Hot Flashes: 10 Causes and How to Cope (2024)

A hot flash is a feeling of sudden, intense heat on the upper body that lasts anywhere from 30 seconds to several minutes.

Hot flashes are thought to occur when a drop in estrogen (or changes in other hormones) disrupts the body's natural thermostat, known as the hypothalamus. Other symptoms include sweating, reddening of the skin, headaches, lightheadedness, and heart palpitations.

Hot flashes, also known as vasomotorsymptoms (VMS), are commonly associated with menopause but can also be caused by medication side effects, thyroid or pituitary problems, and certain cancers or cancer treatments. Even males with low testosterone can experience hot flashes.

This article discusses the various causes of hot flashes, why they happen, and how they are treated. It also offers tips on how to cope with hot flashes and when it is time to see a healthcare provider.

Menopause

Hot flashes are one of the most common symptoms of menopause. In fact, more than 80% of people experience hot flashes during menopause, generally when menopause is first starting.

Hot flashes during menopause are due to a decrease in the hormone estrogen. Estrogen has many effects on the human brain and, along with the hormone testosterone, helps regulate a part of the brain called the hypothalamus that acts as the body's thermostat.

When estrogen levels drop, the imbalance in hormones causes the hypothalamus to think that the body is hotter than it actually is. The hypothalamus responds by activating your sweat glands, increasing your heart rate, and widening blood vessels near the surface of the skin to cool the body down.

The sudden flush of heat usually starts in the face or chest and can spread throughout the entire body. Episodes can last anywhere from a few seconds to up to 30 minutes. Hot flashes tend to start abruptly and end just as quickly.

When hot flashes occur at night, they are commonly referred to as night sweats.

While anyone going through menopause can experience hot flashes, there are certain factors that can influence their likelihood, frequency, or severity, including:

• Older age (typically starting in the40s or 50s)
• Obesity
• Cigarette smoking (past or current)
• Current depression
• A history of oral contraceptive use

Prescription Drugs

If you’re experiencing hot flashes, it could be because of a medication you are taking. Some drugs directly affect the balance of estrogen in the body. Others interfere with a system known as the hypothalamus–pituitary–adrenal (HPA) axis.

The HPA axis coordinates communications between the hypothalamus and the hormone-producing pituitary gland and adrenal glands. By constantly looping chemical messages to and from the hypothalamus—and adjusting hormone levels as needed—the HPA axis ensures that the body's systems are in a constant state of equilibrium. This includes your body temperature.

If the chemical messages are in any way disrupted, vasomotor symptoms can occur.

Medicationsthat cancause hot flashes include:

• Calcium channel blockers
• Chemotherapy
• Clomid (clomiphene)
• Depo Provera
• Evista (raloxifene)
• Monoamine oxidase inhibitors (MAOIs)
• Opioids
• Selective serotonin reuptake inhibitors (SSRIs)
• Tamoxifen
  
• Tricyclic antidepressants
• Viagra (sildenafil)

Hyperthyroidism

Hyperthyroidism (overactive thyroid gland) can also cause vasomotor symptoms. The thyroid gland also interacts with the hypothalamus and pituitary gland to ensure that the right amount of thyroid hormones is produced.

The hypothalamus sends signals "telling" the pituitary gland when to produce thyroid-stimulating hormone (TSH), which in turn "tells" the thyroid gland when to start producing thyroid hormones like thyroxine. When enough thyroid hormones are produced, the hypothalamus "turns off" the pituitary gland until more thyroid hormones are needed.

When the thyroid gland is overactive, it can disrupt this loop and overstimulate the hypothalamus, leading to vasomotor symptoms.

Hypogonadism

It is possible for males and females to experience hot flashes as a result of hypogonadism (low testosterone). This is because hypogonadism can lead to estrogen deficiency.

Under normal circ*mstances, a small proportion of testosterone in the body is converted into estrogen. If testosterone levels are low, estrogen levels can also drop. If estrogen levels are exceptionally low, hot flashes can occur.

People with prostate cancer sometimes undergo androgen deprivation therapy to block the production of testosterone that can otherwise fuel the growth of the cancerous tumor. Doing so can trigger hot flashes in three out of four people undergoing deprivation therapy, according to one study.

Anxiety

Anxiety disorders can cause somatic (physical) symptoms like hot flashes, a racing heartbeat, and increased sweating. This is common in people who have panic attacks or post-traumatic stress disorder (PTSD).

During periods of extreme anxiety, the body releases a hormone called cortisol that triggers the “fight-or-flight" response to better cope with the perceived threat.

Among other things, cortisol causes your heart rate and respiration rate to increase to supply more oxygen to muscles. These and other physiological responses can cause the body to spontaneously overheat, leading to hot flashes.

Carcinoid Syndrome

Though rare, hot flashes can be caused by carcinoid syndrome, a condition in which a carcinoid tumor secretes excessive hormones. A common symptom of carcinoid syndrome is flushing, mainly affecting the face, neck, or upper chest.

Flushing with carcinoid syndrome happens when excessive amounts of the hormone serotonin are released. The sudden surge in serotonin triggers a chain of events that causes the widening of blood vessels (vasodilation) and a surge in blood flow under the skin.

