Written by: Team Femology
Medically reviewed by: Dr. Shabnam Das Kar
You’re sitting down, and all of a sudden, a feeling of heat spreads through your body, face, and neck. Maybe it’s accompanied by some feelings of anxiety, some sweating, or maybe your heartbeat suddenly increases. What is it? Well, if you’re a woman over 40 it’s most likely a hot flash. And you’re not alone.
80% of women experience hot flashes during menopause.
That’s why it’s the most recognized symptom of the menopausal journey.
Hot flashes are most commonly associated with the hormonal changes that women experience anytime from early perimenopause (the years leading up to menopause) all the way up to a few years post-menopause. While the exact cause is not known, most research points to the brain and its ability to regulate body temperature.
Before the hormonal changes of perimenopause, the brain accepts a slight change in body temperature—if you have a hot cup of tea, for example—without trying to adjust anything. But because of the estrogen volatility we experience in perimenopause, our brain now thinks that a cup of tea is making us too hot, and our body temperature attempts to cool off by sweating. But our body temperature isn’t actually rising, it just acts like it is! Fun isn’t it?!
Unfortunately, these shifts are unpredictable and can happen even without an obvious temperature trigger.
Every woman’s experience will be different. Some women will have sweating episodes, day and night. Few will experience a heat or flushing sensation. Some women will not be bothered by the presence of sweats when they occur, but the ‘drenching night sweats’ scenario is unpleasant for many women and can disrupt sleep. Hot sweats and flushes are often followed by a sense of feeling the chills and can be accompanied by palpitations and anxiety. For most women, the symptoms ease with time but the duration is unpredictable.
- Feelings of sudden intense heat
- Flushed face, blushing
- Sudden chillness
- Heart racing
Hot flashes that you experience at night are called night sweats. You can wake up suddenly only to find yourself and your sheets soaked in sweat. This obviously disrupts your overall sleep time and makes it so much harder to get the good night’s sleep that we all so desperately need. Not getting a full, restful night of sleep can cause other issues as well, so it’s good practice to start tracking these changes as they happen.
Generally, each hot flash can last anywhere from 30 seconds to ten minutes, with the average hot flash being four minutes. Most women have them for around 4 years—typically the years leading up to your final menstrual period and continuing through the one year after. Remember, you are technically in menopause only if you’ve gone without your period for 12 consecutive months. However, some women have hot flashes for up to 10 years before menopause and continue for even a few after. If you start having hot flashes earlier in perimenopause—while your cycles are still regular—you are more likely to have them last longer. If they start later in your menopausal journey, you may have them for just one to two years.
Some common triggers are: stress, alcohol, spicy food, tight clothes, heat and smoking. The hormonal shifts in perimenopause/menopause tend to increase our stress hormone cortisol making an otherwise “normal” situation seem far more stressful than before. Smoking is the most studied risk factor. Both current and ever smokers have higher odds of experiencing a more number of and more severe hot flashes.
If hot flashes are bothering you, it’s a good idea to start tracking when they’re coming on and what triggers them. Because women have different triggers and if you can identify yours, then you are well on your way to avoiding them.
It’s not surprising that the sudden onset and unpredictability of hot flashes can take big a mental toll. Add that to the random changes in emotion triggered by changing hormone levels and we can go from being annoyed to scared in a flash [pun intended -insert laughing emoji]. Women have to keep this in mind as they enter perimenopause. Also remember: this is a completely natural thing that we go through. It’s important to be prepared in order to proactively prioritize mental wellness.
Now that you’ve got a handle on the science behind hot flashes, let’s discuss various ways you can manage them! If you track your hot flashes and can identify triggers, then avoiding them becomes a lot easier.
No-brainer Tip #1: Keeping cool (physically and mentally) is a no-brainer when it comes to hot flashes. If you feel a hot flash coming on, then quickly sip a cold drink (switch out hot beverages for iced), and get under a fan. Portable fans can come in handy here.
No-brainer Tip #2: Wear loose cotton in layers so you can quickly add if you get a chill after a flash.
