Hot Flashes After Menopause: Symptoms, Triggers & Prevention

Last updated 11.28.2023 | by Sabrina Johnson | 16 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Hot flashes are deemed the most common symptom of menopause. While conversing with a doctor friend the other day, the latter said that most women cannot think of anything else associated with menopause beyond hot flashes. For many, that’s the only symptom. Did you know that 75% of females have hot flashes when transitioning into menopause?

To elaborate, it is eight of every ten women experiencing hot flashes. If you think you are the only one with severe episodes of hot flashes disrupting your daily life, then let me assure you that you aren’t alone. 10-15% of women have mentioned having severe hot flashes that prevent them from conducting their regular chores with ease.

I had my first hot flash at work after a hot lunch. My sister experienced it just as she was preparing to retire to bed. Every woman has a different hot flash story to share. So what’s your story? Do you know anyone who was spared from hot flashes? Well, that’s an infrequent occurrence in just two of ten women.

Your curiosity about hot flashes won’t end so soon. Right? If you wish to know more about hot flashes, their symptoms, or whether they end with menopause or not, then you should give my write-up a read. I have covered what hot flashes are, their symptoms, causes, duration, and management procedures. Read on to know more:

What Are Hot Flashes?

Those who have gone through hot flashes are aware of what they are. It’s a phenomenon where one may experience a sudden warmth in the upper body. The hotness is mostly confined to the face, chest, and neck. The skin appears reddened like you were blushing. When the body is overheated, it could result in sweating and, eventually, a chilled feeling.

When I had my first hot flash, I, too, felt the same way. A flushed feeling on my face and neck, followed by a lot of perspiration.

Why Do You Get Hot Flashes During Menopause?

In the transition or perimenopause phase, the ovaries do not release as many eggs as before. In menopause, the egg production of the ovaries stops completely. There is also a decline in estrogen levels in perimenopause, which reduces drastically with menopause.

The estrogen not only looks after reproductive health but has a whole lot of other functions as well, like managing your nervous system, cardiovascular health, and so on.

The hypothalamus is the part of the brain that helps in controlling your body temperature. When the hypothalamus senses that you are hot, it signals the sweat glands to cool you down by making you sweat. Similarly, when the hypothalamus understands that you are cold, it signals the muscles to create warmth by making you shiver.

Estrogen plays a significant role in regulating the hypothalamus. However there isn’t any concrete reason as to how low hormone levels lead to hot flashes. Yet, it has been suggested through most research that a reduced estrogen level makes the hypothalamus oversensitive to the slightest change in your body temperature.

If the hypothalamus thinks you are warm, it will begin its action to make you cool. The outcome is the bouts of hot flashes you experience before, during, and even after menopause (to some extent).

How Do You Feel During a Hot Flash? The Possible Symptoms

As I have always mentioned, no two women are similar when it comes to their hot flash experience. It varies in severity, intensity, and frequency. In some, it may be so mild that they’ll barely feel any change. A few women may experience severe bouts of the same.

A friend of mine would feel just a little bit of warmth on her face each time she had a hot flash that would subside in a couple of seconds. In contrast, my sister would sweat severely during a hot flash that would leave her awake the entire night. Each episode would make her so drenched that she would be compelled to change her clothes and sheets. She would have it at least three to four times a week in the initial years, which made it a challenge for her to do her daily work with ease.

Severe hot flashes could trigger palpitation in some. If hot flashes cause palpitation, the heart rate increases rapidly by 8-16 beats. A study conducted on women between 45 and 55 years showed that the number of women experiencing palpitation during hot flashes ranges between 18.6% and 46.8%.

Hot flashes could occur at any time of the day. I mostly had mine in the afternoon. But hot flashes occurring at night during sleep are called night sweats.

So, to sum up, the symptoms in a nutshell, they include:

  • The feeling of warmth across the face, chest, and neck
  • Increased heartbeat
  • Palpitations
  • Red and blotchy skin
  • Increased anxiety
  • Sweating

How Long Does A Single Episode of Hot Flash Last?

