3 most common cause(s)
What are hot flashes?
A hot flash is a sudden and uncomfortable feeling of warmth or increase in body temperature that can last for a few minutes. The sensation is usually most intense in the face, neck, and chest. Your skin may redden, and you may start to sweat. Then, as the hot flash passes, you may have chills.
Night sweats are hot flashes that happen while you are sleeping. They can cause you to sweat a lot.
Hot flashes are a very common complaint of women who are near or in menopause, when estrogen levels decline. But hot flashes can also be caused by hyperthyroidism, certain medications, and pregnancy.
Treatment may include lifestyle changes, hormone replacement therapy, supplements, and other medications, depending on the cause.
Dr. Rx
Patients often describe the hot flashes as coming in waves. They describe it as a sudden heat that starts in their chest and moves upward towards their face. They may also complain that they feel anxious or that their heart starts beating fast. —Dr. Jessica White-Videa
Hot flashes in men
Men can also get hot flashes, but they’re usually caused by low levels of testosterone, the male sex hormone. A decrease in testosterone can occur naturally over time and is a slower and more subtle process than the decline of estrogen in women.
Low testosterone can also be caused by problems in the testicles, which produce testosterone, and by chronic diseases such as diabetes or kidney disease. Low testosterone can also occur in men who are being treated for prostate or testicular cancer because the therapies decrease testosterone to help stop the growth of cancer cells.
Men can be treated with testosterone, though it’s not recommended for low testosterone that is from cancer treatment.
Causes
1. Menopause
Menopause is the time in life when your menstrual period ends. When you haven’t had your period for an entire year, you’re considered to be in menopause. It’s a natural process caused by a decrease in estrogen. Hot flashes are a very common symptom of menopause.
Symptoms
- Hot flashes
- Absent periods
- Mood swings
- Feeling irritable
- Vaginal dryness
- Painful intercourse
- Weight gain, especially in the midsection
- Trouble sleeping at night due to night sweats
Treating menopause
Your doctor may recommend lifestyle changes such as dressing in light layers (so you can easily take off) and avoiding known triggers of hot flashes, like stress, spicy foods, and alcohol. Some women find relief by taking supplements such as black cohosh and dong quai. Always talk to your doctor before taking supplements.
If your symptoms are severe, your doctor may recommend medications that help increase your estrogen levels, known as hormone replacement therapy (HRT). Depending on the types of symptoms you’re experiencing, your doctor will prescribe HRT in a pill, patch, or vaginal ring.
For women who cannot take hormone therapy, one antidepressant, called paroxetine (Paxil), has proven effective in treating hot flashes even if you don’t have depression, according to the North American Menopause Society.
Pro Tip
Not every woman who goes through menopause will have hot flashes. About 20% of women do not experience hot flashes when they become menopausal. —Dr. White-Videa
2. Surgical menopause
Surgical menopause is a term for menopause that happens after both ovaries are removed. Only the ovaries may be removed or it may happen as part of a hysterectomy (removal of the uterus). Some of the reasons your ovaries may need to be removed include large ovarian cysts, a history of endometriosis, or to decrease your risk of ovarian cancer.
Soon after surgery, you may experience menopause-like symptoms, particularly hot flashes. These hot flashes tend to be more sudden and intense than the ones caused by natural menopause. This is because there is a sharp drop in hormone levels after the ovaries are removed.
Symptoms
- Hot flashes
- Absent periods
- Vaginal dryness
- Painful intercourse
- Mood swings
- Feeling irritable
- Weight gain
Treating surgical menopause
It’s important that younger women (under age 50) who have had their ovaries removed talk to their doctors about taking HRT. In addition to easing symptoms, HRT may help prevent future problems related to low estrogen such as heart disease, osteoporosis (bone thinning), dementia, and colon cancer.
3. Perimenopause
Symptoms
- Hot flashes
- Irregular periods (skipping periods for months at a time)
- Weight gain
- Mood changes
Perimenopause is the time before menopause when your ovaries gradually stop producing estrogen. Perimenopause lasts for an average of 4 years, but it can take as long as 14 years. It usually starts in your mid to late 40s.
