woman sweating as she experiences a hot flash during menopause

Hot Flashes and Night Sweats 101

By Christina Hanna, MPH, CHES • Published 06/13/2023

Medically Reviewed by Dr. Kerry-Anne Perkins, DO

There’s a lot to talk about when it comes to hot flashes. They’re the symptom most associated with menopause and often one of the first symptoms experienced during perimenopause. And they’re extremely common — affecting approximately 75% of people who go through menopause.

Although they have a different name, night sweats are just hot flashes that happen at night, often when you’re sleeping (or at least trying to sleep!). Night sweats can be especially difficult because they disrupt sleep, which can affect energy, mood, and metabolism.

You may have also seen them called vasomotor symptoms (VMS).

We’ll start with the basics here and stay tuned for more information on them.

What are hot flashes?

If you haven’t experienced any yet, hot flashes are a sudden feeling of heat in the body. It’s often felt in the upper chest and face. Each episode can last between 30 seconds and 10 minutes. Some people may also get red blotches on their chest, back, and arms. In addition to a feeling of heat, some people also report sweating, anxiety, and heart palpitations. And some people will also experience chills as their body cools off.

Hot flashes are most often caused by a drop in estrogen levels. But if you’ve started experiencing these symptoms, it’s best to talk to a healthcare provider to rule out any other causes.

What causes hot flashes?

Like many menopause symptoms, the drop in levels of estrogen during perimenopause and menopause is what causes hot flashes and night sweats. But why hot flashes? Why does our body react this way? Unfortunately, it’s not well understood.

One thought is that the decrease in estrogen affects the hypothalamus — the part of the brain that regulates body temperature. Estrogen helps the hypothalamus regulate body temperature, so it’s thought that when the amount of estrogen starts to change, the body’s ability to regulate temperature changes as well.

highlight of the hypothalamus region of the brain which regulates body temperature

An external trigger can signal to the brain that the body is too warm and start a series of reactions to cool the body down. One reaction is that blood vessels near the surface of the skin dilate (get bigger) which increases blood flow to the surface to try to release heat. This can make some people’s skin appear red and blotchy. Sweating also often occurs to cool the body down. And a cold chill may follow a hot flash as the body cools. The blood vessel dilation can also make it feel like your heart is beating faster.

What’s not known is why hot flashes eventually stop even though estrogen levels remain low.

What can I do to get relief from hot flashes and night sweats?

There’s no cure for hot flashes, but there are several things you can try to do to help provide relief.

  • Consider medications containing hormones. Depending on where you are in perimenopause or menopause, you can talk to your doctor or a telehealth provider about either taking a low-dose hormonal birth control or hormone replacement therapy for menopause to help relieve the symptoms.
  • Consider other medications. If hormone treatments aren’t an option for you, maybe because of another health or medical conditions, ask your doctor about other medications that may help. One option is a new, hormone-free, FDA-approved medication that helps reduce the number and intensity of hot flashes.
  • Drink cold water. Drink ice water when you feel a hot flash coming on.
  • Dress in layers. Removing layers when a hot flash hits can help you feel more comfortable.
  • Use a fan. If possible, keep a fan with you to help you feel more comfortable during a hot flash. You may also want to keep a small one by your bed and near you at work.
  • Take deep breaths. Slow, deep breaths signal to your body that it’s time to relax. Starting deep breathing when a hot flash starts may help shorten how long they last.
  • Work on getting to or maintaining a healthy weight. Hot flashes may be worse for people who are overweight and losing weight may help improve hot flashes.
  • Explore mind-body practices. Early research has shown that hypnotherapy and meditation may help with managing hot flashes. More studies are needed to fully prove their effectiveness.
woman experiencing a hot flash and finding hot flash relief in front of a fan

For each individual, hot flashes often follow a consistent pattern. But that pattern differs greatly from person to person. To help discover if your hot flashes have a pattern, try tracking them. One-third of our Versalie Ambassadors track their hot flashes. Some of them keep track of them as a note in their phones, while others have just increased their awareness of their possible triggers like food/drink, the weather, and time of day.

Take note if anything triggers your hot flashes and how much they bother you. Sometimes there are certain triggers that can bring on a hot flash episode. Common triggers can include:

  • Eating spicy foods.
  • Drinking warm liquids, caffeine, or alcohol.
  • Feeling stressed or anxious.
  • Smoking or being around cigarette smoke.
  • Warm room or air temperatures.
  • Discontinuing estrogen therapy.
Last Updated 02/15/2024

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REFERENCES

Carmody, J., Crawford, S., Salmoirago-Blotcher, E., Leung, K., Churchill, L., & Olendzki, N. (2011). Mindfulness training for coping with hot flashes: Results of a randomized trial. Menopause, 18(6): 611-620. doi: 10.1097/gme.0b013e318204a05c

Elkins, G.R., Fisher, W.I., Johnson, A.K., Carpenter, J.S., & Keith, T.Z. (2013). Clinical hypnosis in the treatment of post-menopausal hot flashes: A randomized controlled trial. Menopause, 20(3). doi: 10.1097/GME.0b013e31826ce3ed

Endocrine Society. (2022). Menopause. Accessed 1/17/23 from https://www.endocrine.org/patient-engagement/endocrine-library/menopause

Endocrine Society. (2022). Reproductive hormones. Accessed 1/17/23 from https://www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/reproductive-hormones

Kelly, M.J., Qiu, J., & Ronnekleiv, O.K. (2005). Estrogen signaling in the hypothalamus. Vitamins & Hormones, 71: 123-145. https://doi.org/10.1016/S0083-6729(05)71005-0

National Institute on Aging. (2021). What is menopause? Accessed 1/17/23 from https://www.nia.nih.gov/health/what-menopause

National Institute on Aging. (2021). Hot flashes: What can I do? Accessed 1/17/23 from https://www.nia.nih.gov/health/hot-flashes-what-can-i-do

Sliwinski, J.R. & Elkins, G.R. (2017). Hypnotherapy to reduce hot flashes: Examination of response expectancies as a mediator of outcomes. Journal of Evidence-Based Integrative Medicine, 22(4): 652-659. doi:10.1177/2156587217708523

Stearns, V., Ullmer, L., Lopez, J.F., Smith, Y., Isaacs, C., & Hayes, D.F. (2002). Hot flushes. The Lancet, 360(9348): 1851-1861. https://doi.org/10.1016/S0140-6736(02)11774-0

Sung, M-K, Lee, U.S., Ha, N.H., Koh, E., & Yang, H-J. (2020). A potential association of meditation with menopausal symptoms and blood chemistry in healthy women. Medicine, 99(36): e22048. DOI: 10.1097/MD.0000000000022048

The Menopause Society. Menopause topics: Hot flashes. Accessed 10/30/2024 from https://menopause.org/patient-education/menopause-topics/hot-flashes

The North American Menopause Society. (2023). NAMS position statement: The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause, 30(6): 573-590. DOI: 10.1097/GME.0000000000002200

U.S. Department of Health & Human Services, Office on Women’s Health. (2021). Menopause symptoms and relief. Accessed 1/17/23 from https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief

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