The period of a single episode of hot flashes varies from one woman to the other. It could last for an extremely short span of just 30 seconds. At times, it may prolong to around 5 minutes or even a little more. Fortunately, each hot flash episode for me wouldn’t last for more than 30 seconds.

Few women could get hot flashes for a couple of days a week. Some women could get it daily. In cases of severity, medical experts suggest that hot flashes could occur 4-5 times hourly, up to 20-30 times daily.

When Do Women Start Getting Menopause-Related Hot Flashes?

Menopause-related hot flashes start during the transition phase, i.e., in perimenopause. Most of the symptoms are seen in women between 40 and 44. That’s when perimenopause starts, on average. However, in some, the symptoms could occur earlier, when they are in their 30s or a little late, in their 50s.

Do Women Continue to Get Hot Flashes After the Menopause Phase?

After menopause, hot flashes seem to go away on their own in the case of most women. That doesn’t happen immediately, though. However, in some, hot flashes could stay for several years, postmenopause, perhaps until they step into their 60s and 70s. Hot flashes are said to occur frequently in the first 2 years of the postmenopause phase and then eventually subside.

Though 6-24 months was the average time frame for hot flashes, recent studies provide a different estimation. It mentions that hot flashes may last 7 years on average or sometimes even extend to 11 years.

Sometimes, hot flashes can be prolonged. I was reading some stuff the other day, and I came across that some women may experience hot flashes in their 60s, 70s, and, surprisingly, even in their 80s.

A new study on hot flashes conducted by the Mayo Clinic had around 5000 women as participants. Women who were more than 40 years of age had moderate or severe hot flashes. They were married or committed and not in the best of their health. Those with induced or surgical menopause also reported an increased incidence of hot flashes in their 60s. Caffeine was one of the main causes of hot flashes in women over 70.

I would also like to bring forth the findings of another interesting study conducted on 415 women aged 85. The results deduced that around 29 women had hot flashes during the day or day and night. Around ten of them went through moderate to severe hot flashes.

So, from what has been discussed above, it is clear that hot flashes lessen in severity with age. But, in some, it may continue for a really long time. A lot depends on one’s lifestyle as well.

What Are The Triggers of a Hot Flash?

What Are The Triggers of a Hot Flash

The low estrogen levels are responsible for the hot flashes, as mentioned above. Yet, if you have recurring bouts of it, even when you are way past the menopause phase, you need to figure out what exactly is going wrong. Perhaps you aren’t living a healthy life. Or, you could be suffering from an underlying medical condition.

Whatever it may be, you must find the trigger causing the hot flash. It will be easier for you to address the problem and find a solution. Let’s look at the triggers that aggravate hot flashes, making you feel immensely miserable.

1. Alcohol

One of the main triggers of hot flashes in women is alcohol. In menopause, your brain does not regulate the body’s internal temperature well due to the low estrogen levels. Alcohol consumption at this time further impacts the body’s thermoregulatory activity, worsening hot flashes.

Studies conducted on women in the perimenopause and postmenopause phases showed that alcohol use increases the risk of hot flashes. As per a survey conducted on 293 women between 45 and 55, women consuming alcohol daily had an increased occurrence of night sweats and hot flashes.

A friend mostly experienced hot flashes each time she had alcohol at night. She would drink to soothe her mind, but it backfired, and she ended up feeling more miserable. The doctor advised her to refrain from consuming alcohol, even a small amount, till the time she was able to manage her flashes.

Red wine is said to aggravate hot flashes immensely. So, those prone to increased episodes of hot flashes need to be cautious about the same.

2. Spicy Foods

Suppose your meal is incomplete without jalapenos, cayenne, and hot peppers. In that case, you need to give it a second thought, especially if you are in perimenopause or have hit the menopause phase.

Your hot flashes could elevate even more when you eat spicy food. The main reason for the same is capsaicin, which accounts for the heat in the dish. This capsaicin has vasodilating properties that expand blood vessels, triggering hot flashes and sweats even further.

I was a jalapeno fan until I had my first hot flash. Each time I ate it, I would feel hotter. So, I have consciously attempted to avoid jalapeno and other spices that would make me hot.