During perimenopause, hormone production begins to decline and can fluctuate. Often, your period changes, too. You may skip a period or two, it may be longer or shorter, and your flow may become lighter or heavier.
You may experience occasional hot flashes and other symptoms of menopause, like weight gain and mood changes.
Treating perimenopause
If symptoms disrupt your daily life, your doctor may prescribe a low-dose hormonal birth control pill. These can help with hot flashes and also help regulate periods, which can be irregular during this time.
4. Pregnancy
Symptoms
- Hot flashes
- Missed periods
- Nausea
- Vomiting
- Breast tenderness
- Fatigue
Hot flashes can occur during your second and third trimester of pregnancy. During pregnancy, estrogen levels steadily increase, raising your body temperature. Also, blood volume increases, which causes your blood vessels to dilate (widen), including those near the surface of the skin. This leads to increased blood flow, which can make you feel warm or flushed.
Treating hot flashes in pregnancy
Dress in light layers that you can easily take off when you feel a hot flash coming on. Do your best to avoid triggers like stress and spicy food.
5. Hyperthyroidism
Symptoms
- Hot flashes
- Sensitivity to heat
- Fast or irregular heart rate
- Unintentional weight loss
- Irritability
- Restlessness
- Sweating
- Protruding eyes
Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone. This causes an increase in the body’s metabolism, which can lead to hot flashes and make you more sensitive to heat.
Causes of hyperthyroidism include an autoimmune disorder (Grave’s disease) and an inflammation of the thyroid (thyroiditis). It can lead to complications such as heart problems, brittle bones, and eye problems.
Treating hyperthyroidism
Treatment includes anti-thyroid medications and iodine treatment. Sometimes, surgery to remove most of your thyroid may be necessary.
6. Hormone therapy (tamoxifen)
Symptoms
- Hot flashes
- Vaginal dryness
Tamoxifen is a hormonal therapy that can cause hot flashes. It’s given as a treatment for certain types of breast cancer. It is also used to help prevent breast cancer in women who are at very high risk of the disease.
Tamoxifen prevents cancer cells with estrogen receptors from responding to estrogen, causing the cancer to shrink or stop spreading. Women who have surgery to remove breast cancer tumors may take tamoxifen pre- and post-surgery to prevent the cancer from coming back.
Treating hot flashes from hormone therapy
HRT is not recommended if the hot flashes are from taking tamoxifen. Talk to your doctor about non-hormonal options, such as antidepressants like selective serotonin reuptake inhibitors (SSRIs) or the herbal supplement black cohosh.
Other possible causes
Other causes of hot flashes include:
- Pancreatic cancer
- Thyroid cancer
- Thyroid storm (due to untreated or undertreated hyperthyroidism)
- HIV
- Tuberculosis
Pro Tip
Ask your doctor: What are my treatment options? There are different ways to deal with hot flashes. You can make changes to your lifestyle and avoid things that may trigger them. Or you may want to use hormone replacement therapy. —Dr. White-Videa
When to call the doctor
Contact your doctor if your hot flashes are affecting your quality of life or you are getting hot flashes that you don’t think are related to perimenopause or menopause. Men who have hot flashes should always see their doctor.
Should I go to the ER?
Hot flashes aren’t usually an emergency. But if you’re experiencing symptoms of thyroid storm, which includes hot flashes, you should go to the ER because this is a life-threatening condition. Symptoms of thyroid storm include:
- Fever
- Dehydration
- Rapid heart rate
- Nausea
- Vomiting
- Diarrhea
- Irregular heartbeat
- Weakness
- Confusion or disorientation
Treatments
At-home care
- Avoid triggers such as alcohol, stress, spicy food, caffeine, and hot beverages.
- Dress in layers that are easy to remove when you get hot.
- Practice yoga or relaxation techniques.
- During a hot flash, try slow, deep breathing to help it subside.
- Lower the temperature of the room or use a fan.
- Talk to your doctor about taking non-hormonal remedies such as black cohosh.
Other treatment options
- Hormone replacement therapy for hot flashes related to menopause or low testosterone
- Certain antidepressant medications that help with hot flashes
- Acupuncture
- Clonidine (a blood pressure drug) for patients who cannot take hormonal treatments.
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