Hot Flushes

Hot flushes are one of the most common symptoms of menopause. The frequency of hot flushes can range from a few a week to several an hour. Hot flushes can feel unpredictable and difficult to cope with, but there are ways to manage and understand your hot flush triggers. Did you know hot flushes occur in 75-80% of women, but only one in five women seek medical help? Night sweats usually occur during the night, alongside hot flushes that occur during the day. In this article we will go through the causes of hot flushes, how to stop hot flushes fast and other ways to manage hot flushes. 

What is a hot flush?

Hot flushes are often described as a sudden feeling of heat that starts in the chest, neck and face, before soon spreading around the body. The sensation is often associated with sweating, chills and shivering, and sometimes even a feeling of anxiety or awareness of your heart beat. Hot flushes may last a matter of minutes but can be longer.

Why do hot flushes happen?

Despite how common hot flushes are, there is very little research into why they occur. It is thought that declining levels of oestrogen can result in a decrease in norepinephrine, a hormone that helps in temperature regulation in the body, resulting in a temperature rise and hot flushes. Falling oestrogen levels can allow hot flushes to occur, but oestrogen isn't the only culprit: other hormonal and neural changes also affect the ‘thermoregulatory centres’ (the body's thermostat) in the brain. (1)

Temperature control happens in the hypothalamus, a small but super important part of your brain that is responsible for regulating heat and releasing hormones. If the hypothalamus mistakenly senses that you are too warm, it starts a chain of events to try and cool you down. This includes diverting more blood to the surface of your skin causing us to flush and sweat. The body's attempt to dissipate heat is what causes the feeling of a hot flush. (2) This process of diverting blood to the skin is called ‘peripheral vasodilation’. During a hot flush you will typically feel the most heat in your neck, head and upper chest. (3)

Although researchers have come up with ideas about what causes hot flushes, we still don’t know for sure.

How to manage menopause hot flushes

Certain triggers can confuse your brain into this response, which is why avoiding them can be an important part of reducing hot flushes.

Here are some common triggers:

  1. alcohol,
  2. caffeine,
  3. sugar,
  4. tight clothing,
  5. hot rooms or quick changes in room temperatures,
  6. spicy foods,
  7. smoking,
  8. anxiety and stressful situations.

Higher frequency of hot flushes are also seen in those who are overweight, so reducing weight through exercise and good nutrition may reduce hot flushes. You are unique, so what works for someone else may not work for you. The best way to figure out which triggers affect you is to keep a diary of your hot flushes and anything that may have caused them. You can then start to see patterns and discover which triggers to avoid. (4)

Studies have overwhelmingly shown that mood and anxiety play a role in the frequency and severity of hot flushes. Addressing triggers of negative mental health, focussing on self-care and your own wellbeing will be beneficial for your hot flushes.

How to stop hot flushes fast

Unfortunately hot flushes are very common and it won’t always be possible to avoid triggers, but there are ways to tackle hot flushes when they happen. Keeping a fan handy or making sure to wear layers can help manage hot flushes when they do arise. (4) Drinking a cold drink can help to cool your body down from the inside and spraying cold water on your face can cool down the outside of your body. If you have a cold gel pack or ice pack handy this can also help cool you down. (5)

You can deal with hot flushes during the night by sleeping without a duvet and using removable layers instead, such as blankets. In addition, you can manage hot flushes by using a warm temperature rather than a hot temperature during baths or showers. (5) 

There are also other complementary and alternative remedies that can be tried. It is estimated that 50-75% of women have tried one of these and we will cover the most promising therapies below and what to avoid.

Cognitive Behavioural Therapy and Mindfulness

Cognitive Behaviour Therapy, or CBT, is a talking therapy that helps you manage menopause symptoms by changing the way you think and behave. CBT has been shown to be somewhat effective against reducing the bother of hot flushes, but doesn’t appear to have an effect on their frequency. If your mood is being affected by your hot flushes, using CBT can break this negative cycle and change how you approach hot flushes so they don’t interfere with your day-to-day activities. Similarly mindfulness and hypnosis show encouraging results for hot flushes.

Natural remedies for hot flushes

There is research to suggest that natural remedies such as isoflavones and black cohosh can help women to manage hot flushes, but the results are inconsistent. (5) Research by Marziyeh Vahid Dastjerdi and her colleagues found that women given 50 mg of isoflavone every day experienced fewer and less severe hot flushes compared to the women that didn’t take this supplement; (6) however, most trials haven’t shown benefit for hot flushes. If you wish to try isoflavones, foods such as flaxseeds, lentils and grains are wonderful natural sources of isoflavones.

Black cohosh also resulted in reduced frequency and severity of hot flushes in small short-term trials, but larger studies suggest that black cohosh is no more effective than no treatment (7) When considering whether to use herbal or natural remedies, remember to think about potential side effects, interactions with medication you are currently taking, and how much scientific research is available. (8) If in doubt ask your local pharmacist or GP.

Acupuncture and evening primrose oil have both been shown to be ineffective against hot flushes. That being said, they shouldn’t be disregarded as both may have positive effects on your mood and wellbeing, countering the negative effects of hot flushes. However, when compared to placebo treatments in large studies, both acupuncture and primrose oil have not shown any beneficial effects. Read more about vitamins and minerals during menopause here.

Night sweats in women

Night sweats in women occur during menopause and are essentially a hot flush during the night. Therefore, the advice for treating hot flushes and causes of night sweats mirror the advice for hot flushes. If waking up due to night sweats becomes a regular occurrence or you’re experiencing other symptoms such as weight loss or a high temperature, it is important to visit your GP. Although night sweats are a common symptom of menopause, they may have a different cause such as alcohol, medication or or anxiety. (9) Other symptoms can be affecting your sleep, which you can read about here.

When to see a doctor:

Although there are methods to reduce and manage hot flushes, if they are affecting your life a lot and interfering with work or your enjoyment of social life, speak to a doctor. Your doctor will likely prescribe a treatment called hormone replacement therapy, or HRT, which can help to relieve symptoms by increasing oestrogen levels that have dropped as a result of menopause.(5) 

If you are not eligible for HRT, there are also non-hormone based medications that can be tried, so it is worth speaking to your doctor.

Many women we speak to are concerned that menopause symptoms are not important enough to see the doctor for, or may be unsure whether doctors can even help. If you have had a negative experience don’t let this discourage you from seeking advice, send us a message and we will help as best we can.

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