Hot Flashes: Symptoms, Causes, and Treatments

Has it ever happened to you that you are comfortable at home when suddenly, your body starts feeling extremely hot and sweaty? Or maybe you’ve woken up at night because you’re soaked even when the room is freezing? If so, then you are likely having hot flashes.

With more than two-thirds of North American women suffering from them, hot flashes are the sudden flare of heat that may be followed by flushing and sweating. They are the most common symptom of menopause and perimenopause (menopausal transition), and it is still not well understood why they happen so unexpectedly.

Some women may experience them dramatically, with severe symptoms such as increased heart rate or low blood pressure, while others may feel only a temporary increase in their body temperature that improves at the drop of a hat.

Let’s find out more about them!

Understanding hot flashes

As mentioned above, a hot flash is the unexpected and uncomfortable heat sensation that feels like a flare in your body. It may cause flushing and sweating, often most intense over the face, neck, and chest.

Usually, our body regulates its temperature based on different situations, whether when you exercise, during hot or cold weather, illness, or hormonal changes. For example, some women experience hot flashes days before their period as a natural part of their PMS due to hormonal decline.

Their exact cause is still unclear, although it is known that hormonal imbalances and changes in circulation play a role in how your body responds to temperature fluctuations.

Symptoms: Just flushing?

Not at all. Hot flashes symptoms may vary among women, ranging from slightly increasing body temperature to distress. They include:

  • Extreme heat sensation on the neck, face, cheeks, and chest
  • Flushing in the same areas
  • Increased heart rate
  • Increased breathing rate
  • Profuse sweating
  • Palpitations
  • Anxiety
  • Distress and shortness of breath
  • Chills once your body regulates its temperature

Some women may experience hot flashes that wake them up at night, making them difficult to go back to sleep. When a hot flash happens during the night is called night sweats.

However, not all night sweats are due to menopause. Many are related to other hormonal imbalances such as polycystic ovarian syndrome or are simply due to overdressing at sleep time.

Hot flashes can be very bothersome, appearing at unexpected moments and disrupting significant occasions, such as a work meeting or a special event. In addition, how often they occur also differs among women. Some may experience them several times a day, while others once or twice a month. There is no reason for this other than that all bodies work differently.

The explanation behind hot flashes

As your body regulates its temperature by triggering chills or sweats according to the weather, your brain’s small cells also regulate it based on hormonal stimuli. For instance, estrogens lower the temperature, while progesterone produces the opposite.

But how is this possible?

Hormones affect blood vessel diameter once in your blood and can increase or decrease the amount of it reaching your skin. As a general rule, the more enlarged your blood vessels are, the more blood will reach your skin and the warmer you will feel. The opposite happens when the vessels become thinner.

Yet, when there are no hormones, as in menopause, your body perceives it as ”likely cold”, even when it is not, and triggers regulatory pathways to dilate blood vessels to make you feel warmer. Also, due to estrogen deficit, other chemicals contributing to hot flashes are released during this process, such as catecholamines, endorphins, and dopamine (brain substances).

In short, menopause’s hormonal drop activates unnecessary regulatory responses to restore your temperature, even when it is not hot on the outside.

Can hot flashes be prevented?

Unfortunately, you cannot prevent hot flashes because, as the definition says, they are unexpected, but you can stay away from some potential triggers, such as:

  • Caffeine
  • Alcohol
  • Stress
  • Spicy food
  • Tight clothing
  • Sources of heat, such as saunas, enclosed places, hot showers
  • Cigarette smoke

We can assure you that hot flashes usually decrease as time goes by.

Ways to improve hot flashes

Since you can’t prevent them, there are things you can do to improve the flare experience. Before considering medication, try to make a few lifestyle changes, such as:

  1. If you wake up at night soaking, try lowering the room temperature. Also, you can drink small amounts of cold water before bed; this will help lower your body temperature before bedtime and keep you cool for a few hours.
  2. If cooling the room is not enough, try adding a fan near you.
  3. Avoid over-dressing; if it’s unavoidable, dress in layers to remove some of your clothes when the hot flash hits.
  4. If hot flashes hit often, carry a portable fan on hand that you can use anywhere, whether it is in the office or a bar.
  5. Since obese women experience hot flashes more often and intensely, try to eat better to maintain a healthy weight.
  6. Exercise. Daily walking, swimming, or running are great ways to stay healthy and balance your body’s chemicals.
  7. Eat foods that may have estrogenic hormones, such as soy, lemon, orange, celery, onion, apple, parsley and peppers.
  8. Wear light cotton-based clothing and avoid thick fabrics such as linen.
  9. Don’t assume you have a hormonal imbalance, and get blood tests to identify what is going on in your body.

