Hot flashes and what causes them

When estrogen levels drop as menopause approaches, it can disrupt a balance in the body’s temperature regulation. Some people experience this as hot flashes.

Three-quarters of women experience hot flashes in the months or years leading up to menopause.

A hot flash is a sudden intense feeling of heat, sweating and discomfort coming from within, like an internal furnace has been turned on. It typically lasts one to five minutes and usually is felt most strongly over the face, neck and chest. Hot flashes can quicken your heart rate, turn your skin blotchy and red as though you’re blushing, and make you feel anxious.

“You can fan yourself, you can roll the windows down, but it’s not going to matter. It’s not what’s happening on the outside that’s making you hot. It’s what’s happening on the inside,” said Kris E. Barnsfather, M.D., OB/GYN with Norton Women’s Care.

What about night sweats? They are just another name for hot flashes. Because they can wake you up drenched in sweat, night sweats can disrupt sleep, which can affect how well you function the next day.

How hot flashes are felt and how long they last differ from person to person. They may end with the arrival of menopause or continue after menopause.

Are hot flashes disrupting your life? See a Norton Women’s Care Provider

Our team of OB/GYNs provide care based on each woman’s unique needs — during the childbearing years, menopause and beyond.

What causes hot flashes?

Hot flashes happen as estrogen levels decline during the period of time leading up to menopause, called perimenopause. Estrogen is a hormone that plays many roles in the body. Researchers have recently learned that one of them has to do with regulating the body’s thermostat.

As estrogen levels decrease, the part of the brain responsible for controlling the body’s temperature — the hypothalamus — can mistakenly open up blood vessels in the skin and sweat glands to cool the body. This winds up having the opposite effect — making you suddenly feeling hot. It’s only when the hot flash goes away that you may feel chilly.

The hypothalamus is a structure deep in the brain about the size of an almond that is responsible for keeping the body in a stable state. This includes maintaining blood pressure, energy balance and body temperature.

Regulating body temperature can mean producing heat to warm the body or releasing heat through the skin and sweat glands to cool it off.

When estrogen levels drop, it disrupts a delicate balance in the hypothalamus. Estrogen normally quiets neurons in the brain that signal for the body to cool itself off. With lower estrogen levels, these signals become erratic.

“Those neurons start firing at a much more chaotic and rapid pace,” Dr. Barnsfather said. “That’s what causes us to get hot.”

Anxiety or mood changes can trigger hot flashes. Eating spicy foods, or drinking caffeinated drinks or alcohol also can trigger hot flashes.

Obesity and certain lifestyle choices can make the symptoms come sooner and last longer. These include alcohol use, smoking and lack of exercise.

Hot flashes can start as early as age 40 and typically occur over a period of seven to 14 years. They tend to linger two to four years longer for individuals who are Black or Latina.

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