Published 16 September 2024
- Written by Claire Millins
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Key takeaways
Yes, it’s time to talk hot flashes, the dreaded symptom waiting for all of us as we approach menopause. In an earlier article I talked about the trials and tribulations of perimenopause, but this article is dedicated to hot flashes; what they are, how they manifest themselves and what steps you can take to relieve them.
So, as Julie Andrews said in ‘The Sound of Music’: “Let’s start at the very beginning.”
What are hot flashes?
Hot flashes, like the name suggests, are a feeling of intense heat for a short while that are not generally caused by any external factors.
You know the feeling you get when you’ve just eaten a really hot chilli pepper, or the hottest curry. It’s like that, minus the pepper or curry. You can simply be sitting at your desk and suddenly feel ‘flushed’ but on a hotter scale.
The good news is they don’t last too long. In my experience it’s a couple of minutes and then back to normal.
But be prepared, as we are all different we will all experience hot flashes in a different way; some of us will never have any, some will last for a few seconds, some will experience hot flashes that last 10 minutes or more.
As the name suggests they can come on suddenly, or you may feel them coming on and during a hot flash aside from the heat sensation, you can experience:
- Your face and décolletage area getting red, flushed and blotchy
- Your skin feeling warm to the touch
- Slightly elevated heart rate
- Tingling sensation in your fingers
- Sweating
Night sweats are simply hot flashes that occur at night. And again, some women will not have them, others will have mild night sweats where chucking your foot out of the bed and turning the pillow over will do the trick whilst others will have to get up and change night attire.
The science part of hot flashes
Hot flashes and night sweats are two of the most common perimenopause and menopausal symptoms. They’re both vasomotor symptoms.
The vasomotor centre is located in brainstem and is part of the medulla oblongata, and along with the cardiovascular and respiratory centres, it helps regulate blood pressure and other homeostatic functions.
It’s essentially your body’s thermostat that helps keep your body at the right temperature to function properly.
During perimenopause, and menopause, the hormonal changes that take place, specifically the decline in oestrogen levels can affect the vasomotor centre, which then causes hot flashes and night sweats.
What triggers a hot flash?
Although hot flashes are generally caused by the declining levels of oestrogen playing havoc with your body’s thermostat, there are some external influences that can trigger hot flashes or night sweats in some women. These include:
- Alcohol
- Caffeinated products such as coffee and energy drinks
- Spicy food. OK, maybe a hot curry isn’t such a good idea!
- Wearing tight clothing. I’ve now got the scene in Friends in my head where Ross is wearing leather trousers!
- Smoking, or being exposed to smoke
- Bending over. That’s an odd one isn’t it? But bending over makes the blood rush to your head, so I guess that means downward-facing dog is out of the question at Yoga then?
- Feeling stressed or anxious. Yes stressing out about hot flashes can actually make the situation worse.
How can I prevent hot flashes?
Unfortunately there’s no way to avoid, and prevent hot flashes completely.
The first thing to do is try and identify what triggers your hot flashes, and then avoid it.
There are 3 ways that you could look at to help keep them under control and lessen the severity.
1. Lifestyle changes
A few small tweaks to your lifestyle could be all it takes to make a difference to your hot flashes with eating a well-balanced diet and exercise topping the list. Other home remedies and lifestyle changes you could make include:
- Keeping cool
The best advice is to dress in layers, that way if you get a hot flash you can remove a layer and cool down quicker. Other ways to keep cool include:
- Keeping a bottle of cool water with you that you can splash on you face or wrists
- Invest in a fan for the bedroom and buy a hand-held fan for carrying around with you
- Lower the room temperature
- Relaxation techniques
One of the triggers for hot flashes is stress, this is because stress causes the body to release epinephrine which increases the body’s temperature. Relaxation activities help you to relax, which in turn may help decrease the frequency and severity of your hot flashes. Yoga, Tai Chi and Qi Gong are all excellent relaxation exercises.
- Keep calm
If you have a hot flash, don’t panic because that will only increase the severity of the flash. Instead, let the hot flash do its thing while you keep calm and as they say carry on.
- Quit smoking
Aside from being unhealthy, smoking can actually cause early menopause as the tobacco toxins lower oestrogen levels.
2. Alternative Therapy
Although not proven yet, research has shown the following can be beneficial at easing hot flashes:
- Deep breathing
Also known as relaxation breathing involves breathing in and out at an even pace:
- Sit in a comfortable position with your right hand on your stomach
- Inhale through the nose and feel your stomach expand and chest fill with air
- Exhale slowly through the mouth and empty your lungs first and then feel your stomach sink back
This breathing exercise can be done anytime, anywhere, and can help you relax if you feel a hot flash coming on.
- Mindfulness meditation
By focusing on the present and what is happening from moment to moment, mindfulness meditation can help reduce how much those hot flashes bother you.
- Cognitive Behavioural Therapy (CBT)
CBT is a talking therapy and like mindfulness meditation may help you learn to cope better with hot flashes and the changes that are happening in your body
- Acupuncture
- Hypnosis
3. Dietary Supplements
Many women turn to herbal supplements and remedies to alleviate the symptoms of menopause and hot flashes. I was told that sage tea was great for helping with hot flashes. Thankfully I’ve never need to try it and personally, I couldn’t think of anything worse than drinking sage tea, but if you’re in need sometimes you’ll try anything.
Although there’s been no concrete proof that any of them work, there are several dietary supplements commonly used for menopause and hot flashes:
- Plant oestrogens
Phytoestrogens or dietary oestrogens are believed to help menopausal women who are experiencing a drop in oestrogen levels, and they are found in legumes, seeds, whole grains and soy.
Studies have found that in general there is little or no benefit to plant oestrogen supplements, however research is continuing.
- Liquorice root
Liquorice root, which contains phytoestrogens, on the other hand does seem to be very beneficial.
A study of menopausal women concluded that taking 330mg of liquorice extract three times a day for eight weeks did, in fact, reduce both the frequency and severity of hot flashes. Further that upon stopping taking the extract, the effects lasted for another fortnight.
- Valerian root
Similar to liquorice root, 255mg of Valerian three times a day improved the frequency and severity of hot flashes after eight weeks.
Valerian contains phytoestrogens and also helps you sleep better, this is because it may influence serotonin activity. And a good night’s sleep is well-known to improve hot flash symptoms.
A word about black cohosh
Black cohosh is probably the one supplement everyone has heard of. It’s been used for centuries by Native Americans, but studies on its effectiveness show mixed results and the use of it remains controversial.
It can interact with many prescribed medicines, is not recommended for women with uterine, breast or ovarian cancer and the most common complication arising from taking black cohosh is liver damage.
To conclude
As women, we’ll all experience menopause at some point and most of us will suffer from hot flashes.
Some will barely give hot flashes a passing glance while others may consider them a minor annoyance. Some women however will be affected by the severity of hot flashes that may affect their quality of life.
Panic not though, help is at hand. However, before you take any supplements or try anything alternative to help, always check with your doctor.
Is it hot in here, or is it just me?
Just me? I’m off to cool down, so until next time darlings.
Claire
Xx
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Written by
Claire Millins
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Dr Singh is the Medical Director of the Indiana Sleep Center. His research and clinical practice focuses on the myriad of sleep.