Managing Menopausal Hot Flashes

Feeling too hot — or too cold — and sweating for no reason?  You are not alone.  The majority of women over age 40 experience this sticky, sweaty problem –  hot flashes.

But why do they happen?  When should you expect them?  Are there ways to treat them?

Sometimes hot flashes come out of nowhere.  You are sitting there minding your own business, and without any warning, you feel as though you’re burning up from the inside.  You can feel your skin moisten with sweat, and you start peeling off your clothes.

It’s a part of menopause that we all want to ignore, but it just won’t go away.

Hot flashes can be embarrassing and uncomfortable.

More than 80% of women experience hot flashes at some point during perimenopause or menopause transition.  Chances are, you’ve already felt one or have a friend who has.

And for many women, it can last nearly a decade (Sometimes more).

Talking about hot flashes can be uncomfortable.  But if you understand what hot flashes are—and aren’t—you’re more likely to feel better.

What Exactly is a Hot Flash?

Hot flashes are known to leave women soaked in sweat and are one of the most troubling symptoms of perimenopause and menopause.  These are intense bursts of heat that can occur during the day or night.  They usually start gradually and become more severe over time.

But how do you know if you have a hot flash?  The most common sign is a sudden feeling of warmth in the face and chest area — usually accompanied by sweating and chills — that lasts for a few seconds.  Other signs include:

• Irritability

• Nausea or indigestion

• Fatigue or exhaustion

• Headaches and lightheadedness

• Restlessness and feelings of anxiety-nervousness.

When you get hot flashes, your temperature rises quickly. A handheld thermometer would register at least a degree rise in temperature.

The temperature may go as high as 102 degrees F (39 degrees C) and then it falls just as quickly as it started.  Sometimes this initial flash is followed by another flash, and another and another after that.

This intense feeling of heat usually starts on the upper body or head.  It spreads throughout the whole body, sweeping over a woman’s head, neck, and chest.

A hot flash usually lasts 30 seconds to 5 minutes.  The time between flashes can vary from a few hours to a few days to a week or more.  Some women have just one hot flash a day.  Other women have them several times a day for several days in a row.  One of my patients reported hot flashes every 12 minutes for hours at a time. 

While hot flashes aren’t dangerous, they can be very frustrating and even a bit scary.  They cause sweating that stops when the hot flash ends.  Shivering, chills and heart palpitations (irregular or rapid heartbeat) may be experienced during this recovery.

What Causes a Hot Flash?

There are several reasons women experience hot flashes:

Hormonal Changes: Going through menopause is a common reason for experiencing hot flashes.  According to the National Institutes of Health (NIH), among many other sources, hot flashes are triggered by hormonal changes. When levels of estrogen (and progesterone) in the body suddenly go up and down, hot flashes happen.

These hormonal changes cause the body to warm up quickly.  This is when your hormone levels dip so much that your body can no longer control its internal temperature — you’re chilled one minute, practically on fire the next, which isn’t so fun.

If you have ever been pregnant, you may have experienced hot flashes then, as a result of rapid changes to your hormone levels.

Low Estrogen: Though there are many different triggers for hot flashes, estrogen loss is the most common cause. A decline in estrogen levels causes the body to release more norepinephrine (a hormone that causes the body to get warmer) and a drop in serotonin (a hormone that causes you to feel happier).

It begins when women go into perimenopause––the time just before menopause, when a woman stops producing hormones such as estrogen.  Most women experience them at some point in their lives, between the ages of 45 and 55.

Medications: Certain drugs can cause hot flashes or make them worse when they occur.  The most common medications associated with hot flashes include antidepressants, blood thinners, and some types of heart medications.  Other drugs used to treat a variety of conditions may also be a contributing factor in the development of hot flashes or worsen existing symptoms.

No one likes hot flashes—especially you.  However, as with all things, knowledge is key.

And the first step to combating those nasty temperature spikes is understanding exactly what’s happening when they strike.  When you understand what’s happening to your body, hot flash symptoms aren’t so scary.

So What Exactly Happens During A Hot Flash?

Our bodies are programmed to keep our internal temperature or “core temperature” within a certain range – that’s the body’s thermostat.  Its core temperature is kept at a comfortable average body temperature that is often 99.6ºF (37ºC).

Hot flashes happen when the body’s thermostat is off balance.

Fortunately, our body has a clever way of maintaining the ideal temperature for its organs.  If it becomes too hot or cold, it works hard to get back to normal.

Just like how your thermostat keeps the temperature comfortable in your home, your body regulates its temperature through sweating and flushing.  Your body heats up and starts to sweat to get rid of the excessive heat, and flushing is like your body getting rid of toxins.

