womens guide
Symptoms Overview
Menstruation Changes
Hot Flashes
Sleep Disturbances
Cognitive Symptoms
Vaginal Dryness
Urinary Incontinence
Treatment Overview
Hormone Therapy
Herbal Remedies


Hot Flashes

Hot flashes are the most common symptom of menopause. Approximately 75-85% of women in the US experience hot flashes as they go approach menopause and post menopause. While hot flashes are known to occur up to a year or two after menstruation has stopped, the intensity and frequency decreased as time goes by. On average, 25-50% of women have hot flashes for > 5 years.
hot flash


If you’ve ever had one, the feeling is unmistakable. Hot flashes are characterized by an sudden and intense feeling of heat that starts from your chest and moves upward to your shoulders, neck, and face. The skin temperature in some women can rise 10 degrees (F) during a hot flash!

The hot flash is often followed by a flushing & reddening, and can trigger mild to intense perspiration. As the perspiration evaporates, you may also experience a chill and feel weak or faint.

The flash is often accompanied with other physical symptoms such as nausea, dizziness, anxiety, headache, and rapid heart beat. Many women in fact can sense an oncoming hot flash. Hot flashes can occur at any time of day or night.

Causes of Hot Flashes

During perimenopause, decreased levels of the hormone estrogen affect the hypothalamus in some unknown way. The hypothalamus is the part of your brain that controls things such as hunger, sleepiness, sex drive, and body temperature. The decreased level of estrogen somehow causes the hypothalamus to think that the body is “too hot”.

The hypothalamus responds to this “high temperature” alert and signals the body to get rid of the heat ASAP through epinephrine and other related nervous system compounds such as norepinephrine, prostaglandin, serotonin. This chemical message instantly triggers several reactions:

  • the blood vessels in your skin dilate (widen) so more heat can be radiated
  • your heart pumps faster to circulate more “hot” blood to the dilated blood vessels
  • your sweat glands release perspiration to help cool you off

These reactions are what your body would normally do to cool off in the summer, but the low estrogen levels associated with menopause trigger these changes even when you are not too hot. Besides the discomfort of the actual hot flash, the unnecessary cooling of your body can leave you cold, soaked, and miserable. Hot flashes that occur during sleep are called night sweats and can often leave the woman sleep deprived, irritable, and fatigued.

Menopause is not the only possible cause of hot flashes. In certain rate situations, thyroid disease, infection, or a cancer can also cause hot flashes. Additionally, certain drug therapies such as tamoxifen (for cancer) and raloxifene (for osteoporosis) can cause hot flashes.

Severity and Duration of Hot Flashes

Hot flash frequency, intensity, severity, and duration varies uniquely with each person. In some women, hot flashes last only 30 seconds, while other women have hot flashes that last several minutes or more. Some women may have hot flashes every hour, while others may experience hot flashes only occasionally. There is no way of predicting when they will start or stop.

In general though, the severity of your symptoms will depend on how fast the transition to menopause is occurring. A slower, more gradual transition to menopause gives the body more time to adapt to the new hormone levels and thus helps lessen the severity of hot flashes. In a similar vein, women who produce more estrogen in other parts of their body (primarily the adrenal glands) often experience milder symptoms since this helps soften the decreased hormone levels.

Hot Flash Treatment

The good news is that hot flashes typically stop on their own over time. If your hot flashes are sever enough to warrant intervention, hot flash discomfort can be reduced or even eliminated through a combination of lifestyle and medical treatment.

Hot Flash Prevention

While there are many possible treatments for menopause symptoms, arguably, the best way to treat your hot flash symptoms is to avoid the hot flash all together! Hot flashes are often triggered by specific things in your environment, thus identifying these triggers should help you avoid and prevent hot flashes.

Stress is the most commonly reported trigger, but there are many other potential triggers you should be on the look out for:

  • Caffeine
  • Alcohol
  • Smoking
  • Spicy Food
  • Diet pills
  • Hot tubs / saunas / showers

Additionally, certain lifestyle changes such as exercise, relaxation/stress reduction, and diet changes can often help mitigate and alleviate hot flashes. Increased physical activity has been shown to reduce hot flash frequency and also positively impacts nearly all other symptoms of menopause and aging as well.

Nonprescription Remedies

There are a wide variety of herbal and homeopathic remedies on the market to treat hot flashes. The most commonly used include various forms of isolavones (plant derived estrogens) such as various soy products, and supplement pills containing the herb black cohosh. Read more about herbal remedies for hot flashes here.

Prescription Medications

For severe hot flashes, your doctor may prescribe you one of the following.

  • Estrogen Therapy – multiple studies have shown that systemic estrogen replacement therapy is the most effective form of treatment. Estrogen comes in a variety of forms and doses and many women notice relief within a few days. Read more about HRT here.
  • Combination Hormonal Therapies – your doctor may prescribe a combination estrogen – progestin compound depending on your unique situation. Read more about HRT here
  • Non-Hormonal Drugs – If hormonal drugs are not an option, there are several prescription medications that your doctor may prescribe for you to treat your hot flashes. Examples include gabapentin (Neurontin), paroxetine (Paxil), fluoxetine (Prozac), and venlafaxine (Effexor). Note, these are “off label” uses.

More information about menopause treatment options can be found here.

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