Hot flashes are the most common symptom of menopause and perimenopause. More than two-thirds of North American women who are heading into menopause have hot flashes. They also affect women who start menopause after chemotherapy or surgery to remove their ovaries.
What Is a Hot Flash?
It's a sudden feeling of heat and sometimes a red, flushed face and sweating. We don't know exactly what causes them, but they may be related to changes in circulation.
Hot flashes start when blood vessels near the skin's surface widen to cool off, making you break out in a sweat. Some women have a rapid heart rate or chills, too.
When they happen while you sleep, they're called night sweats. They can wake you up and may make it hard to get enough rest.
A hot flush is a hot flash plus redness in your face and neck.
How Long Will You Have Them?
That depends. About 2 in 10 women never get hot flashes. Others have hot flashes for only a very short period of time. Still others can have them for 11 years or more. On average, however, women get hot flashes or night sweats for about 7 years.
Prevention
There’s nothing you can do to avoid hot flashes around menopause. But you can stay away from triggers that may make them more frequent or more severe. Common ones include:
Stay cool. At night, a "chill pillow" filled with water or other cooling material might help. Use fans during the day. Wear lightweight, looser-fitting clothes made with natural fibers such as cotton.
Try deep, slow abdominal breathing (6 to 8 breaths per minute). Practice deep breathing for 15 minutes in the morning, 15 minutes in the evening, and when a hot flash starts.
Plant estrogens, found in soy products, may have weak estrogen-like effects that could cut hot flashes. Doctors recommend you get your soy from foods like tofu and edamame rather than supplements. Some studies suggest black cohosh may be helpful for 6 months or less. Botanicals and herbs may have side effects or change how other medications work, so ask your doctor first.
Treatments
Some women can wait out hot flashes with no treatment.
When you stop taking HRT, the hot flashes may come back. Some short-term HRT can make you more likely to have blood clots, breast and endometrial cancers, and gallbladderinflammation.
If HRT isn't right for you, other treatments may offer relief. Prescription treatments include:
Brisdelle, a paroxetine formula specifically for hot flashes
Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashes
B complex vitamins, vitamin E, and ibuprofen may help, too.
It’s important to talk to your doctor before you take any new medication or supplements, including over-the-counter products.
Overview
Hot flashes are sudden feelings of warmth, which are usually most intense over the face, neck and chest. Your skin might redden, as if you're blushing. Hot flashes can also cause sweating, and if you lose too much body heat, you might feel chilled afterward.
Although other medical conditions can cause them, hot flashes most commonly are due to menopause — the time when menstrual periods become irregular and eventually stop. In fact, hot flashes are the most common symptom of the menopausal transition.
How often hot flashes occur varies among women and can range from a few a week to several an hour. There are a variety of treatments for particularly bothersome hot flashes.
Symptoms
During a hot flash, you might have:
A sudden feeling of warmth spreading through your upper body and face
A flushed appearance with red, blotchy skin
Rapid heartbeat
Perspiration, mostly on your upper body
A chilled feeling as the hot flash lets up
Hot flashes can vary in frequency and intensity. How long symptoms last varies greatly. On average, symptoms persist for more than seven years. Some women have them for more than 10 years.
When to see a doctor
If hot flashes become particularly bothersome, consider seeing your doctor to discuss treatment options.
The cause of hot flashes isn't known, but it's likely related to several factors. These include changes in reproductive hormones and in your body's thermostat (hypothalamus), which becomes more sensitive to slight changes in body temperature.
Risk factors
Not all women who go through menopause have hot flashes, and it's not clear why some women do have them. Factors that may increase your risk include:
Smoking. Women who smoke are more likely to get hot flashes.
Obesity. A high body mass index (BMI) is associated with a higher frequency of hot flashes.
Ethnicity. More African-American women report menopausal hot flashes than do women of European descent. Hot flashes are less common in women of Japanese and Chinese descent than in white European women.
Complications
Nighttime hot flashes (night sweats) can wake you from sleep and, over time, can cause chronic insomnia. There is some association with hot flashes and increased risk of heart disease and bone loss.
A hot flash is a feeling of warmth spreading over the body that is often most strongly felt in the head and neck regions. Hot flashes may be accompanied by perspiration or flushing and usually last from 30 seconds to several minutes. Although hot flashes are a characteristic symptom of perimenopause, rare tumors, and other medical conditions may sometimes also cause hot flashes. Taking certain medications, eating spicy foods, and the consumption of alcohol have also been associated with the occurrence of hot flashes.
Although the exact cause of hot flashes is not fully understood, hot flashes that occur in the perimenopause are thought to be due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen levels. Hot flashes can often begin before the menstrual irregularities characteristic of menopause are even noticed. Up to 40% of regularly menstruating women in their 40s report having hot flashes. About 80% of women will be finished having hot flashes after five years, but sometimes they may persist for a longer time period. Hot flashes can sometimes be accompanied by night sweats (episodes of drenching sweats occurring at nighttime).
Hot flashes can also occur in men. Most commonly, they arise as a result of a dramatic drop in testosterone levels in men who have their testes surgically removed (as part of the treatment for prostate cancer) or who are taking medications that counteract the effects of testosterone.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
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