Where Are You in Your Menopause Journey?
Take Our QuizIf you’re one of the 74% of perimenopausal or menopausal women experiencing hot flashes, the sweltering summer weather can add insult to injury. In fact, research shows you may be 66% more likely to experience hot flashes and 50% more likely to experience night sweats than in winter.
So, can you beat both summer heat and hot flashes? Absolutely! Here’s your guide to understanding what causes hot flashes and what really works to help give you relief.
What Are Hot Flashes?
A hot flash is a sudden wave of heat that spreads through your body, often affecting the face, neck, and chest. Many women also experience sweating, flushing, chills (yes, chills!), a racing heart, and anxiety as the hot flash happens. If you’re waking up at night with sweats, that’s technically a hot flash too.
Hot flashes are one of the most common symptoms of perimenopause and menopause. For some, they’re occasional and mild, and for others, they can be a huge disruption to sleep, work, concentration, and daily life. Hot flashes are part of a group of symptoms known as vasomotor symptoms (VMS), which result from hormonal changes that affect the body’s ability to regulate temperature.
What Causes Hot Flashes?
Hot flashes start in the brain, specifically the hypothalamus, which is the region that acts as the body’s thermostat. In perimenopause leading to menopause, estrogen and progesterone production changes and drops, signaling to the hypothalamus that your body temperature needs attention. In the case of hot flashes, the hypothalamus receives a signal that your body temperature is rising and causes the flash, signaling the body to then cool down or re-regulate. In essence, a hot flash is a sign that your body is doing just what it needs to do for homeostasis and balance.
While hormones are the underlying cause, certain factors can make hot flashes feel more intense or frequent, including caffeine, alcohol, spicy foods, tight-fitting clothes, and not getting quality sleep.
How Long Do Hot Flashes Last?
A single hot flash can last anywhere from 30 seconds to several minutes, although some women feel lingering effects afterwards. You can start experiencing hot flashes during perimenopause, the years leading up to menopause, and they can continue into the postmenopausal years. Their frequency can also vary widely from woman to woman: Some experience hot flashes a few days a week, while others can have them multiple times a day. It’s also critical to note that Black women are more likely to have symptoms and more severe symptoms vs. Asian women and white women.
What Helps With Hot Flashes?
You don’t simply have to wait them out; there are several options that can help ease this common symptom of perimenopause and menopause.
Menopausal Hormone Therapy: The Gold Standard
You’ve probably heard a lot about hormone therapy lately, and that’s because research and major menopause organizations, including The Menopause Society considers hormone therapy the gold standard for treating vasomotor symptoms, including hot flashes.
According to research, systemic estrogen alone or combined with a progestin can reduce vasomotor symptom frequency by up to 75% compared with placebo.
Since it’s the changes in estrogen and progesterone during perimenopause and menopause that affect the brain (hypothalamus), either estrogen or a combination of estrogen and progesterone treatment can help relieve hot flashes and also have a significant impact on overall temperature regulation, mood, anxiety, and many other symptoms. Menopausal hormone therapy can also have a positive effect on your overall health, including your cardiovascular and bone health.
Hormone therapy can come in gel, patches, rings, or pills. The right approach depends on your age, symptoms, medical history, and personal preference so talk to your doctor about what might work for you.
More Prescription Options for Treating Hot Flashes
SSRIs: Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, have been used to treat hot flashes, but they’re typically less effective than hormone therapy at reducing he number of and intensity of hot flashes.
Gabapentin: Gabapentin is a medication thought to impact the hypothalamus or the temperature regulation aspect of the brain, and has proven effective at reducing hot flashes. A meta-analysis came out in 2020 with follow-up of gabapentin as a leading contender for women seeking support from hot flashes. However, many women should use caution with gabapentin as it does have a warning for suicidal thoughts or behaviors and can cause drowsiness, dizziness, and issues with balance and coordination. If you suffer from disruptive sleep due to hot flashes, and do not want to try menopause hormone replacement therapy, gabapentin could be an option for you to discuss with your clinician.