Here’s what’s happening: When your brain senses temperatures rising, it tells your sweat glands to produce extra sweat.

During hot flashes, the body works to regulate its core temperature by breaking heat down and releasing it through the skin surface.

When your body feels hotter than normal, you flush (get red) and sweat (get sticky).  Hot flash happens when the blood vessels near your skin surface expand. When you get hot, your skin turns red because blood vessels get wider so that your body can lose more heat through your skin.

After hot flashes, you’ll probably be very wet and cold.

Here’s why:

The heat radiates from your skin to the external environment.  The result?  You sweat… a lot.  The warmer our body becomes, the more sweat glands produce sweat to cool us down.

And this happens very suddenly.  When you sweat, it removes excess heat from your body which keeps you cool.

You also might shiver or feel like your heart is pounding.  Your body temperature decreases slightly while your heart rate speeds up.

The body tries to prevent our temperature from dropping below a certain point.  When you get cold, your body will work to warm itself up.  The warm blood is sent to places in your body that are cold.

We know that the human body tries to maintain an inner temperature that’s close to 98.6 degrees Fahrenheit (37 degrees Celsius). If you go too far below this zone’s lower limit, you shiver to trap heat in our system and increase the rate at which our muscles burn

Shivering and chills may help rewarm your body while heart palpitations (or an increased pulse rate) help you keep your cool.

These uncomfortable symptoms usually go away when your body cools back down to its normal temperature.

How Hot Flashes Can Affect Your Life

If hot flashes are common, you may think they’re not really a problem.  But they can be more than just annoying.

They also occur when you least expect them, upsetting your daily routine.

You can be in a meeting then suddenly your ears, neck, and face flush.  You start to perspire.  Your heart pounds.  Your palms get sweaty.  

Your breathing becomes rapid and shallow.  This can throw you off track, ruin your composure and leave you feeling defeated.

One of my patients, Nancy, told me how she had to bring several changes of clothes to teach 5th grade, and when her students would ask her why she changed her clothing, she’d say she spilled something on herself.  Eventually, she would buy multiples of the same outfit to avoid the conversation altogether.  Finally, we balanced her hormones and she didn’t have to keep changing clothes.

Hot flashes can also affect how well you sleep at night, either by waking you up or by making it hard for you to fall asleep again.  Some women feel more frazzled during the day after a night of hot flashes.

If you’re waking up every single night, for this reason, there are medications and even lifestyle changes that can help relieve your symptoms so you can sleep better through the night.

How to Keep Your Cool When a Hot Flash Strikes

It’s a fact: for many women, menopause can bring uncomfortable symptoms like hot flashes.

And we all know that it can be difficult to keep your cool when you’re having a hot flash.

You know that heat is being transferred from your skin through your clothes and to the outside world, leading to a sense of discomfort or embarrassment.

Hot flashes are uncomfortable and annoying. Fortunately, you don’t have to live with them.

Here are Some Tips to Help You Cope with Hot Flashes:

1. Avoid the Triggers of Your Hot Flashes. Hot flashes can be triggered by a number of things. If you can identify your specific triggers of hot flashes, you can avoid those things to bring down the severity and frequency of those hot flashes.

Don’t sweat the small stuff. The small stuff is often the biggest trigger.

Here’s what some of that small stuff is:

Emotional stress.  Office politics, deadlines, bad customers, unhappy employees; the list goes on.  Stress will make you sweat.  And there’s no way around it.  You can’t always control it, but you can learn to cope with it.  Emotional stress can trigger even mild hot flashes, so it’s important to take steps to reduce stress in your life.  Lowering your stress level with activities like yoga or meditation can also help regulate your hormones and reduce your chances of suffering from hot flashes.

Spicy Foods.  Avoid spicy foods because they also contain capsaicin, which can trigger the nerves that make your body feel warmer and lead to sweating to cool it back down.  It’s best to avoid spicy foods all day long, except maybe occasionally.

Smoking or drinking too much caffeine or alcohol.  Avoid caffeine and alcohol after noon.  These substances make blood vessels more sensitive to stress hormones like cortisol, which puts extra stress on your body and makes hot flashes worse for many women who deal with them regularly.  Smoking or drinking too much caffeine or alcohol can also dehydrate you and dehydration is associated with hot flashes in some women.  On the other hand, research showed that women who had ever smoked cigarettes were 1.6 times more likely to experience hot flashes compared to women who had never smoked cigarettes.

• Maintain a healthy weight and exercise on a regular basis.  Physical activity is one of the best ways to deal with hot flashes.  It’s important to stay physically fit, because exercise improves circulation and helps the body retain its core temperature.