Natural herbs and vitamins have helped women the world over reduce their hot flashes. However, you will find lots of supplements making dramatic claims, without the scientific research behind them.
Our promise is that everything we do—from the information we give to the products we develop will—will be grounded in evidence-based science. We will never include junk science or snake oil cures!
The herbs and vitamins that have been used successfully to reduce hot flashes include the following: Soy Isoflavones, Black Cohosh root, Chasteberry, Passionflower, St John’s Wort, and Vitamin B6.
Points to note:
- Beware of any natural supplement claiming to be a cure-all or quick-fix.
- Natural ingredients in supplements are not regulated by most governments. This leads to frequent contamination with heavy metals and microbes. Only put things in your body that you know are safe.
- It is also often found that the active ingredient amount is not what the label says. So it is extremely important to go to a trusted source.
- Treat supplements like medication: take it for a purpose and aside from preventive ones (vitamin D, B etc), re-evaluate after 3 months to see if they are helping.
Sign up here to be notified when our exceptional quality, designed for women, natural supplements are out, because we got you covered.
If hot flashes are affecting your work, relationships, and overall quality of life significantly, you may want to consider prescription treatments.
- Menopause Hormone Therapy
Hormone therapy is the most widely used treatment for menopausal symptoms, including hot flashes. And you should note two things: they must be started at an appropriate time in your menopausal journey, and the specific hormone combination used is based on your personal medical history and risk factors. There are some risks with hormone therapy, and it’s important to discuss them with a doctor that is up-to-date with the guidelines around menopausal usage. The form and dosage are usually much lower than hormonal birth control. Estrogens available today are also much safer than the ones used many years ago.
- SSRIs (selective serotonin reuptake inhibitors)
- Menopause Hormone Therapy
SSRIs are a class of medications used mainly as antidepressants.However, they have been shown to also help with hot flashes and other menopausal symptoms. Again, the specific medication and dosage required may be different for hot flashes, so you need to consult a doctor that is up-to-date on this usage.
You can use foods that support hormones to reduce hot flashes.
Soy products like tofu can help with hot flashes. They contain isoflavones—considered to be phytoestrogens—because they mimic estrogen in the body.
Flaxseed and Sesame
Flaxseeds and sesame seeds are also phytoestrogens. It is best to consume the powder as whole seeds are not as effective.
Note: Phytoestrogens like soy, flax, and sesame seeds have long been part of traditional diets and are healthy additions, even if you don’t find they reduce your hot flashes.
Alcohol is a trigger for many women. If you do choose to enjoy a drink, then try to look for patterns. Many women find red wine to be more of a trigger than white wine. But again, this is very individual, so it’s important to track your symptoms.
Protip: You can try having a drink with food or earlier in the evening, so it has less impact on your sleep.
Spicy food can definitely be a trigger for hot flashes. If it is for you, then it’s a good idea to avoid it for a bit of time.
Meditation and Mindfulness
We all know that meditation and mindfulness is good for us as it reduces stress and anxiety. And it makes sense to manage our stress levels now as increased stress fuels even more hot flashes.
Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (CBT) for hot flashes and broader menopausal symptoms has been shown to be very effective in clinical trials. CBT focuses on the links we have between our physical symptoms and our thoughts and feelings. The way we think about situations affects our emotions, which can then increase or decrease the intensity of the symptom. For example, if you feel the onset of a hot flash, and you think everyone is looking at you, you may feel embarrassed and anxious. That anxiety can lead to increased sweating and palpitations. CBT helps you learn how to have a calmer, more neutral response so you feel more in control.
Acupuncture has been shown to be very effective in reducing hot flashes. According to Johns Hopkins Medicine, an NIH study found that women who received acupuncture found their hot flashes reduced by 50% during the period of their treatment.
We know that there isn’t enough reliable information out there for us. Much of it is confusing and also contradictory. Sign up for the Femology Newsletter to make sure you’re armed with the latest and greatest information to support you through perimenopause and menopause.