While they are completely normal, they can be uncomfortable at best - and debilitating at worst. Knowing what can trigger them is key, as well as how certain lifestyle changes can impact their severity.
What are hot flushes?
If you’re menopausal and regularly fling open the window, or wake up drenched in sweat – it’s likely you’re having hot flushes.
A hot flush varies from woman to woman, but they are usually recognisable by a sudden, creeping feeling of intense warmth or heat. They can often come from nowhere and quickly spread through the face, neck, chest and body. Sweating, palpitations, or dizziness may accompany them too.
"Hot flushes can last anything from a matter of seconds or up to an hour," says Dr Louise Newson GP and author of Menopause (£9.74, Haynes).
For some women they’re mild, but others say their flushes, make them feel like they’re trapped in a furnace.
Regularly feeling hot and flustered can disrupt daily routines and knock confidence levels, so it’s no wonder this is one of the most bothersome symptoms for women going through the menopause.
And although hot flushes – or hot flashes as they’re also known, are a common menopausal symptom, they can also occur for other reasons.
What age do hot flashes start?
Hot flushes tend to start with the onset of the menopause. "The average age of the menopause for UK women is 51," says Dr Newson.
Genetics, underlying medical conditions and treatment for cancer could cause the menopause to start earlier.If the menopause begins before the age of 45, then it is considered early menopause.
It is common to experience hot flushes during peri-menopause too. This is the transition period before the menopause when hormone production decreases and a woman may begin to have symptoms.
Taking into account peri-menopause, this means it’s possible for hot flushes to begin anytime between the ages of 45 and 55.
How many hot flushes a day is normal?
Every woman will experience menopausal symptoms differently. This means there’s no ‘normal’ when it comes to the frequency of hot flushes.
Having between five and ten flushes a day is considered to be average, but some menopausal women will suffer with more than this throughout the day and night.
Other women report having with no flushes at all, or having only a few, very mild flushes as they go through the hormonal transition.
Kim, 56, from the Midlands, found her hot flushes increased over time. “At first I would only experience mild flushes once or twice a day, and they would be worse if I had drunk alcohol,” she says.
“However, after a couple of years they became much more regular and severe. Some days I would lose count – it felt like I was permanently on fire. It was the frequency of these hot flushes that prompted me to see my GP about menopause treatment.”
Hot flushes triggers: the main culprits
Alcohol causes the blood vessels to expand in the body and the increases blood flow in the vessels makes you feel hot and causes the skin to flush. All types of alcohol can bring on a flush, but red wine in particular is a known trigger. Switch to drinks with a low-alcohol content, or drink spritzers to reduce your intake.
Sweating is also common with a hangover, – if you are going through the menopause, drinking alcohol may contribute to uncomfortable night sweats.
Some food ingredients and spices can bring on a hot flush. This is due to a ‘fiery’ food compound called capsaicin that is found in peppers and chilli powder.
A cup of coffee leaves you feeling alert and raring to go, but it might also cause a hot flush. Caffeine speeds up the heart rate, so blood is pumping through the body faster, causing you to feel hotter.
Other common triggers include:
- hot food and drinks
- tight clothing
- hot baths
- using a hairdryer
Identifying and steering clear of your own ‘triggers’ can help to reduce the frequency and severity of your flushes.
How can you treat hot flushes?
Often the first line of treatment for women suffering with menopausal symptoms, HRT (Hormone Replacement Therapy) could be an option if you’re suffering from hot flushes. One US study found that low-dose estradiol – which is a form of oestrogen, the female sex hormone, helped to reduce hot flushes by 50%.
Other types of HRT such as combined HRT patches that contain both oestrogen and progestogen are also effective.
Speak to your GP to find out if it’s the right option for you.
If you don’t want to take HRT, other prescription medicines, including certain antidepressants and clonidine (usually prescribed to help with blood pressure) might help.
Heat triggers flushes for some women. Using a fan and taking cooler baths and showers can help. Wear layered clothing and switch your duvet for layers of sheets too. And weird as it sounds, some women wear socks to bed to lower their core body temperature!
You could also try cooling gels or placing a cold compress on the back of your neck when you feel a hot flush coming on.