3. Smoking

Smoking comes with many after-effects, and the risk is even greater when you are in menopause. If you’ve been a smoker all your life, you may have increased bouts of hot flashes in menopause and even the period after that. A study way back in 1962 showed that around 20% of a total of 650 smokers were at risk of early menopause. Whereas of the 5000 nonsmokers, just 1.7% had early menopause.

4. Tight-fitted Clothing

Wearing tight-fitted clothes will make your hot flashes worse. It’s because tight-fitting clothes restrict blood flow and irritate the skin by causing friction.

Keep your style statement intact, but take care of your comfort level, too. Go for loose-fitting clothes and those with breathable fabrics. Silk satin is a perfect fabric for hot flashes. It’s soft and comforting on the skin. At the same time, it has an immense moisture-absorbing ability.

5. Caffeine Intake

An increased caffeine intake is considered another trigger for hot flashes, making them increasingly severe and even disrupting sleep, as shown through studies. However, there have been many contradicting studies regarding caffeine’s impact on vasomotor symptoms (hot flashes and night sweats).

I was recently going through a study conducted on 2507 women in the menopausal phase. It mentioned that women consuming caffeine could be troubled with more hot flashes. However, they experienced less stress and concentration issues.

Still, I would say limit your caffeine intake when you are in your 40s. You should do that even more if you are troubled with frequent hot flash episodes.

6. Stress

Hot flashes in menopause are inevitable; if your stress levels are high, they will be triggered further. The body enters a fight-or-flight response mode when you are stressed or anxious. There is also an increase in cortisol levels. More cortisol means severe bouts of hot flashes. With so much happening around, staying calm may be a challenge. Yet, I would say try to control the anxiety levels by doing what gives you happiness. Relaxation techniques will also be of greater help.

To manage my anxiety when I was going through menopause, I joined a zumba class. We were a big group. We danced together and shared each other’s woes as well. This helped me immensely.

7. Heat

If the weather is too hot or your body is overheated because of strenuous exercise or activity, it may make you feel warm and overheated. Also, it could worsen your hot flashes even more.

Treatment to Prevent/Lessen Episodes of Hot Flashes in And After Menopause

Hot flashes can be managed in several ways. Altering your lifestyle or food habits may lessen the severity. However, in case you can’t control your hot flashes and they keep getting worse after your menopause, then medical intervention may be needed.

1. Hormone Replacement Therapy

Medical practitioners often prescribe HRT (hormone replacement therapy) for hot flashes. This method of treatment is debatable. However, through this therapy, the estrogen and progesterone levels in the body are stabilized to a certain extent.

It is said to help lessen the severity of several symptoms of menopause, like hot flashes, night sweats, bone loss, sleep difficulties, and vaginal dryness. Hormone treatments are available in different forms. These include rings, patches, pills, creams, gels, and implants. However, before going for it, women should talk to their healthcare provider about the risks associated with hormone therapy. They could be associated with breast cancer, stroke, blood clots, dementia, and gallbladder disease.

2. Medicinal Treatment

When hot flashes come in the way of your daily living, your doctor might even prescribe you medicines that could help control the hot flashes to a certain extent. Most of the prescribed medicines are antidepressants that help to lessen hot flashes and even deal with sleep problems.

The commonly prescribed ones include:

  • Gabapentin
  • Escitalopram
  • Clonidine
  • Paroxetine
  • Fluoxetine
  • Venlafaxine
  • Desvenlafaxine

Though these medicines provide relief, you should remember that each one of them has side effects like:

  • Nausea
  • Dry mouth
  • Weight gain
  • Fatigue
  • Low sex drive
  • Inconsistent bowel movement
  • Headache
  • High or low blood pressure
  • Drowsiness

So, never take these medications until prescribed by the doctor. Also, make sure that you strictly follow the recommended dosage.

3. Herbal Remedies

Herbal remedies have been considered effective in managing hot flashes and the associated symptoms.

  • Evening Primrose Oil – One study speaks about the benefits of evening primrose oil for providing relief from hot flashes in menopause.

Besides its oral use, it can be applied topically as well. However, you must also take into consideration the side effects of evening primrose oil. These include abdominal pain, headache, nausea, diarrhea, stomach upset, and allergic reactions.

