During perimenopause — the period before menopause when the body begins its transition out of its reproductive years — which lasts an average of four years, many women begin to experience the cliché symptoms we all associate with menopause. And when it comes to cliché menopause symptoms, hot flashes are the most iconic (who hasn’t seen an image of a feral-looking middle-aged woman fanning herself wildly?). But, even though we think we understand hot flashes before we experience then, they can also seem somewhat mysterious. So what exactly is a hot flash and what causes them? Let’s discuss.
What Is a Hot Flash?
A hot flash is, well, just what it sounds like. It’s a sudden feeling of heat in the upper body, particularly the face, neck, and chest. During a hot flash, it’s common to become flushed (a temporary reddening of the skin in the affected area) and to sweat. Hot flashes can happen anytime, even at night and while you’re sleeping. when hot flashes happen during sleep, we call them “night sweats.”
Other symptoms associated with hot flashes include:
● Red, blotchy skin
● Rapid heartbeat
● Perspiration (mostly on your upper body)
● Chills as the hot flash ends
● Feelings of anxiety
The intensity of these symptoms varies from woman to woman. Some may experience relatively mild hot flashes, while for others, hot flashes are so intense they get in the way of living life to the fullest.
How Long Do Hot Flashes Last?
This is a question with two different answers, really, so let’s break it down:
How long is a hot flash?
When you’re having a hot flash, it can feel unbearable and like it’s never-ending. In reality, individual hot flashes are, thankfully, pretty short-lived and typically last somewhere between 30 seconds and, on the upper end, up to around five minutes.
How long do most women experience hot flashes?
You may have heard that hot flashes related to menopause typically stop after 6–24 months. For a long time, that’s been the conventional wisdom, even among healthcare professionals. Unfortunately, new research has revealed that most women who have hot flashes and night sweats during menopause deal with them for much, much longer — seven years on average, in fact. Research also indicates that, for some women, hot flashes continue for 11 years or even more.
How Common Are Hot Flashes?
Not every woman will experience hot flashes during perimenopause and menopause, but the odds of being in that lucky group aren’t great. Hot flashes are among the more common menopausal symptoms, with as many as 75% of all women experiencing them to some degree during their menopausal transition through their early postmenopausal years. And if you do experience hot flashes, the good news is you probably won’t experience them daily but they may fluctuate in frequency and intensity over time.
What Are Risk Factors of Hot Flashes?
Unfortunately, the exact cause of hot flashes is still unknown, but there are some factors that are associated with an increased likelihood of experiencing them. According to the Mayo Clinic, the following are risk factors associated with hot flashes:
- Smoking: Women who smoke are more likely to get hot flashes.
- Race: More black women report having hot flashes during menopause than do women of other races. Hot flashes are reported least frequently in Asian women.
- Social determinants of health — lower socioeconomic status, lower level of education, and ACEs (adverse childhood events)
- Mental health — stress, depression and anxiety
- Caffeine intake
- Warmer weather
Can Hot Flashes Be Treated?
If your hot flashes are intense and you want some relief, you can talk to your doctor about treatment options.
Hormonal Therapy to Treat Hot Flashes
Hormonal therapy works by steadying the levels of estrogen and progesterone, which fluctuate greatly during perimenopause and menopause, causing many of the symptoms associated with the menopausal transition. It’s important to note, however, that there are several health risks associated with hormonal therapy, including increased risk of heart attack, stroke, blood clots, breast cancer, gallbladder disease, and dementia.
Non-Hormonal Medication Treatment for Hot Flashes
If you don’t want to take on the risks associated with hormonal therapy, but still want extra help managing your hot flashes, talk to your doctor about non-hormonal medication options. Specifically, some antidepressants could help manage hot flashes. The FDA has approved paroxetine, a low-dose SSRI antidepressant, for use treating hot flashes. Citalopram, escitalopram and venlafaxine and also used. Other options include gabapentin and pregabalin. Of course, any medication has potential side effects and you should talk to your doctor about them and weigh them against the benefits, before taking a new medication.
Lifestyle Changes to Treat Hot Flashes
You don’t necessarily need to take hormones or other medication to get some relief from hot flashes, or at very least help in managing them. There are lots of lifestyle changes you can make to help in managing hot flashes, including:
- Avoiding alcohol, spicy foods, and caffeine, all of which can make menopausal symptoms worse for some women.
- Dressing in layers, so you can remove outer layers during hot flashes to help regulate your temperature and comfort.
- Avoiding smoking, which makes menopausal symptoms worse.
- Maintaining a healthy weight.
- Practicing yoga or meditation, which early research suggests may help improve menopausal symptoms overall.
- Trying hypnosis, which studies have shown to reduce the frequency and intensity of hot flashes.
The information provided on StateOfMenopause.com is not intended and should not be construed as medical advice, treatment, or diagnosis. Always seek the guidance of a qualified healthcare provider with any questions or concerns regarding your health.