, and can last anywhere between 30 seconds and a few minutes. Other studies indicate, however, that these hot flushes can last up to 30 minutes. The intense heat is sometimes accompanied by reddened skin, a rapid heartbeat, sweating, a high temperature and insomnia. A hot flash occurrence can be followed by chills and shivering. [2]

Hot flashes make the body feel like it is on fire, as if it is a raging furnace. The overwhelming heat takes over the body and clothes or bedding feel heavy and feel like they are suffocating you, even in the dead of winter. If the hot flashes are usually followed by chills, then this is caused by the sweat drying on the skin. This sudden, intense, overwhelming heat can come on a regular basis for some women, while others experience it at random times.

Symptoms of Hot Flashes

Hot flashes are very distinct, and as the name suggests, a woman who is experiencing them will have a feeling of warmth going through her upper body and her face. This feeling varies in intensity, but for women who experience severe hot flashes, the heat may make her body feel like it is burning up. This is followed by a flushed face, neck and chest, which appears red and blotchy. [3]

The heart may beat rapidly, what is better known as heart palpitations. With heart palpitations, the heart feels like it is beating much faster than usual. The woman may then perspire profusely in the upper part of her body. If the hot flash occurs at night, then her bedding and night clothes may be drenched in sweat. As the hot flash subsides – which happens as suddenly as the onset of the hot flash – the woman may experience chills as a result of the sweat on her skin.

Who gets Hot Flashes?

A large percentage of menopausal women in western societies get hot flashes. In the United States for example, as many as 85% of women experience hot flashes as they approach menopause. These can last for a number of years during the post menopause years. Hot flashes can also be experienced by men and women undergoing cancer treatment. This, as in the case of menopause, is caused by lower levels of sex hormones (testosterone in men and estrogen in women). Each person has a unique hot flash experience as these vary in terms of duration, frequency, intensity and onset. [4]

How are Hot Flashes Diagnosed?

Hot flashes are usually diagnosed by a doctor from a description of the symptoms. Because the symptoms are so distinct, diagnosing them is quite straightforward. The doctor may then run tests to determine what the cause of the hot flash symptoms is. The blood tests will confirm whether a woman is approaching menopause. The doctor may also test the thyroid to ensure that the hot flashes are not as a result of an overactive thyroid gland (also known as hyperthyroidism). [5]

Risk Factors

Although the reasons why some women experience hot flashes are yet unknown, there are a number of risk factors which make women more prone to hot flashes. Firstly, women who smoke place themselves at a greater risk of experiencing hot flashes during menopause than those who do not smoke. Secondly, obese women also place themselves at greater risk. If they have a higher body mass index (BMI) than normal, then they may have a higher hot flash frequency. [6]

Thirdly, women who do not exercise regularly are also placing themselves at risk of hot flashes. Furthermore, women of Japanese and Chinese descent have the lowest occurrence of hot flashes, followed by European, then African-American women (highest occurrence). Lastly, a woman's diet contributes to the frequency of hot flashes, and women in menopause should actively avoid caffeine, alcohol and spicy foods.

How Hot is Hot?

The heat experienced during a hot flash varies in intensity. For some women, it feels like a warmth that spreads across the upper part of the body and face. It does not really stop them from their normal duties. In the most severe cases, however, women can experience intense heat that incapacitates them for the duration of the hot flash. The heat from the hot flash can feel like a burning furnace, as if the body is on fire. [7]

A woman will often feel like removing all her clothes and lying down on a cold floor to try to cool off this intense heat. These severe hot flashes obviously incapacitate a woman such that she has to break from whatever she is doing for the duration of the hot flash. The accompanying sweat and heart palpitations also make it difficult to carry on with life as usual during an attack.

Treatment for Hot Flashes

The most effective hot flash treatment is hormone therapy, with clinical trials showing up to 75% drop in the frequency of hot flashes. Lifestyle changes that include exercise and diet also help treat hot flashes. A number of natural remedies like soy, vitamin E, red clover and black cohosh have also brought relief for hot flashes to some women. [8]

  • Hormone Therapy: Often considered for women whose hot flashes are severe, hormone therapy can be effective in reducing the frequency and intensity of hot flashes.
  • Medications: Certain non-hormonal medications, such as antidepressants and blood pressure drugs, have been shown to alleviate symptoms.
  • Lifestyle Adjustments: Incorporating regular exercise, maintaining a healthy weight, dressing in layers, and avoiding known triggers (like hot beverages, spicy food, alcohol, and caffeine) can help manage symptoms.
  • Alternative Remedies: Herbal supplements (like black cohosh and evening primrose oil), vitamin E, and acupuncture are explored by some individuals seeking non-medical treatment options.
  • Mind and Body Techniques: Practices such as yoga, meditation, and paced respiration can also contribute to reducing the severity of hot flashes

Stay Cool During a Hot Flash

In order to stay cool during a hot flash and maintain the body’s temperature, women should wear lightweight cotton clothing and dress in layers during winter. This allows a woman to quickly peel off the layers when a hot flash occurs. Using air conditioning or fans also helps to cool the body down faster during a hot flash. Avoiding hot drinks and foods, and consuming them cold instead also helps.

Conclusion

In conclusion, while hot flashes can be a challenging symptom of the menopausal transition, understanding their causes and recognizing their symptoms opens the door to effective management strategies. By combining lifestyle adjustments, dietary considerations, and, when necessary, medical interventions, individuals can significantly alleviate the discomfort they may experience.

This guide aims to empower those affected with the knowledge and tools to not only face hot flashes with confidence but also to maintain a high quality of life throughout this natural phase of life. Remember, seeking support from healthcare providers and peer groups can also provide additional comfort and guidance along the way.

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8 Sources

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[1] Lugo, Tania and Maggie Tetrokalashvili. "StatPearls [Internet]." Hot Flashes. StatPearls Publishing, 19 Dec. 2022, www.ncbi.nlm.nih.gov/books/NBK539827.
[2] David PS, Smith TL, Nordhues HC, Kling JM. A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms. Int J Womens Health. 2022 Mar 10;14:353-361. doi: 10.2147/IJWH.S282396. PMID: 35300283; PMCID: PMC8921794.
[3] "Hot Flashes: What Can I Do?" National Institute on Aging, 15 Apr. 2024, www.nia.nih.gov/health/menopause/hot-flashes-what-can-i-do.
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[6] Fisher WI, Johnson AK, Elkins GR, Otte JL, Burns DS, Yu M, Carpenter JS. Risk factors, pathophysiology, and treatment of hot flashes in cancer. CA Cancer J Clin. 2013 May;63(3):167-92. doi: 10.3322/caac.21171. Epub 2013 Jan 25. PMID: 23355109; PMCID: PMC3640615.
[7] Crandall CJ, Mehta JM, Manson JE. Management of Menopausal Symptoms: A Review. JAMA. 2023 Feb 7;329(5):405-420. doi: 10.1001/jama.2022.24140. PMID: 36749328.
[8] Bansal R, Aggarwal N. Menopausal Hot Flashes: A Concise Review. J Midlife Health. 2019 Jan-Mar;10(1):6-13. doi: 10.4103/jmh.JMH_7_19. PMID: 31001050; PMCID: PMC6459071.