Research has shown that women who exercise regularly are less likely to suffer from hot flashes than their couch-potato counterparts.  This is because exercise helps your body cool off, thereby reducing your temperature and the likelihood of hot flashes.

Exercise also helps release endorphins which have a calming effect on some people during stressful periods.  Let’s not forget that exercising will improve your health in a lot of other ways too.

• Stay hydrated. Keep yourself well hydrated throughout the day to prevent overheating.  Staying hydrated helps lower your body’s core temperature. Drinking water also burns calories, which burns heat.

• Eat well.  It’s all about what you eat.  Choose foods that contain iron, calcium, magnesium, B vitamins and vitamin C.  This will reduce your chances of experiencing hot flashes.  Vegetables and fruits also contain water, which will help you stay hydrated and reduce your likelihood of having a hot flash.

Eating more foods high in fiber has been shown to help with hot flashes because it keeps blood sugar stable between meals, so you don’t experience those pesky cravings for sugary snacks between meals that trigger hot flashes.

• Eat a phytoestrogen rich diet:  Phytoestrogens are a class of plant-derived, natural estrogens, which mimic some of the effects of estrogen.

Plant estrogens, such as isoflavones, are thought to have weak estrogen-like effects that may act by reducing hot flashes. They may work in the body like a weak form of estrogen. Examples of plant estrogens include: soybeans, chickpeas, lentils, flaxseed, grains, beans, fruits, and vegetables (be sure to choose organic) and soak seeds, grains, and legumes to make them easier to digest and unlock deeper nutrition.

• Get adequate sleep. Sleep helps regulate hormones.  Research shows that women who get too little sleep may be at risk for developing hot flashes and other symptoms of menopause, such as mood swings and anxiety attacks because they’re not getting enough of the hormones that help maintain their healthy moods and emotions.

You can also optimize your sleep with a proper nighttime routine.  Calming herbs like lemon balm, chamomile, passionflower, and skullcap are found in physician-formulated supplements such as GLOW PM.  Plus, it also has a powerful combination of herbs and nutrients like St John’s Wort, Hops, GABA, and melatonin to help encourage your total body relaxation. This in turn helps promote restful sleep and has been clinically shown to reduce hot flashes and night sweats.

• Get support from nutritional supplements. Many women find relief from hot flashes by taking supplements such as calcium, magnesium, or zinc.  In addition, many of these supplements also have other health benefits as well as the intended effect on hot flashes.  Maintaining adequate levels of these nutrients plus vitamin C, D, B12, combined with adaptogens like Ashwagandha and ginseng all found in supplements like Daily Glow can help control hot flashes naturally.

• Try to keep your environment cool.  Try regulating the temperature in your environment to accommodate the changes in your body.  The summer months may be especially challenging.  If that’s the case, try to keep your bedroom cool, and opt for a fan in the daytime.  If you’re feeling hot flashes during the night, you might want to take a shower before going to bed.  A cold pack under your pillow will help you cool down, while flipping your pillow can help keep your head resting on a cool side.

• Dress in layers. If you sweat a lot, it’s a good idea to dress in layers so you can remove them if you’re no longer comfortable. To control hot flashes, wear loose, breathable clothing, which helps keep you cooler.

BONUS TIP:

Replace lost estrogen and progesterone naturally with BHRT.  If you have severe hot flashes, there are medications that can help called Bioidentical Hormone Replacement Therapy or BHRT.

Bioidentical Hormone Replacement Therapy gives you back the estrogen (and progesterone and testosterone) that you have lost.  Restored healthy levels of estrogen result in balanced levels of norepinephrine (a hormone that causes the body to get warmer) and serotonin (a hormone that causes you to feel happier).

In a relatively short time, bioidentical hormone replacement therapy leads to a decrease in the frequency and intensity of your hot flashes.  Many times, eliminating them altogether. 

Plus, not only will BHRT help to eliminate hot flashes, but can also be key to reversing nearly all of the 30+ debilitating symptoms of menopause.

Takeaway

As we age, women experience a variety of changes to their bodies, such as hot flashes.  Menopause can be a trying time to work through and it is no wonder that hot flashes and night sweats should be high on the list of problems.

A hot flash can begin suddenly and without warning, causing intense sweating and feeling on fire.

Hot flashes can be very distressing.  It can interrupt your sleep, reduce your energy level, and cause mood swings, which can equate to weight gain, depression, and a whole host of unpleasant downstream effects.

Sure, hot flashes are no fun but there’s hope!

Millions of women experience hot flashes, but there are steps you can take to help reduce their occurrence. Every woman is different, but the techniques to manage the symptoms are basically the same.

Knowing what causes them, what causes them to happen, and what you can do to prevent them is the first step to making sure you have the least amount of discomfort possible.