Although these tips are very helpful in preventing and experiencing hot flashes to a lesser degree, some women still experience them as unbearable and very uncomfortable. In these cases, hormonal treatment may be the best option.

Hormonal screening

Although hot flashes in women are mainly due to hormonal imbalance, a specialist must still evaluate your hormone blood levels to confirm or rule out that you have an endocrine disorder and take action to restore it.

Sometimes hormone imbalances are related to hormones other than estrogen and progesterone, such as thyroid hormones, which can produce similar symptoms to menopause. Therefore, physicians may determine the diagnosis and specific treatment based on blood testing results compared to reference values.

The routine female hormone panel includes blood testing for the following hormones:

  • Progesterone
  • Estradiol
  • Testosterone
  • DHEA
  • Thyroid-derived hormones, such as thyroxine (T4), triiodothyronine (T3), and thyroid-stimulating (TSH)

Non-hormonal causes of hot flashes

Not as often, hot flashes can be caused by reasons other than menopausal hormonal imbalances.

Other possible causes are medication side effects, thyroid problems, increased blood pressure, certain types of cancer, and side effects of cancer treatment, such as chemotherapy.

Hot flashes treatment

Since hot flashes appear precisely because of the lack of hormones, providing your body with exogenous ones can prevent its unexpected response after the menopause chemical drop.

After undergoing blood testing, many women are candidates for hormone replacement therapy (HRT). This treatment stabilizes the body’s estrogen and progesterone levels to relieve hot flashes and other typical symptoms of menopause, such as vaginal dryness, osteoporosis, and depression.

Hormone replacement therapy

As you may know, hormones are chemicals your body naturally produces in the sex organs, such as the ovaries and testes. During the transition to menopause, the ovaries begin to function less and less, and the body’s production of hormones such as estrogen and progesterone decreases over time to stop completely.

HRT raises blood levels of estrogen and progesterone again by the daily intake (or as prescribed by a specialist) of exogenous bioidentical hormones, which improve hormone imbalances symptoms, such as:

  • Depression
  • Anxiety
  • Hair loss
  • Unexplained weight gains or loss
  • Loss of sexual desire
  • Skin thinning
  • Sleeping problems
  • Muscle weakness
  • Sudden fatigue
  • Slowed or accelerated heart rate

HRT works not only for menopause but is also ideal for many male and female imbalances. Some of these include:

  • Feminization
  • Androgenetic alopecia
  • Endometriosis-associated pain
  • Erectile dysfunction
  • Polycystic ovary syndrome (PCOS)

What are the signs that you need hormone replacement therapy?

It is enough to approach menopause for you to consider HRT as a treatment option. However, signs that you may need hormone replacement therapy are:

  • Hot flashes
  • Night sweats
  • Vaginal dryness
  • Loss of sexual desire
  • Loss of bone density
  • Pain, itching, or burning during intercourse
  • Mood changes

Can I take hormones orally?

Since some women cannot take oral hormones, you can take them as long as your doctor prescribes them. All of our female protocols are 100% bioidentical and are cream-based versus oral.

Please, do not take oral hormones or in any form, if you:

  1. Have had allergic reactions to hormone medications
  2. Have had a stroke or heart attack, or have a strong family history of stroke or heart disease
  3. Have had blood clots
  4. Have had certain types of cancer, such as breast cancer or uterine cancer
  5. Have liver disease
  6. Think you are pregnant or could become pregnant
  7. Have had vaginal bleeding problems or have a bleeding disorder

Take control of your hormone health with help of a board-certified team of doctors at HRT Doctors Group – today! Our experienced medical team will work with you to find the hormone replacement therapy that is right for your body and your overall health. Book your appointment now and experience the benefits of balanced hormones!

Dr. Jay Flottman

Dr. Jay Flottman

Dr. Jay Flottmann is a physician in Panama City, FL. He received his medical degree from University of Texas Medical Branch and has been in practice 21 years. He is experienced in military medicine, an FAA medical examiner, human performance expert, and fighter pilot. Professionally, I am a medical doctor (M.D. from the University of Texas Medical Branch at Galveston), a fighter pilot (United States Air Force trained – F-15C/F-22/AT-38C), and entrepreneur.

  • Education & Training
  • National Defense UniversityNational Defense University – M.S., 2015
  • Keesler Medical CenterKeesler Medical Center – Residency, Pediatrics, 1997 – 1998
  • University of Texas Medical Branch School of Medicine – Class of 1997
  • Texas A&M University – B.S., Biomedical Science, Magna Cum Laude, 1993