  • Black Cohosh – This has been found to have positive effects in lessening the vasomotor symptoms that trouble you most during menopause – night sweats. Studies have also shown the effectiveness of black cohosh in reducing body and muscle pains during menopause.

Black cohosh’s stems and roots are marketed as teas, powders, and capsules. You could take them in any form to combat hot flashes. Take extra care about the doses. The common side effects include stomach upset, feeling of heat, sweating, and palpitations.

4. Acupuncture

Many women aren’t keen to go for hormonal therapies to deal with the troubling symptoms of menopause. Many have said to resort to acupuncture which is an alternative medicine. Besides hot flashes, acupuncture has also been said to positively affect other menopausal symptoms like mood swings, sleep disorders, etc.

A study conducted on 70 women having moderate to severe symptoms of menopause showed that those who underwent acupuncture for 5-weeks had reduced incidences of hot flashes, mood swings, sleep problems, and night sweats.

5. Plant Estrogens

Some plants contain phytoestrogens, a compound that mimics the functions of estrogens. The four compounds grouped as phytoestrogen are lignan, isoflavones, coumestan, and stilbene. Studies have shown that phytoestrogens can lessen the severity of hot flashes. Including foods with phytoestrogen properties would be better than going for supplements. The foods rich in phytoestrogen are

  • Lentils
  • Cruciferous vegetables
  • Flaxseeds
  • Red clover
  • Beans
  • Grains
  • Fruits
  • Chickpeas

How to Manage Hot Flashes at Home During and After Menopause?

Besides the medicinal treatments, there are several ways in which you can manage hot flashes at home. Let’s take a look at some of the useful tips.

  • If hot flashes are bothersome, the first thing that you must do is to stay cool. Make sure you keep a glass of cold water by your bedside and drink it in sips before bedtime, especially if you have hot flashes at night. A chill pillow filled with water or other cooling components that help to remain cool is another great option.
  • Besides wearing loose-fitting clothing, dressing in layers is also important to manage hot flashes. Wear an open cardigan over your cotton shirt in a cold ambiance for warmth. You could take off the cardigan if hot flashes strike. Again, if you feel chilled after the flashes and sweat, you could wear the cardigan for comfort.
  • Ensure that the room where your work or sleep is well-ventilated, with the windows open and a fan close to you.
  • Exercise regularly. It may be a combination of many things like dancing, jogging, bicycling, swimming, or walking.
  • Practicing meditation and relaxation techniques is extremely helpful for hot flashes. In fact, breathing in and out for 15 minutes each morning and evening will help lessen the frequency of hot flashes. I benefitted from it greatly.
  • Reduce your caffeine and alcohol intake and even quit smoking.

FAQs

Q. When to see a doctor regarding your hot flashes?

When hot flashes are severe to the extent that you get them every other day, and they come in the way of your daily life, then a doctor’s consultation is necessary.

Q. Why do women keep getting hot flashes even after their menopause?

Low estrogen levels are the main reason for hot flashes. After menopause, the ovaries stop making estrogen, and the levels dip drastically. The body takes time to cope with the low hormone levels, leading to frequent hot flashes. However, with time the severity and frequency lessen. Yet, it could continue in some women until their 70s or even lifelong.

Q. Do you have hot flashes only due to menopause?

Though menopause is one of the main reasons for hot flashes, there are other causes, like thyroid problems, cancer, or the side effects of medicines.

Conclusion

Though you cannot do anything about getting hot flashes, you could take initiatives from your end to lessen its severity and frequency. Maintaining a healthy lifestyle which includes eating and exercising well, should be high on your priority list. I altered my lifestyle a lot since my first hot flash. It had come of immense aid indeed.

Did you find this article helpful? Did you find the answer you were looking for? Do share your thoughts in the comments section below.

References:

  1. ncbi.nlm.nih.gov
  2. Acupuncture for Menopause: How This Alternative Therapy Brought Me Relief
  3. ncbi.nlm.nih.gov
  4. ncbi.nlm.nih.gov
  5. clevelandclinic.org
  6. nia.nih.gov

Author

  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.