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What Causes Hot Flashes and How to Ease Them

03/14/2023 | 9 min. read

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One of the most uncomfortable symptoms during the menopausal transition--the one that will often push women over the edge of their comfort zone and into their doctor’s office to get some help--is hot flashes!

By the name alone, they don’t sound fun, and if you’ve experienced one you KNOW they aren’t fun. They can be incredibly uncomfortable and interrupt your daily life. Especially when they happen at night, causing night sweats, and wake you from your sleep… when it might have already taken you a while to fall asleep.

Fear not, we have some helpful treatment options for you to consider! Just remember, like your beautiful unique body, not all hot flashes are the same so your experience and ideal solution for managing your hot flashes is going to be unique to you as well.

What are hot flashes?

A hot flash is a vasomotor symptom that causes a woman to suddenly experience an intense heat that seems to come from within her. Although this feels torturous to many, it may be your body trying to do it’s best to adjust and support you through the changes occurring around this time in your life.

We don’t know exactly why hot flashes occur, but we believe it has to do with the reduction in estrogen levels experienced during the menopausal transition and how this also confuses the hypothalamus--an area in our brain that controls our temperature regulation system. Our body becomes more sensitive to temperature changes in our environment and may even inappropriately sense that our body is getting too hot. That’s when the hypothalamus jumps into action to cool us down, dilating our blood vessels at the surface of our skin, causing redness and flushing (often on the upper body including the chest, neck and face) and sometimes even leaving beads of sweat on your skin to help dispel this heat and cool you down.

As a result of our body’s overzealous act to cool us down, some women can be left feeling chilled after a hot flash. A women’s heart rate can also increase as a result, and she may even experience feelings of anxiety.

Want to know more? Ok, here we go…

When do hot flashes start?

Hot flashes typically around your late 40s to early 50s. For most women, hot flashes will start before they experience their final menstrual period.

How common are hot flashes?

Up to 80% of American women report hot flashes during their menopausal transition, whereas only 2 out of 10 women report never getting a hot flash (lucky ducks!).

How long do hot flashes last?

For some women a hot flash may come on suddenly, seemingly out of the blue, while others may feel it starting to come on. Some hot flashes come and go within a few seconds while longer hot flashes may linger for more than 10 minutes. On average, hot flashes are reported to last around 4 minutes.

Some women experience them for a short period of time (3-4 years) and others report experiencing them for 11 years or more. Research shows that the length of time you’ll continue to experience hot flashes tends to depend on when in your menopausal transition they began. If hot flashes began earlier in your premenopausal or perimenopausal phase, they are likely to last longer. Later onset hot flashes, starting only after your final menstrual period, tend to last for a shorter duration of time. On average, women tend to experience hot flashes for around 7 years.

How often do hot flashes occur?

The frequency of hot flashes can vary. Some women report experiencing a few hot flashes in a week while others may be hit with several hot flashes in the span of an hour. This frequency can also depend on, and change, based on where you are in your menopausal transition.

How severe are hot flashes?

For someone women hot flashes may be no more than a minor disturbance, but for others they can be downright miserable and debilitating.

What triggers a hot flash?

Triggers also vary. Aren’t women so beautifully unique? Triggers can include heat and hot weather; certain foods and drinks such as caffeine, alcohol and spicy foods; tight clothing; stress; as well as unregulated blood sugar and being overweight or obese.

To know what triggers are unique to you, I highly recommend keeping a journal of what you were wearing, eating, drinking, feeling, and doing when your hot flashes came on to see if you can identify a pattern to triggers that are unique for you.

What can I do to help stop hot flashes?

LIFESTYLE CHANGES

Keep it cool - Turn the temperature down in your bedroom, to between 66-70 degrees. Try bringing a fan into your bedroom for an extra cool effect or additionally you can put an icepack under your pillow so that you can easily flip your pillow and always have a cool side to rest your head on. There is a pillow, called a Chillow, specifically made for this.

During the day, try bringing a portable fan along with you to use as needed when you feel a hot flash coming on. If you are at home you can try placing a cold pack on the back of your neck or wherever feels relieving to you.

Keep it natural - Use natural fabrics that can be more breathable for pajamas and bedding such as cotton, silk, or linen. Bamboo sheets can also feel cool and refreshing to the touch.

During the day, be mindful of tight clothing and opt for natural fabrics instead of synthetic fabrics that may not be as temperature regulating.

Embrace layers - Using layers on your bed and on your body can be helpful so that you can easily add or discard a layer throughout the night to adjust to what feels comfortable to you.

During the day as well, layers are your friend and will allow you to easily adjust to suit your body’s temperature need.

