15223 Hot Flashes

Overview

A hot flash is a sudden wave of heat that spreads across your face, neck and chest. Your skin may turn red and feel warm, you may sweat, and your heart may beat faster. It usually lasts from a few seconds to a few minutes, and it can leave you feeling chilled afterwards. At night these same heat waves are called night sweats. Hot flashes are very common around the menopause, which is the time when a woman's periods stop for good. They are uncomfortable but not dangerous in themselves.

Yes, very common. Most women going through the menopause have hot flashes at some point, and for many they are the most noticed symptom. They can also happen for other reasons, such as some medicines, thyroid problems or infections.

Hot flashes mostly affect women in the years around the menopause, usually between the ages of 45 and 55. They can also happen earlier, for example after surgery to remove the ovaries, or after certain cancer treatments. Some men treated for prostate cancer, and people taking particular medicines, can get them too. Children rarely get hot flashes, so a child with flushing should be checked by a doctor.

Symptoms

Common symptoms

• A sudden feeling of heat over the face, neck and chest
• Red, warm or blotchy skin
• Sweating, sometimes heavy
• A racing or pounding heartbeat
• Feeling chilled or shivery afterwards
• Night sweats that soak your bedding or nightwear
• Trouble sleeping, which can leave you tired the next day

Symptoms in children

• Hot flashes are unusual in children
• Flushing or sweating in a child is more often caused by fever, hot weather, activity or a mild illness
• See a doctor if a child has repeated flushing with fever, weight loss, a fast heartbeat or unusual tiredness

Symptoms in older adults

• Hot flashes can continue for years after periods stop, and a few people have them into their 60s or beyond
• In older adults, flushing can also come from other causes such as thyroid problems, infections, some medicines, or, rarely, other conditions
• New hot flashes that start many years after the menopause should be checked by a doctor

Causes

Main causes

• Falling levels of the hormone oestrogen around the menopause — this is by far the most common cause
• The menopause happening early, for example after surgery to remove the ovaries, or after some cancer treatments
• Hormone treatment for prostate cancer in men
• An overactive thyroid gland
• Some medicines, such as certain painkillers, antidepressants and treatments for hormone-sensitive conditions
• Infections that cause fever
• Alcohol, spicy food and caffeine can trigger flashes in people who are already prone to them
• Rarely, other conditions such as some cancers or a hormone-producing tumour

Risk factors

• Being in the years around the menopause
• Smoking
• Being overweight
• Not being physically active
• Stress and poor sleep
• Drinking alcohol regularly
• Having had surgery to remove the ovaries
• Some ethnic backgrounds are linked to more frequent or longer-lasting hot flashes

When to see a doctor

See a doctor urgently if:

• Hot flashes with chest pain, breathlessness or fainting — call your local emergency number
• Drenching night sweats with fever or weight loss
• Flushing with swelling of the face, lips or tongue
• Hot flashes with a fast or irregular heartbeat that does not settle

Book a routine appointment if:

• Hot flashes are troubling your sleep, mood or daily life
• You are unsure whether your symptoms are linked to the menopause
• Hot flashes started after a new medicine
• You have hot flashes before the age of 40
• You have hot flashes many years after your periods stopped
• You would like to talk about treatment options

Diagnosis

For most people, a doctor can tell what is going on by talking with you about your symptoms, your periods and your age. There is no single test for hot flashes. Tests are mainly used to rule out other causes or to check whether the menopause has started, especially if you are younger than expected.

Tests that may be done

• A blood test to check hormone levels linked to the menopause
• Thyroid function blood tests
• A full blood count to look for anaemia or infection
• Blood sugar checks
• Sometimes tests for other hormone levels or vitamin levels, depending on your symptoms
• In rare cases, scans if your doctor suspects another cause

What to expect at your appointment

Your appointment will mostly be a conversation. Your doctor may ask about how often the flashes happen, what brings them on, how they affect your sleep and mood, and your medical history. They may suggest a blood test, and they will explain what the results mean. You can bring a note of your symptoms and questions with you — it often helps.

