When to seek care for hot flushes

Overview

Hot flushes are sudden feelings of warmth, usually most intense over the face, neck, and chest. They can make your skin red and sweaty. They are often related to hormonal changes, especially during menopause, but can also happen for other reasons.

Yes, hot flushes are very common. About 8 out of 10 women experience them during menopause. Men can also get hot flushes, often due to hormone treatments for prostate cancer.

Hot flushes mostly affect women in perimenopause and menopause, typically between ages 45 and 55. They can also occur in younger women after surgery or certain treatments, and in men with low testosterone or after prostate cancer treatment.

Symptoms

Common symptoms

• Sudden feeling of heat in the face, neck, or chest
• Red or flushed skin
• Sweating, especially on the upper body
• Rapid heartbeat or palpitations
• Feeling of anxiety or unease during the flush
• Chills or shivering after the heat subsides

Symptoms in children

• Hot flushes are rare in children. If a child experiences unexplained flushing, it could be due to an infection, fever, or a side effect of medication. Consult a doctor to rule out other causes.

Symptoms in older adults

• In older adults, hot flushes may still be linked to hormonal changes. However, they could also signal thyroid problems, certain infections, or side effects of medicines. It's wise to mention them to your doctor.

Causes

Main causes

• Hormonal changes, especially decreasing estrogen levels during menopause
• Treatments for cancer, such as hormonal therapy for breast or prostate cancer
• Thyroid disorders, such as an overactive thyroid
• Side effects of certain medications, including some antidepressants or steroids
• Infections that cause fever
• Alcohol or spicy foods in some people
• Anxiety or stress

Risk factors

• Being in perimenopause or menopause
• Having had both ovaries removed surgically
• Receiving hormone-blocking treatments for cancer
• Smoking
• Obesity
• Family history of hot flushes

When to see a doctor

See a doctor urgently if:

• If hot flushes are accompanied by chest pain, trouble breathing, or a severe headache – call your local emergency number.
• If you have a high fever with chills and feel very unwell.
• If you faint or nearly faint during a hot flush.

Book a routine appointment if:

• If hot flushes are new and you are not sure what is causing them.
• If they are frequent, severe, or interfering with your sleep, work, or daily life.
• If you are younger than 45 and have hot flushes, or if you have a family history of early menopause.
• If you have other symptoms like weight loss, fatigue, or night sweats.
• If you are taking a medication that could be causing hot flushes and want to explore alternatives.

Diagnosis

Your doctor will ask about your symptoms, how often they happen, and any triggers. They will also ask about your menstrual history if relevant, and about any medicines you take. Usually, no tests are needed if the pattern is typical of menopause.

Tests that may be done

• Blood tests to check hormone levels (like estrogen or FSH) if menopause is uncertain
• Thyroid function tests if there are signs of thyroid problems
• Tests for other causes like infection or anemia if symptoms are unusual

What to expect at your appointment

The doctor will ask about your symptoms in a calm, private setting. They may also measure your blood pressure and pulse. Most of the time, a clear cause is identified without complicated tests. You will have time to ask questions and discuss management options.

Treatment

Treatment for hot flushes depends on how much they bother you. Many people find relief through simple lifestyle changes. If symptoms are severe, there are medical treatments that can help. Always discuss options with your doctor before trying any medication.

Self-care at home

• Dress in layers so you can remove clothing when a flush starts
• Keep a fan or cold water nearby to cool down quickly
• Avoid triggers like spicy foods, caffeine, alcohol, and hot drinks
• Practice slow, deep breathing when you feel a flush coming on
• Maintain a healthy weight to reduce frequency and severity
• Use cotton bedding and wear breathable fabrics, especially at night

Medical treatments

If self-care is not enough, your doctor may suggest hormone therapy (low-dose estrogen) if it is safe for you. Non-hormonal options include certain antidepressants, blood pressure medications, or nerve pain medications that have been shown to reduce hot flushes. These are only available with a prescription and should be discussed carefully with your healthcare provider.

When is surgery considered?

Surgery is not used specifically for hot flushes. In some cases, if a woman had both ovaries removed, hot flushes may be more severe, and hormonal or non-hormonal treatments can be offered.

Living with this condition

Hot flushes can be managed by being prepared. Carry a small fan, wear light clothing, and avoid rushing. Let your family and coworkers know so they understand. Most people find that hot flushes become less frequent over time.

Lifestyle tips

• Practice relaxation techniques like yoga or meditation to reduce stress
• Get regular exercise, which can improve sleep and reduce flushes
• Avoid smoking, as it can worsen hot flushes
• Limit alcohol, especially before bedtime

Diet and exercise

A balanced diet rich in fruits, vegetables, and whole grains can help. Some people find that avoiding spicy foods and caffeine helps. Regular exercise, such as brisk walking or swimming, can improve overall wellbeing and may reduce the intensity of hot flushes.

Mental health and emotional wellbeing

Hot flushes can be embarrassing and disruptive, leading to anxiety or low mood. Talking to a friend or a healthcare professional can help. If you feel down or anxious, speak to your doctor – they can offer support and, if needed, refer you to a counselor.

Prevention

Hot flushes are a natural part of menopause and cannot always be prevented. However, maintaining a healthy weight, not smoking, and avoiding triggers may reduce how often they happen. If hot flushes are due to cancer treatment, your doctor can help you manage them.

Screening programmes

There is no specific screening for hot flushes. But if you are in perimenopause, your doctor may discuss general health checks like blood pressure and cholesterol.

Complications

If left untreated

• Poor sleep quality leading to fatigue and daytime drowsiness
• Increased risk of depression or anxiety
• Impact on work performance and personal relationships
• If hot flushes are caused by an underlying condition (like thyroid disease), that condition could go untreated

Long-term outlook

For most people, hot flushes improve over time without treatment. Even if they last for several years, symptoms usually become less intense. With simple lifestyle changes or medical help, you can manage hot flushes and maintain a good quality of life.

Find support

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