What are hot flashes?

Hot flashes are sudden feelings of flushing and heat that are common and early signs of menopause. You may start having hot flashes before you stop having menstrual periods. Hot flashes may stop after a few months, or you may have them for several years.

What is the cause?

The exact cause of hot flashes is not fully known.

Female hormones, such as estrogen, change the balance of chemicals in the brain that help regulate body heat. The hypothalamus is a part of the brain that makes hormones that control body temperature, heart rate, and sleep. The drop in estrogen levels may tell the hypothalamus that you need to cool down. It does this by widening blood vessels in the face, chest, and body to release heat.

What are the symptoms?

Symptoms may include:

• Sudden redness and warmth on the skin of your face, neck, shoulders, or upper chest
• Pounding heartbeat
• Sweating followed by a slight chill

Hot flashes usually last a few seconds to a few minutes. Most last no more than 2 or 3 minutes. Hot flashes can happen at night and interrupt your sleep. These are called night sweats.

How are they diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you.

How are they treated?

If your hot flashes are mild and don’t happen often, use a fan or sip a glass of cool water or juice when you start having a hot flash.

If your hot flashes are frequent, severe, or keep you from sleeping at night, your healthcare provider may recommend lifestyle changes, such as a healthy diet and exercise program. Your provider may prescribe medicine to:

• Treat anxiety, depression, and mood swings
• Treat hot flashes and other symptoms

Hormone replacement therapy, or menopausal hormone therapy, can treat menopausal symptoms and help prevent bone loss (osteoporosis). Discuss the risks and benefits of hormone therapy with your healthcare provider. Hormone therapy may increase your risk for heart disease. It may also increase your risk for stroke, breast cancer, blood clots, gallbladder problems, and possibly dementia. If you still have your uterus and choose to take hormones, you will need to take progesterone with the estrogen. Taking estrogen alone may increase your risk of cancer of the uterus.

Estrogen may be taken in many different forms, such as:

• Tablets to be swallowed
• Patches or lotion to be put on the skin
• A cream, ring, or tablet put into the vagina
• Pellets placed under the skin
• Shots

If you are going to take hormone therapy, ask your healthcare provider about:

• The different types and dosages of hormone therapy
• Any side effects or special precautions you should know about
• When you should start and stop taking the hormones

Claims have been made that certain herbal and dietary products help control hot flashes. These include black cohosh, soy, dong quai, red clover, and evening primrose oil. No herb or dietary supplement has been proven to consistently or completely relieve symptoms. Supplements are not tested or standardized and may vary in strengths and effects. They may change how your prescription medicines work or have side effects and are not always safe. Talk with your healthcare provider before taking nonprescription medicines or supplements.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Keep as cool as you can. Wear light, cotton clothing and dress in loose layers. Keep your house cool and use lightweight blankets at night.
• Keep track of and avoid things that trigger your hot flashes. The following may help:
  • Avoid hot, spicy foods.
  • Don’t drink a lot of red wine or eat a lot of chocolate or aged cheeses. These foods contain a chemical that can trigger a hot flash.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider’s instructions.
• Ask your provider:
  • How and when you will hear your test results
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.