Treatment

Treatment depends on how much hot flashes are affecting your life. Many people manage well with simple changes to daily habits. If symptoms are moderate or severe, your doctor can talk you through options, including hormone-based treatment and non-hormone medicines, along with talking therapies and lifestyle support. The right choice is personal and depends on your health history and preferences.

Self-care at home

• Wear layers you can take off, and choose light, breathable fabrics
• Keep a small fan or cold water handy at home and at work
• Try slow, steady breathing when you feel a flash starting
• Keep your bedroom cool and use light bedding
• Cut back on alcohol, caffeine and spicy food if you notice they trigger flashes
• Drink water regularly and stay active
• Try to keep to a regular sleep routine
• Note your triggers for a couple of weeks — patterns are easier to spot

Medical treatments

Your doctor may discuss hormone-based treatment, which replaces the hormones that fall around the menopause and is usually the most effective option for menopause-related hot flashes. It is not suitable for everyone, so your doctor will review your history first. If hormone treatment is not right for you, there are non-hormone prescription medicines that can reduce how often flashes happen. Talking therapies such as cognitive behavioural therapy can help you cope with flashes and with sleep problems. Some people also find relief from treatments such as acupuncture or herbal remedies, although the evidence for these is mixed — always check with your doctor or pharmacist first, because some herbal products interact with other medicines. Any medicine should only be started after a conversation with a qualified healthcare professional.

When is surgery considered?

Surgery is not a treatment for hot flashes themselves. It may come up only in specific situations — for example, if you have an underlying condition that needs surgical treatment, or if you have surgery to remove the ovaries, which can bring on the menopause and hot flashes earlier.

Living with this condition

Hot flashes can be awkward, especially at work or in social situations. Knowing your triggers and having a plan — a cool drink, a layer to remove, a quiet moment of slow breathing — makes them easier to handle. It also helps to tell the people around you what is happening, so they understand if you need to step out or open a window.

Lifestyle tips

• Stay physically active — regular movement is linked to fewer and milder flashes
• Keep to a healthy weight
• If you smoke, stopping can reduce hot flashes and has many other benefits
• Limit alcohol and caffeine, especially in the evening
• Try relaxation or mindfulness to lower stress levels
• Keep your home and workplace cool and well ventilated
• Wear layers and keep a change of clothes handy for night sweats

Diet and exercise

There is no special diet that stops hot flashes, but eating regular balanced meals and drinking enough water can help you feel steadier. Some people notice that spicy food, hot drinks, caffeine or alcohol set off a flash — keeping a short diary can help you see your own pattern. Aim for movement you enjoy most days, such as walking, swimming, cycling or yoga. Weight-bearing and strength exercise also help protect your bones, which matters around the menopause.

Mental health and emotional wellbeing

Hot flashes and night sweats can break your sleep, and poor sleep can affect mood, memory and patience. It is very common to feel irritable, anxious or low during this time. These feelings are understandable and treatable — please talk to your doctor if they are affecting your daily life. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis support service straight away.

Prevention

You cannot prevent the hormonal changes of the menopause, so hot flashes linked to it cannot be fully prevented. You can reduce how often they happen and how much they bother you by avoiding your triggers, not smoking, staying active, keeping to a healthy weight and managing stress.

Screening programmes

There is no screening test for hot flashes. Regular health checks, including blood pressure and, where relevant, bone health and cervical and breast screening, are still important around and after the menopause — your doctor can tell you what applies to you.

Complications

If left untreated

• Broken sleep and ongoing tiredness
• Low mood, anxiety or irritability
• Difficulty concentrating at work or at home
• Avoiding social situations or activities you enjoy
• Discomfort and embarrassment during the day and night
• If hot flashes come from another condition, such as a thyroid problem, that condition may go untreated if you do not seek advice

Long-term outlook

The outlook is good. For most people, hot flashes become less frequent and milder over time, and there is a lot you can do to feel more comfortable in the meantime. If simple steps are not enough, your doctor has effective options to discuss with you. Many people find that with the right support, hot flashes become a manageable part of life rather than something that runs it.

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