Hot flushes

Overview

A hot flush is a sudden feeling of intense heat that spreads over the body, often with sweating and reddening of the skin. It is most commonly caused by hormonal changes around the time of menopause.

Yes, hot flushes are extremely common. Around 3 out of 4 women experience them during the menopause transition. They can also occur in men, especially after treatment for prostate cancer.

Hot flushes most often affect women in their 40s to 60s, particularly during perimenopause and menopause. They can also affect men and people of any gender who experience hormonal changes due to medical treatments or conditions.

Symptoms

Common symptoms

• Sudden feeling of heat, especially in the face, neck, and chest.
• Reddening of the skin (flushing) that may look like a blush.
• Heavy sweating, sometimes followed by chills.
• Rapid heartbeat or palpitations.
• Feeling of anxiety or unease during the flush.

Symptoms in children

• Hot flushes are rare in children but can occur during puberty due to normal hormonal shifts.
• In children, hot flushes may also be a side effect of certain medications or treatments for chronic conditions.

Symptoms in older adults

• In older adults, hot flushes may continue after menopause or be triggered by medications.
• They can also be a sign of an underlying condition such as an overactive thyroid or infection.
• Sudden onset of hot flushes in an older adult should be checked by a doctor.

Causes

Main causes

• Normal hormonal changes during perimenopause and menopause (declining estrogen).
• Hormone therapy for breast or prostate cancer (e.g., tamoxifen, GnRH agonists).
• Certain medications, such as some antidepressants or opioids.
• Underactive or overactive thyroid (thyroid disorders).
• High alcohol or caffeine intake, spicy foods, or smoking.

Risk factors

• Being a woman, especially during perimenopause or menopause.
• Family history of hot flushes or menopausal symptoms.
• Obesity or being overweight.
• Smoking cigarettes.
• Certain medical treatments, such as chemotherapy or hormone-blocking therapy.

When to see a doctor

See a doctor urgently if:

• If hot flushes are accompanied by chest pain, shortness of breath, or a severe headache.
• If you have a fever, cough, or other signs of infection with hot flushes.
• If you have a known heart condition and notice new symptoms during flushes.

Book a routine appointment if:

• If hot flushes are bothering you or affecting your daily life, sleep, or mood.
• If you are in your 40s or 50s and noticing other signs of menopause (e.g., irregular periods).
• If you have vomiting, diarrhea, or other symptoms that might point to a condition like carcinoid syndrome.

Diagnosis

Your doctor will ask about your flushes, how often they happen, what triggers them, and any other symptoms. They may also ask about your menstrual history if relevant.

Tests that may be done

• Blood tests to check hormone levels (e.g., estrogen, FSH) if menopause is suspected.
• Thyroid function tests to rule out an overactive or underactive thyroid.
• Other tests as needed if there are unusual symptoms (e.g., tumour markers, imaging).

What to expect at your appointment

The doctor will take a thorough history and may perform a physical exam. They will likely discuss lifestyle changes first. If needed, they may recommend treatments or refer you to a specialist. The process is usually straightforward and not invasive.

Treatment

Treatment for hot flushes focuses on relieving symptoms and improving quality of life. It begins with simple self-care steps, and if those are not enough, there are medications and therapies a doctor can discuss with you.

Self-care at home

• Dress in light, breathable layers that you can remove easily.
• Keep your bedroom cool and use a fan at night.
• Identify and avoid personal triggers like spicy foods, hot drinks, alcohol, or caffeine.
• Practice slow, deep breathing when a flush starts.
• Exercise regularly and maintain a healthy weight.
• Try relaxation techniques such as yoga or meditation.

Medical treatments

If lifestyle changes are not enough, your doctor may suggest hormone therapy (using low-dose estrogen) for menopausal hot flushes after a careful discussion of risks and benefits. There are also non-hormonal prescription treatments, such as certain antidepressants or blood pressure medications, that can help reduce hot flushes. Your doctor will explain the options and help you choose what is best for you. Do not take any over-the-counter supplements without medical advice.

When is surgery considered?

Surgery is not a standard treatment for hot flushes on their own. It may only be considered if the cause is a condition that requires surgery, such as removing the ovaries (oophorectomy) for other medical reasons. This is a last resort and not recommended for managing hot flushes alone.

Living with this condition

Living with hot flushes means being prepared. Keep a portable fan or cool water spray handy, dress in layers, and try to stay calm when a flush hits – it will pass. Track your flushes in a diary to identify triggers and patterns.

Lifestyle tips

• Avoid common triggers like hot rooms, stress, caffeine, and spicy foods.
• Stay active with moderate exercise like walking, swimming, or cycling.
• Practice good sleep hygiene – keep the bedroom cool and avoid screens before bed.
• Try mindfulness or breathing exercises to reduce the stress of sudden flushes.

Diet and exercise

Eating a balanced diet rich in fruits, vegetables, and whole grains may help. Some women find that avoiding spicy foods, alcohol, and caffeine reduces flushes. Regular exercise helps control weight and may improve hormone balance. Aim for at least 30 minutes of moderate activity most days.

Mental health and emotional wellbeing

Frequent hot flushes can disrupt sleep and cause embarrassment or anxiety. This can affect mood, concentration, and self-esteem. It is important to acknowledge these feelings and seek support. Talk to your doctor if hot flushes are affecting your mental health.

Prevention

Hot flushes cannot always be prevented, especially those related to menopause. However, maintaining a healthy weight, not smoking, and avoiding known triggers may reduce how often they happen or how severe they are.

Complications

If left untreated

• Persistent sleep problems due to night sweats.
• Increased stress and anxiety, which can lead to low mood or depression.
• Reduced quality of life and productivity.
• Embarrassment or social withdrawal.

Long-term outlook

For most people, hot flushes are a temporary phase. They often improve over time, even without treatment. With simple self-care and medical help when needed, the vast majority of people can manage hot flushes effectively and live comfortably.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.