Over-the-counter and non-hormonal treatments
Cognitive Behavioral Therapy (CBT) can help ease the stress response to hot flashes that can amplify them. Research shows CBT can help hot flashes feel less disruptive even if it doesn’t reduce how often they occur.
Clinical hypnosis is a mind-body approach that uses guided imagery and relaxation, and has been studied. A trained professional helps you reach a calm, focused state then uses personalized imagery and suggestion to help your body and mind respond differently to hot flashes. Research has found that clinical hypnosis can help reduce both the frequency and severity of hot flashes.
There are numerous tinctures, herbal teas, and supplements that trend on social media periodically claiming to help with hot flashes. But, while some women report feeling better, unfortunately, the research is mixed and too inconclusive to demonstrate a significant impact on reducing the number of or intensity of hot flashes or night sweats. In fact, the Menopause Society’s most recently revised guidelines reviewed the research and specifically does not recommend black cohosh, wild yam, evening primrose, maca, ginseng, chasteberry, milk thistle, rhubarb, soy foods and omega-3 fatty acids as remedies to help with hot flashes. Given the limited research and lack of evidence, The Menopause Society’s guidelines also don’t recommend cannabinoids for relieving menopause symptoms.
Decades of case studies, surveys, and clinical trials with different non-hormonal treatments just show too many variables, and OTC remedies can interact with medications or other supplements you may be taking, so be sure to talk to your doctor before starting anything new.
Do Lifestyle Changes Help with Hot Flashes?
Lifestyle habits may not help with the frequency or intensity of flashes, but regular exercise (resistance and aerobic), nourishing meals, getting good sleep and limiting alcohol can benefit your bones, heart, mood and well-being; all of which can help you feel your best during perimenopause and menopause.
Some women notice that alcohol, spicy foods, caffeine or tight clothing may seem to trigger or worsen their hot flashes. Keeping a symptom journal can help you identify your patterns. Wearing breathable layers, using a fan and keeping your bedroom cool may help make you more comfortable when a hot flash happens, but these strategies have not been shown to consistently reduce how often hot flashes occur.
When it comes to what you eat, research is mixed, with some surveys showing that eating more vegetables was associated with fewer menopausal symptoms. It’s always a good thing to eat healthfully; rather than relying on specific foods, aim to have a diet that’s rich in fruits and vegetables, fiber, protein and healthy fats. Soy foods such as tofu, edamame and tempeh can be nutritious sources of protein but evidence doesn’t support soy or other specific foods as proven remedies for hot flashes.
Why Are Hot Flashes Worse At Night?
Night sweats happen for the same reason daytime hot flashes do: hormonal changes affect the brain’s temperature regulation system. But hot flashes at night (aka night sweats) can feel especially intense because several factors converge while you’re sleeping.
Your body temperature naturally drops in the evening as part of your circadian rhythm, and the hormonal changes of perimenopause and menopause can make your internal thermostat more sensitive to even small shifts in temperature. Nighttime hot flashes also tend to feel worse because they interrupt your sleep. A surge of heat and sweating can wake you just as you’re entering a deeper stage of sleep, making it harder to fall back asleep afterwards.
The combination of hormone therapy and cognitive behavioral therapy (CBT) have been shown to help with insomnia and sleep disturbances that can come with perimenopause and menopause. And, a few moves, including lowering the thermostat before bed, choosing pajamas in breathable fabrics like cotton or using moisture-wicking sheets and pajamas may help you feel more comfortable if a night sweat hits, although research hasn’t shown that these habits impact the frequency or hot flashes.
Hot Flashes In Summer Months
For many women, the steamy months of summer can feel like adding insult to injury. Heat and humidity can intensify hot flashes, making them more frequent and/or intense. In fact, research shows that on a hot, humid day, high temperatures and humidity can make it harder for sweat to evaporate from the skin. Because evaporation is one of your body’s cooling strategies, you may feel hotter for longer or have a harder time recovering from a hot flash once it starts.
More Resources
Commit to making self-care a priority now that you know that there are ways to reduce the impact that hot flashes have on your sleep, energy levels, and overall mood. By following these tips and using the tools from the Menopause Toolkit, you should enjoy the end of summer as cool as a cucumber!