Try relaxation and meditation tactics
Some women will do slow, deep abdominal breathing to ease symptoms. Try 15 minutes in the morning and evening, as well as when a hot flush starts, to help control the severity. Meditation, yoga or tai chi also helps in some cases.
Target your diet
Phytoestrogens are found in plant foods like soy beans, chickpeas, lentils, ground flaxseed and red clover. These natural compounds have a similar chemical makeup to oestrogen, and as a result there's some evidence that eating foods rich in phytoestrogens can help to reduce the frequency and severity of hot flushes.
Women’s heath specialist Dr Sally Moorcroft suggests eating green vegetables daily as they’re packed with magnesium. She also advises drinking Kefir for gut health. ‘A happy gut health to less inflammation in the body, which can reduce your symptoms,’ she says.
The adaptogenic herbs Ashwagandha and Tulsi may help to reduce the effects of stress on the body, and reduce flushing. Try Pukka Organic Tulsi Clarity Herbal Tea (£2.80 for 20 sachets).
Supplements for hot flushes
Non-prescription medications and menopause supplementsmay help with hot flush symptoms.
Folic acid: Taking 1 mg folic acid a day has been found to reduce the severity, duration and frequency of hot flushes
Vitamin E: Taking 400 IU Vitamin E a day has also been found to reduce the severity and frequency of hot flushes
Ibuprofen: Some women find that taking an anti-inflammatory non-steroidal painkiller like ibuprofen relieves their hot flush symptoms
Hypnosis helps hot flushes and night sweats. “It can also be beneficial for anxiety or low mood that accompanies them,” says Dr Caroline Houlihan-Burne, clinical hypnotherapist at The Princess Grace Hospital.
During an appointment, you discuss your symptoms, then have a session of around 15-25 minutes. Once you understand the practice, self-hypnosis is a helpful tool.
“Close your eyes, breathe deeply and count down from 10 to one on each out breath. Repeat a positive suggestion in your mind, such as ‘I’ll remain cool and calm all day’. When you’re ready to come out of self-hypnosis, count from one to 10. On the count of 10, your eyes will open and you’ll come out of the trance,” says Dr Houlihan-Burne.
Cognitive behavioural therapy is a form of talking therapy. It identifies negative thought patterns to create positive changes in feelings and behaviour. It’s particularly effective during the menopause, explains clinical psychologist professor Myra S Hunter.
“CBT has been found to help women handle hot flushes and night sweats, as well as improve mood, sleep and quality of life,” she says.
It’s available on the NHS without a referral from your GP, visit nhs.uk, or find a private therapist at cbtregisteruk.com.
A study found that women given 15-minute sessions of acupuncture weekly, for five weeks, were significantly less troubled by hot flushes.
So, how does it work? Mark Bovey, head of research at the British Acupuncture Council explains: “Acupuncture’s effect on neurotransmitters linked to pain relief and mood regulation may influence the thermoregulatory centre in the hypothalamus region of the brain.”
Visit acupuncture.org.uk for more information.
This herbal medicine is in the same plant family as the buttercup and is used by some women to help hot flushes and night sweats.
These are a type of phytoestrogens similar to natural oestrogen and are found in red clover. Some women take isoflavones to reduce hot flushes, but they are not recommended if you have a history of breast cancer.
Don quai, evening primrose oil or kava have also been used by women to treat hot flush symptoms, but there’s currently little evidence to support their effectiveness.
Always talk to your doctor before trying a complimentary medicine. Some may interfere with other medications, or cause side effects.
TheraPearl cooling neck wrap
£15.43, amazon.co.uk Cold therapy packs can reduce the severity of a hot flush – keep this gel-bead cold compress in the fridge for instant relief when one strikes.
Handheld and foldable desk fan
£12, John Lewis A cooling companion that you can use at home or on-the-go. This 3-speed fan is surprising quiet and can be charged via a standard USB port.
Anti-Flush short sleeve night dress
£44.95, webecome.co.uk This super-soft night dress boasts anti-flush technology to cool the skin and wick away moisture while you sleep.
Hot & Not duvet
from £50, nanusleep.co.uk Are menopausal night sweats creating ‘too hot, too cold’ cover squabbles with your partner? You can customise each half of this duvet to your perfect sleeping temperature.
Schwabe Pharma MenoMood tablets
£15.38, amazon.co.uk This herbal remedy contains Black Cohosh to help with hot flushes.