What causes hot flashes apart from menopause? Doctor reveals the conditions to look out for

It may surprise some people that there are actually many causes of hot flashes apart from menopause. It's the most natural link to make since it's estimated that 75% of women this age experience flushes. 

But hot flashes in the years before menopause or in the time afterward are certainly something to be aware of. While it could be something as simple as a complication with prescription medication, some causes of hot flashes apart from menopause are serious underlying medical conditions. If you're experiencing them, visit your doctor. 

As well as advising on the best way to calm hot flushes during menopause and beyond, they can diagnose and offer treatments for possible other causes of the sticky, warm, uncomfortable feeling that's become known as a hot flash. 

What are hot flashes?

A hot flash is a sudden, intense feeling of warmth normally focused around the face, neck, and chest. While they can look a little different for everyone, skin typically reddens and you might start to sweat. 

They're one of the most common symptoms of perimenopause as well. "Around 85% of menopausal women experience hot flushes and night sweats, according to a study in association with Lahore College Women University, which can be extremely unpleasant," says Dr Deborah Lee, a women's health specialist from Dr Fox Online Pharmacy. 

Some women will only get a few mild hot spells, she explains, whereas anyone severely affected by hot flashes could have 50 or more episodes per day. "When severe, the woman often feels dizzy, faint, and unwell, and cannot catch her breath. Hot flashes can occur very close together, making someone feel exhausted a debilitated."

Hot flashes can also occur at night and are often referred to as night sweats in this case. "When they occur at night, people often wake up from sleep, soaking the sheets and nightclothes, such that these need changing," Dr Lee says. "If sleep is persistently disrupted, this leads to insomnia, fatigue, and complete exhaustion."

If these symptoms all sound a little too familiar and you're not perimenopausal or you're postmenopausal, there are other reasons for hot flashes. 

What causes hot flashes apart from menopause?

1. Anxiety disorders and panic attacks

Menopause and anxiety are famously linked, with both likely to contribute to the other. But regardless of whether you're experiencing menopause, anxiety and panic attacks can trigger a hot flash.

"Moderate or severe anxiety symptoms increase the risk of hot flushes between three and five times respectively," explains Dr Lee. "This is down to the overactivation of the sympathetic nervous system, which leads to a surge in the output of adrenaline and makes you feel hot and sweaty with a racing heart."

2. Hyperthyroidism

The thyroid is a butterfly-shaped gland in the neck that produces hormones responsible for various bodily processes, including heart rate and body temperature. Having an excess of the hormone thyroxine is referred to as hyperthyroidism and it can cause the body to overheat. It also increases heat intolerance, says Dr Lee. 

When it comes to locating the cause of hot flushes, it's definitely worth considering this as one of the causes of hot flashes apart from menopause since, according to the NHS, women are 10 times more prone than men to have them - particularly those between 20 and 40 years of age. 

But hot flashes are not the most common symptom of this condition. If you're worried this could be the cause, watch out for other signs, says Hussain Abdeh, clinical director and superintendent pharmacist at Medicine Direct . "This problem may be the issue if your hot flashes are accompanied by symptoms like fatigue, changes in your body temperature, and muscle and joint pain," he says.

3. Carcinoid syndrome

Carcinoid syndrome is a set of symptoms that some women develop when they are dealing with a neuroendocrine tumor, one that typically grows in the bowels or appendix. But it can also be found in the stomach, pancreas, lung, breast, kidney, or ovaries. 

This type of tumor, Dr Lee says, "can affect a variety of organs and it secretes excess serotonin, which causes the skin to flush, blood vessels to dilate, and the skin loses heat."

While they tend to grow slowly, if you are experiencing any of the other symptoms linked with this type of tumor - including stomach pain, rectal bleeding, tiredness, weakness, and/or unexpected weight loss - then it's vital to see a doctor. According to a study by The University of Texas MD Anderson Cancer Center, this syndrome is most commonly found in those with stage one or two cancer and it's more often associated with women than men. 

4. Dumping syndrome

If you've recently undergone any kind of gastric surgery and are experiencing hot flashes, dumping syndrome could be the cause. This is a condition where food moves too quickly from the stomach to the duodenum, a part of the small intestine, causing glucose levels to drop. 

According to research from OBH-Interfaith Medical Center, the condition affects between 20 to 50% of people who undergo the procedure. 

"A sudden drop in blood glucose levels can occur after gastrointestinal surgery," says Dr Lee. "And low blood glucose causes sweating and feeling unwell."

Other causes of dumping syndrome include diabetes, viral illnesses, and idiopathic causes, the research says. But whatever the trigger, while dumping syndrome can be uncomfortable, it's often just treated with dietary changes. Meals should be small and eaten more frequently, and liquids shouldn't be drunk at all in the 30 minutes following a meal. 

"Additionally, simple sugars and milk products should be avoided and protein and fat calories should be increased to compensate for a decreased carbohydrate intake," the study leads concluded. 

5. Pheochromocytoma tumor

Although rare, another type of tumor called a pheochromocytoma tumor could be responsible for hot flushes, Dr Lee explains. 

"It's an adrenal tumor that secretes adrenaline and causes high blood pressure. High adrenaline levels cause increased heat production and result in excessive sweating," she says. 

It's because of the adrenaline surge that we might also experience a hot flush during particularly stressful periods too, which is why it's important to learn how to deal with stress.

6. Prescription medication

Various prescription medications are a common cause of hot flushes apart from menopause. "For example opiates, nitrates, SSRIs, calcium channel blockers, GnRH antagonists, levodopa, antioestrogen, and selective estrogen receptor modulators (SERMs)," recalls Dr Lee. 

It's all to do with how they react within the body. "Opiates cause flushing as they activate histamine receptors. Nitrates cause facial flushing with increased blood flow to the facial skin, and calcium channel blockers cause smooth muscle relaxation and vasodilation resulting in lower blood pressure and flushing," she explains. 

And some medications are more likely to bring on a hot flush than others. "Hot flushes are a specific feature of SERMs, drugs used in the prevention and treatment of breast cancer and osteoporosis. Hot flushes occur for some reason because when the drug attaches to the estrogen receptor, the estrogen receptor has been modified."

How to stop hot flashes

 The best way to stop hot flushes for good is to identify the underlying cause of them, Dr Lee says. "You can then treat the cause and avoid any known triggers."

Most people have hot flushes during menopause and one of the most common ways to treat this is with hormone replacement therapy (HRT), but naturally, if the hot flush isn't caused by age-related hormonal changes, this isn't going to work. 

Dr Deborah Lee lays out the best ways to stop hot flushes in their tracks if you're experiencing them and it has nothing to do with menopause:

• Try to keep cool: "Wear loose-fitting cotton garments, and avoid the midday sun," she says. 
• Use a fan or an air conditioner
• Sleep with the windows open, even in winter if you can
• Try a cold-gel pillow
• Find the best way to reduce stress where possible: "Take up yoga for beginners, meditation, or Tai Chi," she suggests. "Practise breathing exercises twice a day and make sure to exercise regularly."
• Avoid other known triggers like caffeine, alcohol, cigarettes, or spicy food. 
• Keep calm when you have a hot flush, try to breathe slowly and deeply. 
•  Weight loss: A University of California study suggests that menopausal women who are overweight or obese have fewer hot flashes after they lose weight.
•  Cognitive behavioural therapy (CBT): "It's been found to be highly effective in helping to reduce hot flushes," she says. 
• Get some fresh air: "Remind yourself this is natural and that it will pass. The more anxious you get, the worse it will be," Dr Lee advises.