What Are Hot Flashes—And Why Do They Happen During Menopause?
Hot flashes are practically synonymous with menopause—but, despite most people being aware of their existence, many don't know what, exactly, hot flashes are.
While not every women experiences hot flashes during menopause, those that have (and do) are well aware that the experience is pretty miserable. “I've had several patients describe being in meetings and needing to excuse themselves because of the profuse sweating they are experiencing,” Arianna Sholes-Douglas, MD, author of The Menopause Myth, tells Health.
So, the basic understanding here is that hot flashes make you feel...hot—but here’s what else you need to know about the common phenomenon, why it happens, and what you can do to cool off in the moment.
What are hot flashes?
Hot flashes are a disturbance in your body’s thermoregulatory system, i.e. the process that allows your body to maintain its core temperature, Jonathan Schaffir, M.D., an ob/gyn from The Ohio State University Wexner Medical Center, tells Health.
"During menopause, the thermostat gets shifted so that women are increasingly sensitive to small changes in temperature,” he explains. “Their body overreacts to try to cool them off by dispersing heat and sweating.”
The process happens to everyone when their bodies are trying to get rid of heat, but it “happens in a much more magnified sense in these hot flashes,” says Dr. Schaffir.
What causes hot flashes?
The exact reason why hot flashes happen during menopause isn’t clear, Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School tells Health. But it’s thought that the decrease in your body’s production of reproductive hormones, including estrogen, during menopause can make you more sensitive to slight changes in body temperature, says Dr. Sholes-Douglas.
“The estrogen hormones fluctuate and, although the total estrogen levels may not be low, there are moments where estrogen levels fall relative to where they were,” she explains. This then triggers a change in your blood vessels, which can make you feel hot and sweaty.
While you can just have a hot flash for seemingly no reason, hot flashes can be exacerbated by things like sugar, stress, spicy foods, and alcohol, says Dr. Sholes-Douglas.
When you have a hot flash during the night, it’s often referred to as night sweats. “But these are essentially the same,” says Dr. Sholes-Douglas. Night sweats tend to wake women up and can make it tough to sleep.
What does a hot flash feel like?
Hot flashes can feel different for everyone. Some women have “horrible” hot flashes, while others don’t have any, says Dr. Schaffir, adding that “it’s unclear why.”
“Some women experience a hot flash from the bottom, up and some women experience their hot flash from the top, down,” says Dr. Sholes-Douglas. “Some women feel as if they were sitting in an oven and feel red and flushed for no apparent reason.”
The aftermath of a hot flash doesn’t feel great either. “When women lose heat from the hot flash, they then can shiver—it’s not a very pleasant sensation,” says Dr. Minkin.
Are there any treatments for hot flashes?
There are a slew of treatment options, from medication to lifestyle changes, that can help. Low doses of estrogen, especially when menopausal symptoms first start, “can be a lifesaver for women experiencing hot flashes,” says Dr. Sholes-Douglas. She also recommends limiting sugar, spicy foods, and alcohol, since these can make hot flashes worse.
If you have intense hot flashes, a supplement called Siberian Rhubarb can be effective, says Dr. Sholes-Douglas (just talk to your doctor before trying any new kind of supplement). Dressing in layers that you can remove during a hot flash, carrying a portable fan, and maintaining a healthy body weight can also help, according to the National Institute on Aging (NIA).
Overall, if you’re experiencing hot flashes and it bothers you, talk to your doctor. They should be able to help guide you on next steps.
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