Other cancers, such as pancreatic cancer, medullary thyroid cancer, bronchogenic carcinoma (an uncommon type of lung cancer), and renal cell carcinoma (a common type of kidney cancer) can also cause hot flashes.

Infection

Any infection that causes a fever can trigger hot flashes. The body’s temperature can rise as it tries to kill off a viral or bacterial infection. If an infection is the cause of your hot flashes, you may also experience other symptoms such as fatigue, joint aches, and sweating.

There is a wide range of infections that could cause hot flashes, including:

• Urinary tract infection (UTI)
• Tuberculosis (a communicable lung infection)
• Human immunodeficiency virus (HIV)
• Endocarditis (inflammation of the heart muscle)
• Osteomyelitis (a type of bone infection)
• Abscess (a collection of pus caused by infections)

Neurological Disorders

Hot flashes may also be the result of certain neurological disorders (conditions that affect the brain, nerves, and spinal cord). Sometimes, these conditions can interfere with the autonomic nervous system, which helps keep the body’s temperature in check.

For example, people with migraines often experience a feeling of extreme, sudden heat with sweating during the migraine attack.

Other neurologic disorders like Parkinson’s disease and multiple sclerosis (MS) can also prompt symptoms like excessive sweating, sudden body temperature shifts, and skin flushing.

Diet

Your diet also has the potential to cause hot flashes.

Alcoholic beverages can cause an abnormal response in some people that leads to blood vessel dilation and facial flushing. The phenomenon is a type of aldehyde dehydrogenase deficiency (alcohol intolerance) caused by a gene mutation common in people of East Asian descent.

Foods that contain nitrites used in processed foods like hot dogs and deli meats can have a similar effect on some people. The response is thought to be related to a nitrite intolerance rather than a nitrite allergy.

Rosacea

Rosacea is a skin condition characterized by redness and/or bumps on the face along with chronic facial flushing. The condition is characterized by vasomotor instability mainly affecting the forehead, cheek, nose, and skin around the eyes and mouth. Rosacea tends to start in childhood as common facial flushing, often in response to stress.

People with rosacea are encouraged to avoid triggers like hot environments, spicy foods, hot beverages, alcohol, stress, and any medications that cause vasodilation.

How Are Hot Flashes Treated?

While there isn’t a “cure” for hot flashes, there are some ways to relieve the discomfort they can cause. The treatment will vary based on the underlying cause.

Medical Treatment

It’s important to seek a thorough diagnosis to pinpoint the exact cause of your hot flashes. This is especially true if you have symptoms of carcinoid syndrome, severe infections, hyperthyroidism, or anxiety disorders.

In some cases, prescription medications might help ease hot flashes, including:

• Estrogen replacement therapy (ERT)
• Veozah (fezolinetant): Approved by the Food and Drug Administration in 2023, it targets receptors in the brain.
• Brisdelle (paroxetine)
• Antidepressants like Effexor XR (venlafaxine), Paxil (paroxetine), Celexa (citalopram), and Lexapro (escitalopram)
• Neurontin (gabapentin)
• Lyrica (pregabalin)
• Oxytrol (oxybutynin)
• Catapres (clonidine)
  

A procedure called stellate ganglion block may be used to treat moderate to severe hot flashes by injecting an anesthetic into a nerve cluster in your neck. Study results vary, with some people responding better to the nerve block than others.

Lifestyle Changes

If you are dealing with frequent hot flashes, consider making some of the following changes to help ease your discomfort:

• Wear lighter, breathable clothing.
• Use a fan or air conditioner when conditions are warm.
• Stay well hydrated, drinking around eight 8-ounce cups of water per day (or more when overheated).
• Reduce stress levels with mind-body therapies like deep breathing or meditation.
• Avoid alcohol, spicy foods, and excess caffeine.
• Quit smoking.

Talk to your doctor before making any dietary or medication changes, such as cutting back on caffeine, niacin supplements, or OTC fever reducers. The abrupt change in any habit may also trigger vasomotor symptoms.

When to See a Healthcare Provider

There are many different reasons for experiencing hot flashes. While most of them are not serious, you do need to know what is causing them.

If you’re having trouble narrowing the cause, try keeping track of the episodes. List the details about the outdoor and room temperature at the time that you had a hot flash, your diet and activity levels, and any medications that you used. In time, you and your healthcare provider may be able to pinpoint the problem.

See your healthcare provider if you have one or more of these symptoms along with hot flashes:

• They are suddenly becoming more frequent or getting worse.
• They are happening with symptoms of an allergic reaction.
• They are causing you stress and anxiety or interfering with your everyday life.
  

Summary

Although menopause is the most common cause of hot flashes, other situations and conditions can result in them, too. Sometimes, hot flashes are simply a result of sleeping in a hot room, drinking too much caffeine, or using certain medications or supplements. Other times, hot flashes can be a sign of something serious, such as multiple sclerosis or another neurological disorder.

If you have been experiencing hot flashes and you are not sure what is causing them, contact your healthcare provider. Treatments including hormone replacement therapy or the FDA-approved drug Brisdelle (paroxetine) may help.