Hot Flashes

What are hot flashes?

A hot flash is a sudden flare of intense heat, sweating and flushed skin. It’s a common and uncomfortable vasomotor (making your blood vessels larger or smaller) symptom of menopause. The reason hot flashes happen isn’t completely clear, but experts know hormonal changes cause it. As many as 3 in 4 people report having hot flashes in the years leading up to menopause (perimenopause).

Hot flashes can feel different for everyone. Some people have mild and brief hot flashes, while others have severe hot flashes that disrupt their lives.

Even though hot flashes are common, it doesn’t mean you have to accept it as normal. There are ways to manage hot flashes and improve your quality of life. Talk to a healthcare provider if you need relief from hot flashes. They can discuss what options are available for you based on your symptoms and health history.

What does a hot flash feel like?

Hot flashes feel different for everyone. What might be a short inconvenience for one person could be intense, longer lasting discomfort for another. Hot flashes usually feel like a brief sensation of heat or warmth throughout your body. You may also have:

• Flushed skin (skin that appears red or discolored).
• Sweating.
• Clammy skin (cool, damp skin).
• Chills.
• Heart palpitations or a faster heartbeat.

Not only can the intensity of hot flashes vary, but the length of time you have each hot flash can also vary. Hot flashes can even happen at night. These are called night sweats.

How long does a hot flash last?

A typical hot flash lasts between one and five minutes each time. It varies from person to person. Up to 1 in 3 people report having more than 10 hot flashes per day.

At what age do hot flashes start?

Hot flashes are a symptom of menopause that can happen as soon as you begin skipping periods or having irregular menstrual cycles. On average, menopause happens in your late 40s to early 50s. How many years you have hot flashes also varies. Some people have hot flashes for a few months, while others have them for years.

What causes a hot flash?

Hormonal changes are most likely the cause of hot flashes. Healthcare providers aren’t entirely sure of why, but they know there’s a connection between estrogen and body temperature. When estrogen levels decline during menopause, your body’s temperature regulation system can be disrupted. This can lead to sudden sensations of heat because your body may lose its ability to control its temperature.

Other factors like stress, medication and your environment can also contribute to the intensity and frequency of hot flashes.

What can trigger a hot flash?

A trigger is something that can set off a hot flash. Common triggers of hot flashes can include:

• Hot weather or warm environments.
• Being overheated, especially during exercise or when wearing heavy clothing.
• Drinking caffeinated or alcoholic beverages.
• Eating spicy foods.
• Feeling stressed.
• Drinking hot beverages like coffee, tea or hot chocolate.
• Taking hot showers or baths.
• Smoking cigarettes.

Avoiding things that trigger your hot flashes can be a great way to help manage how often you get hot flashes.

How do I treat a hot flash?

Hot flashes may seem like an inevitable symptom of menopause that you just need to deal with. But there are treatment options to improve your hot flashes. If you have hot flashes, particularly hot flashes that disrupt your daily life, reach out to a healthcare provider to learn more about treatment options.

In general, there are two categories of treatment options for hot flashes: prescription medications and over-the-counter (nonprescription) therapies.

Some prescription medications are used as off-label treatments to help reduce hot flashes. Using a product “off label” means that it’s not approved by the U.S. Food and Drug Administration (FDA) for the treatment of hot flashes, but it can be safe and effective as a treatment option. There are also lifestyle changes you can make to help manage hot flashes.

It’s important to talk to your healthcare provider about any treatment option and discuss the pros and cons. Your provider is aware of your medical history. Some treatment options may not be safe to take with your other medications or other medical conditions.

Prescription medications

Your provider may prescribe hormone replacement therapy or nonhormonal prescription medications.

Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) boosts your hormone levels and can relieve other symptoms of menopause like vaginal dryness. The hormones you receive depend on if you still have your uterus. Your options are:

• Estrogen and progesterone: If you still have your uterus, you need to take medication containing estrogen and progestin (a human-made version of progesterone).
• Estrogen only: If you don’t have a uterus (like if you’ve had a hysterectomy), you can take estrogen on its own.
• A newer option involves taking estrogen and bazedoxifene, a type of selective estrogen receptor modulator (SERM).

Nonhormonal prescription medications

Medications that don’t contain hormones can also be a treatment for hot flashes. Most of these treat conditions like depression, anxiety, sleep problems or overactive bladder. While they weren’t made for hot flashes, the following medications can reduce the frequency or intensity of them:

• Venlafaxine (Effexor®).
• Desvenlafaxine (Pristiq®).
• Fluoxetine (Prozac®).
• Paroxetine (Paxil®, Brisdelle®).
• Escitalopram (Lexapro®).
• Citalopram.
• Gabapentin (Neurontin®).
• Oxybutynin.

A newer medication called fezolineant (Veozah™) was specifically designed to help with hot flashes. It works by altering receptors in your brain. Fezolinetant and low-dose paroxetine are the only two medications that are FDA-approved for hot flashes.

Over-the-counter (nonprescription) therapies

There are other medications you can take for hot flashes that don’t require a prescription. If you’re interested in natural treatments for hot flashes, ask your provider what they recommend.

The following list of nonprescription and herbal therapies isn’t recommended by most experts. This is because even though some small studies were done using these treatments, the research either had significant limitations or didn’t show any true benefit for hot flash relief.

Examples of nonprescription or herbal therapies are:

• Evening primrose oil.
• Black cohosh.
• Soy (plant estrogen).
• Acupuncture.
• Vitamin E.

Are natural products safe to use for hot flashes?

It’s always a good idea to talk to your healthcare provider before starting a new medication or supplement for hot flashes. Sometimes, a product might seem safe on the surface, but it might not be a good option for you when you factor in other medications you take or other medical conditions you might have.

Are there foods that can help with my hot flashes?

Many people try to eat more plant estrogen (phytoestrogens) to combat the hormonal changes that go along with menopause. Plant estrogens are thought to have estrogen-like effects that might reduce hot flashes. While consuming more of these foods is generally safe, you should talk to your healthcare provider first (especially if you have a history of breast cancer).

Examples of phytoestrogens are:

• Soybeans.
• Chickpeas.
• Lentils.
• Flaxseed.
• Grains.
• Beans.

Lifestyle changes

Making small changes to your normal lifestyle can sometimes help limit the number and severity of your hot flashes. Some tips for managing hot flashes you can do on your own include:

• Dress in layers.
• Keep your home cool using fans or air conditioning.
• Drink cold beverages.
• Have cool compresses available for when a hot flash strikes.
• Maintain a healthy body weight. Having obesity can intensify hot flashes.
• Don’t smoke or use tobacco products.
• Avoid drinking beverages containing alcohol.
• Exercise for at least 20 minutes most days. It’s best for hot flashes to exercise in a cool environment.
• Use light sheets instead of heavier blankets when you sleep.
• Manage your stress with breathing exercises or activities like yoga and meditation.

Can I prevent hot flashes?

You can’t prevent hot flashes, but you can avoid things you know cause them. This can reduce how frequently or how intensely you have hot flashes.

When should I see my healthcare provider about hot flashes?

Contact your healthcare provider if hot flashes are interfering with your life. They can discuss treatment options with you to help reduce your symptoms.

What causes hot flashes other than menopause?

While menopause is one of the most common causes of hot flashes, thyroid disorders are also a common cause. Viral infections like the flu can cause hot flashes, too, as can certain medications.

If you have hot flashes and aren’t in perimenopause, another condition or factor could be responsible. Contact a healthcare provider so they can help determine what’s causing your symptoms.