Hot flashes are a common symptom experienced by many perimenopausal women in the years leading up to menopause, and sometimes even after reaching menopause. Here, Dr. Jessica Chan of Cedars-Sinai Medical Center sheds light on the basics of hot flashes, their most likely underlying causes, and available treatment options.*

Hot flash basics

Hot flashes are sudden waves of intense heat mainly affecting the face, neck, and chest, often accompanied by sweating and skin redness. These episodes can range from mild discomfort to severe disruption, causing significant distress and impacting daily functioning. 

Night sweats, another common occurrence during perimenopause, can further exacerbate sleep disturbances, leading to long-term sleep problems and affecting various aspects of life, including:

• Energy levels, 
• Productivity, and
• Personal relationships.

Hot flashes and night sweats, collectively called vasomotor symptoms, typically occur over a span of seven to ten years, with Black and Latino women often experiencing them earlier and for a longer period of time. Dr. Chan underscores the significance of addressing these symptoms promptly to mitigate their adverse effects on overall well-being and quality of life.

Why do hot flashes occur?

While hot flashes can occur as a result of certain medications, medical conditions such as thyroid issues, and other causes, fluctuating hormone levels, particularly a decline in estrogen, are thought to be the cause of menopause-related hot flashes. 

Research suggests that these hormonal changes trick the hypothalamus–the part of the brain that regulates body temperature–into thinking that the body is overheating. In response, it tells the sweat glands and the blood vessels near the skin to open and cool the body down. 

Hot flashes can result not only from naturally occurring menopause, but also from:

• Medical menopause (surgical removal of the ovaries), and 
• Taking hormonal treatments.

Transgender men receiving hormone therapy or undergoing ovary removal may also experience hot flashes, highlighting the role of hormonal fluctuations in these episodes.

Understanding the diverse demographic affected by hot flashes underscores the need for personalized approaches to symptom management and emphasizes the importance of inclusive healthcare practices. Dr. Chan emphasizes the significance of seeking medical guidance to address hot flashes effectively, irrespective of gender identity or hormonal status.

How can I get relief from hot flashes?

Identifying potential triggers for your hot flashes can guide you in making lifestyle changes that may help alleviate hot flash frequency and intensity. Common catalysts include:

• Anxiety 
• Alcohol
• Caffeine
• Obesity
• Smoking
• Spicy foods

In terms of treatment options, Dr. Chan suggests they be tailored to individual needs and medical histories. 

Hormone replacement therapy (HRT) remains the most effective treatment for relieving hot flashes, but it may not be suitable for everyone, particularly individuals with a history of certain cancers or cardiovascular conditions, or those who are already several years into perimenopause. 

Non-hormonal alternatives, such as Brisdelle (paroxetine) and Veozah (fezolinetant), offer viable options for those unable to tolerate, or who opt against, HRT. 

In addition to pharmacological interventions, lifestyle modifications, such as maintaining a healthy weight through diet and exercise, and practicing mindfulness meditation, can complement treatment strategies and contribute to symptom management. 

While Dr. Chan advocates for holistic approaches to symptom management, including healthy lifestyle choices and mindfulness practices, she stresses the importance of crafting a personalized plan in partnership with your own healthcare provider, to ensure comprehensive support and improved quality of life.

*Seaton, J. (2023, August 8). Why Hot Flashes Occur and How to Treat Them. Cedars-Sinai Blog. https://www.cedars-sinai.org/blog/why-hot-flashes-occur-and-how-to-treat-them.html#:~ 

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