Hydrate - Try keeping an insulated water bottle with some cool water beside your bed and with you throughout the day that you can grab and sip as needed.

Remove potential dietary triggers - Try avoiding alcohol, spicy food, and caffeine, as these have been reported to make hot flashes and night sweats worse.

Quit smoking - Do you smoke? If so, this may be the helpful motivator you’ve been looking for to help quit. It could not only help to reduce your hot flashes, it will also definitely be a beneficial change for your overall health.

Maintain a healthy weight - Research has shown that hot flashes and night sweats are experienced more frequently and severely by women who are overweight or obese. Losing weight can significantly improve the severity of hot flashes.

Balance your blood sugar - Diabetes and metabolic syndrome are thought to be aggravating factors that can increase the incidence of hot flashes.

Exercise regularly – It may sound counterproductive to do something that can increase your body temperature and make you sweat when you are trying to cool yourself off from a hot flash, but research has shown that exercising can actually help! Studies have shown that starting an exercise program of jogging and cycling 4-5 times/week helped women improve their ability to regulate their body heat. As a result, those women had less of a rise in skin temperature and showed less sweating during a hot flash compared to those who did not exercise. Even better, at the end of the study there was a 60% reduction in hot flash frequency by those participants who exercised!

Reduce your stress - Whenever I am working to support a woman’s hormones, I am also always supporting her stress level and adrenal function. Research has shown that hypnotherapy and mindfulness meditation, cognitive behavioral therapy and relaxation techniques can help with managing hot flashes. You can also consider deep breathing and restorative exercise practices such as tai chi, chi gong, and yoga.

NATURAL THERAPIES

Acupuncture - Studies have shown that the severity of hot flashes was significantly reduced by the women who received acupuncture.

Phytoestrogens - When women are in a low estrogen state, phytoestrogens (containing isoflavones and lignans) bind to estrogen receptors and elicit an estrogen like effect to help counter the effects of decreased estrogen levels.

Soybeans and soy products such as organic edamame, tofu, tempeh, miso, and soy milk contain isoflavones and have been shown to decrease hot flashes.

Flaxseeds, containing lignans, have also been shown to reduce hot flash frequency and intensity.

Lignans are also found in whole grains, fruits, vegetables, and legumes (chickpeas and lentils) so adopting a whole food diet may also be a worthwhile change for easing your hot flashes, in addition to many other health related benefits.

Nutritional Supplements can also be very supportive. The ones I use most frequently include:

  • Red clover
  • Dong quai
  • Evening primrose oil
  • B-complex
  • Vitamin E
  • Hesperidin
  • Maca
  • Vitex
  • Siberian rhubarb root extract (ERr 731®)
  • Supplemental soy Isoflavones

Because I see so many women struggling with the symptoms of hormonal changes, I recently worked with my team at Healthy Directions to formulate a supplement that includes many of the ingredients I've found to be most effective. It's called Cool Comfort, and it can really help improve symptoms like hot flashes, night sweats, stress and anxiousness, sleep, and even sexual satisfaction. I'm so excited to be able to have this comprehensive supplement now available for my patients!

HORMONE THERAPY

Estrogen therapy has been used to replete low estrogen levels and help improve menopausal symptoms including hot flashes. Topical estrogen is preferred. I do not recommend oral estrogen based on safety data.

If a women still has a uterus, progesterone should always be given in addition to estrogen to support uterine health. In women who have had a hysterectomy, some are given only estrogen however some may still benefit from progesterone for other aspects of their health.

PRESCRIPTION MEDICATION

Other medications have been shown to help with hot flashes. These include:

Low dose antidepressants such as Effexor, Prozac, and Paxil have been prescribed as treatments for hot flashes.

Gabapentin, usually given for nerve-mediated pain or seizures, can offer relief for some women.

In Summary

Hot flashes may be one of the first signs telling you that your body and hormones are starting to change. I believe a great way to support your body during this time is, at a minimum, by embracing some of the lifestyle changes discussed above that could help you go through this time in your life more comfortably. If these changes include diet, exercise, stress reduction, weight loss, reducing alcohol consumption and quitting smoking, the potential long term benefits you could experience from these changes are endless! All these behaviors will positively impact your health in countless ways, and I love encouraging my patients to be proactive in their health. 

Dr. Briana Sinatra

Meet Dr. Briana Sinatra

Dr. Briana Sinatra is a board-certified naturopathic doctor with a vibrant practice in the Pacific Northwest. There she focuses on women’s and family health, taking a holistic approach to healthcare by empowering women with the knowledge and tools they need to live their best life now and protect their future wellness by looking at how all the systems in the body work together and how diet, lifestyle, and environment all influence health.

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