What is a Hot Flash?
I have been cold for most of my life (and I’m talking physically, not metaphorically).
I am always the one with a sweater on, even in the dead of summer. I am the last one to turn on a fan when working out, and I once wore a scarf – in Mexico.
I am probably the only woman on earth that couldn’t wait for menopause and hot flashes to start.
Fast forward to today and here I am kinda wishing I wasn’t so vocal to the hormone gods that I wanted some hot flashes.
What Exactly is a Hot Flash
Hot flashes are a common symptom of menopause. It’s a quick feeling of heat that is not caused by any external sources, leaving us sweating from our scalps all the way down to our toes.
They can range from mild and tolerable, to downright troublesome, and all the way to severe and debilitating.
Some women can have hot flashes for decades, while others for just a few years.
A few weeks ago I reached out to my community to ask them how a hot flash felt for them, and here are some of the responses I received:
“A heat that feels like it’s “radiating from your body” late at night or the early hours of the morning…often accompanied by a sweaty neck and restless sleep.”
“…my experience has been with night sweats which you wake up and find yourself very hot and sweaty, sometimes having to change because you have soaked your pj’s – not fun! I have experienced day ones too, which you don’t give you any warning. One minute you’re fine and then the next you are wanting to take your clothes off because you are so hot and uncomfortable. It can be very embarrassing depending where you are, thank goodness I don’t get those very often. I do find if I have had wine that night that I am more prone to having a night sweat.”
“Hot flashes are a very uncomfortable feeling as they come suddenly and leave suddenly. Nights are the hardest as I dress up, undress, dress up, undress, probably 20 times a night.”
“Before hormone replacement I was getting hot flashes that would make my head and face feel like a volcano had erupted on it.”
“…a hot flash feels like my blood is burning up from the inside of me and my face and neck area gets very red, my arms are really hot and a darker color. Thank god they don’t last too long. You can feel them coming on and then you feel normal again.”
Researchers believe that women with hot flashes have more sensitive thermostats in their brain, so they are only comfortable in a small range of temperatures (North American Menopause Society – NAMS).
Researchers also hypothesize that hot flashes may be because of a change in our circulation (WebMD).
Dr. Karen McGee, naturopathic physician in Fort Langley who specializes in women’s health, says that a drop in estrogen is one of the factors in a hot flash, however she says that it is a bit more complex than just low estrogen.
She explains that we are actually designed to fight off hot flashes, but lifestyle hinders that fight.
There is a layer of our adrenal glands that releases sex hormones, and these hormones can prevent hot flashes. But, throw in a busy lifestyle and chronic stress and our adrenal glands are left being busy dealing with day-to-day life stuff. They are unable to balance the thermoregulation needed to prevent a hot flash.
And so the hormone sh*t-storm begins.
Hot Flash Triggers
While you can’t escape hot flashes during menopause, there some triggers you can avoid to help with the intensity of them.
- Stress (to keep your adrenal glands happy)
- Spicy Foods
- Tight clothing
- Cigarette smoke
NAMS recommends if your hot flashes are mild or moderate you may find relief by simply changing your lifestyle.
But, if you have severe hot flashes, while you will still benefit from lifestyle changes, you may also choose to take a nonprescription therapy or a prescription medication, including hormones to help you manage your symptoms.
A big lifestyle change that can help produce a difference with hot flashes is to stay cool (both physically and metaphorically), and reduce your stress.
Other relief options can include:
- Avoiding warm rooms (no more saunas or hot tubs), hot drinks and foods, alcohol, caffeine, excess stress, and cigarette smoking.
- Wearing layers of clothing made from light, breathable fabrics. This way you can remove a layer or two when you’re hot and replace them when you’re cooler (this is a tactic I use).
- Using cooling products, including sprays, gels, and a Chillow pillow.
- Reducing stress and promoting a more restful sleep by exercising regularly.
- Meditation, yoga, qigong, tai chi, biofeedback, acupuncture, or massage will also lower your stress levels.
When you feel a hot flash coming on:
- Try “paced respiration” (NAMS). This is slow, deep, abdominal breathing where you breathe in through your nose and out through your mouth. You want to breathe like that for only 5 to 7 times per minute. So it is much slower than usual, and continue breathing like that until you feel the flash subside.
- You can also try different strategies to stay cool while sleeping, such as dressing in light, breathable nightclothes. Or, wear workout wear, like a Nike dri-fit top.
- Use layered bedding that can be easily removed during the night.
- Cool down with a bedside fan.
- Keep a frozen cold pack under your pillow, and turn the pillow often so that your head is always resting on a cool surface.
- If you wake at night, sip cool water and to get back to sleep try meditation, paced respiration, or getting out of bed and reading until you become sleepy.
Women who are overweight tend to have more hot flashes, so maintaining a healthy weight and exercising regularly will help in both decreasing the hot flashes while also improving your overall health.
Many nonprescription therapies can help reduce hot flashes, but not because of how you would think.
Researchers claim that nonprescription therapies work because of the placebo effect.
When nonprescription treatments are studied scientifically (NAMS) it has been found that they are JUST as effective as the placebo.
But, even if relief is simply all in our heads it is still worth a shot to try, yes?
Yes, I think so too.
Some remedies you might want to consider for hot flash relief are:
- Soy: eat one or two servings of foods daily (containing isoflavones). This can be tofu, tempeh, soymilk, or roasted soy nuts.
- Supplements containing soy isoflavones.
- Herb supplements: such as black cohosh, have also decreased hot flashes in some studies
Dr. McGee sees success with her patients using bio-identical hormone replacement therapy (replacing your estrogen and progesterone).
Estrogen, in a pill or a transdermal patch, is highly effective at reducing, and in some cases, eliminating symptoms.
However, there are risks with hormone therapy (HT).
Long term studies of women receiving oral preparations of combined hormone therapy of both estrogen and progesterones were halted when it was discovered that the women in the study had an increased risk for heart attack, stroke and breast cancer when compared with women who did not receive HT.
Later studies of women taking estrogen alone showed that estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer.
So, the decision to start, or continue taking, HT is a hard one and a very individual choice. Talk to your health care provider to weigh the pros and cons.
Other prescription therapies include:
- Low-dose depression drugs like fluoxetine (Prozac), paroxetine (Paxil), or venlafaxine (Effexor)
- Clonidine, a blood pressure medication
- Gabapentin, an anti-seizure drug
- Brisdelle, a paroxetine formula specifically for hot flashes
- Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashes
You can also read what the North American Menopause Society recommends by clicking here.