What Causes Hot Flashes?

3 minute read

By: Barbara Brody|Last updated: May 10, 2022

Is it hot in here — or is it just you?

While that sounds like a cheesy pickup line, it’s not at all unusual for women of a certain age to feel like their body temperature is out of sync with everyone else’s. That discrepancy often happens in sudden bursts: One minute you’re perfectly comfortable; the next you’re flushed and drenched with sweat. Welcome to menopausal hot flashes.

What causes hot flashes isn’t fully understood, but scientists have some solid theories. In short, changes in hormone levels around menopause can mess with your internal thermostat and make it easier for you to go from “I feel fine” to “OMG who cranked up the heat in here?!” in mere seconds. This rapid shift can be uncomfortable, embarrassing, and disruptive, so it’s natural to wonder why it’s happening to you.

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Hot Flash Causes

Menopausal hot flashes most likely stem from the fluctuations in hormone levels that occur as you get closer to the end of your fertile years. When you were younger, your levels of estrogen and progesterone followed a steady, predictable pattern. But during perimenopause — the years leading up to menopause — these hormones can bounce around before they ultimately plummet.

Low estrogen levels, in particular, seem to influence other hormones that control the hypothalamus, the area of your brain that’s responsible for temperature control. These changes may make your hypothalamus think you’re too hot even if your body temperature is pretty normal.

A related problem is that the menopausal transition seems to narrow your “thermoneutral zone”—the temperature range in which you aren’t sweating or shivering. With less wiggle room, even a slight increase in your body temperature can make you feel super steamy. From your body’s perspective, the best way to cool down fast is to start sweating. That’s why blood flow to your skin increases, your vessels dilate, and you perspire (which cools you through the evaporation process).

Some women who experience hot flashes get chills right after the intense blast of heat. Remember: With a narrowed thermoneutral zone, it’s easy to get too hot as well as too cold. If you feel too cold, you might start shivering, which is your body’s way of warming you back up.

Impacts on Menopausal Hot Flashes

About 75 percent of American women experience hot flashes around menopause. If you smoke or your body mass index (BMI) is considered obese you’re more apt to be part of that unlucky majority.

Race and ethnicity seem to play a role, too. Black women are most likely to have hot flashes while Asian women are the least likely group. Recent research, published in the journal Menopause, suggests that specific genetic variants might explain why certain groups of women are more susceptible to hot flashes.

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What to Expect

Menopausal hot flashes can last mere seconds or as long as an hour. But most women report that the discomfort lasts for a few minutes.

While a few minutes of extra heat might not sound too terrible, some women experience hot flashes every single day… or even several times a day. That can be uncomfortable, not to mention embarrassing as you struggle to regain your cool in social and professional settings.

Some simple lifestyle changes like dressing in layers (so you can peel some off as needed) and going easy on alcohol, spicy foods, and caffeine may help. Deep breathing sometimes helps, too.

You might also want to stock up on a few cooling products: think moisture-wicking sheets and pajamas, a portable fan, and maybe even a cooling pillow and cooling jewelry!

Some research suggests that acupuncture might also help with hot flashes, but the evidence is mixed.

Extra Help for Hot Flash Causes

Some women say that a supplement called black cohosh eases hot flashes, though there isn’t any great proof that it makes much difference. As long as your doctor OKs it, it’s probably safe to give it a try if it interests you. Just keep an eye out for possible side effects (especially abdominal swelling or jaundice, which could indicate liver damage) and tell your doctor right away if they appear.

If your hot flashes are very severe and disruptive, your best bet is probably hormone therapy, which entails taking prescription estrogen (along with progesterone if you have a uterus, to reduce the risk of uterine cancer). Low-dose, short-term treatment with hormone therapy is generally effective and safe. The catch is that this menopause treatment might increase your risk of blood clots, stroke, gallstones, heart disease, and breast cancer.

A few other non-hormonal options have also been approved for mitigating menopause symptoms, including hot flashes. Certain antidepressants (SSRIs) such as paroxetine (Paxil), the blood pressure drug clonidine (Catapres), and the antiseizure drug gabapentin (Neurontin) all fall into this category.

Are your symptoms bad enough to warrant a prescription — or might lifestyle changes be sufficient? Tracking your symptoms is a good way to help sort it out. You can go old school with a pen and paper, but online trackers can also help.

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Other Possible Causes of Hot Flashes

If you’re a woman in your 30s, 40s, or 50s who’s experiencing hot flashes, impending or recent menopause is the likely culprit. But there are some other possible explanations you should know about:

Thyroid disorders: An overactive thyroid, a.k.a. hyperthyroidism, may cause hot flashes. Hyperthyroidism might also cause heart palpitations and insomnia, which can be confusing since these symptoms may similarly be related to hot flashes and other menopausal symptoms. If your hot flashes are coupled with unexpected weight loss (and you’re not dieting), your eyes starting to bulge out a bit, or the development of a goiter in your neck, ask your doctor about getting your thyroid checked.

Medication side effects: Antidepressants sometimes cause night sweats, which are hot flashes that happen while you’re asleep. Drugs that dilate blood vessels, such as calcium channel blockers and nitroglycerin for heart disease, also have the potential to cause flushing. If your hot flashes have coincided with taking any new medication, ask your doctor if you might be experiencing a side effect. A tweak to your regimen (changing drugs or lowering the dose) might help.

Cancer: While hot flashes don’t usually signal cancer, there are certain types of cancer that might cause you to sweat more than usual, especially at night. Those include non- Hodgkin lymphoma, Hodgkin lymphoma, leukemia, mesothelioma, bone cancer, liver cancer, and carcinoid tumors. If you’re experiencing hot flashes along with odd symptoms that don’t seem related to menopause—for example, you’re bruising and bleeding more easily or developing fevers when you’re not sick—be sure to tell your doctor.

Cancer treatment can also causes hot flashes, especially for younger women who are abruptly pushed into menopause by chemotherapy or the surgical removal of their ovaries.

Experts agree that for the vast majority of healthy women, supplementing your body's natural hormones is the safest and most effective treatment to ease the vasomotor symptoms of menopause, including hot flashes and night sweats. Head to our product page to check out your options. A menopause-trained doctor will review your choices to make sure you get the right treatment.


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  17. https://www.breastcancer.org/tips/menopausal/treat/hot-flashes/causes

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