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Managing hot flushes during the menopause

Hot flushes have become synonymous with the menopause and are one of the most common symptoms.

middle-aged woman cooling herself with a hand fan indoors

In this blog, we look into the causes of hot flushes and how to live with them during the menopause.

What Are Hot Flushes?

The hot flush is a well known classic menopausal symptom. Hot flushes and night sweats are called vasomotor symptoms and vary immensely in both their severity and duration.

Hot flushes are often described as a sudden and unexpected feeling of heat on the face, neck and chest and can spread all over the body.

It is thought that the level of sweating and relaxation of blood vessels (vasodilation) close to the skin during a 3-minute-long hot flush is like that caused by a 30-minute moderate-intensity bicycle ride.

In fact, hot flushes can increase blood flow on the surface of the skin by 80% and sweating can be five times more than normal!

Not only are hot flushes uncomfortable but they can also lead to a feeling of embarrassment, particularly because of the changes to the appearance of skin like redness and sweatiness.

For many women, they occur occasionally and do not cause much distress. However, for about 20% of women, they can be severe and can cause significant interference with work, sleep and quality of life.

It is estimated that 73% of postmenopausal women experience hot flushes, but this figure could be as high as 80%.

What Causes Hot Flushes?

Declining Oestrogen Levels

Research shows that hot flushes are associated with the falling oestrogen levels in the female body during the menopausal transition.

As your oestrogen declines, alongside other contributory factors, the thermostat in your brain malfunctions so that it thinks your body is overheating when it isn't.

“This leads your brain to switch on cooling down mechanisms such as sweating and blood flow through skin blood vessels (flush) to dissipate heat,” says Dr Curriefounder of Menopause Matters and an associate specialist gynaecologist and obstetrician at Dumfries and Galloway Royal Infirmary. “How this feel varies, as does the severity, duration and frequency of the hot flush.” 

Women are affected very differently during the menopause, and there is no way of predicting how the transition from normally functioning ovaries to the ovaries ceasing to function, and hence decline in oestrogen, will affect each individual.

“It’s important to remember that every woman will be impacted differently by menopausal symptoms, especially as there are so many variables such as diet, lifestyle and life stresses, that can all contribute to your experience,” explains Dr Heather Currie, 

Other Symptoms caused by hot flushes

Dr Currie goes on to explain the impact these symptoms can have on other areas such as your sleep, mood, headaches and heart palpitations.

“If they occur at night, they can disturb your sleep, which can then have secondary effects on your energy, fatigue and mood,” she says.

Normally, there is a daily pattern of rises and falls in your body temperature, being lowest at about 3 am and highest in the early evening. These small changes are not normally noticed, but a menopausal woman may flush with every temperature rise, whether these are normal changes or not; for example, moving between areas of different temperature or having a hot drink.

Hot flushes can also be associated with headaches and palpitations; with approximately 85% of women being affected in some way by these early-onset symptoms, they can feel hard to manage or adapt to.

How Long Do Hot Flushes Last?

In terms of the duration of a hot flush episode, these usually last between three and five minutes.

Hot flushes can last for many years and about 50% of women experience symptoms of hot flushes for around seven years.  Many continue experiencing them in their 60s, and some even longer, so there is a huge variation.

How To Cope with Hot Flushes

Diet & Lifestyle

Simple steps, like wearing loose layers of cotton clothing, rather than man-made fibres and having the bedroom windows open or a fan in your bedroom can help keep you cool.  Other tips to help with hot flushes and night sweats include:

  • Sipping cold drinks
  • Avoid hot showers or baths, in favour of a lukewarm shower or bath
  • Try having sheets on your bed rather than a duvet or try a lighter weight duvet
  • Cold gel packs or spritzing your face with cool water may also help with a hot flush

There are certain factors which can increase the frequency and intensity of hot flushes and avoiding them is probably beneficial, including:

  • Smoking
  • Drinking tea or coffee
  • Alcohol
  • Eating spicy food

Excess caffeine can worsen palpitations, so drink coffee, tea and caffeinated soft drinks in moderation.

Exercise

Did you know you may be able to improve hot flush severity with exercise?

Research has shown that exercise can reduce the severity of hot flushes in post-menopausal women. 30-minutes of moderate-intensity exercise can help and is also a good way to combat other symptoms of the menopause.

HRT And Natural Supplements

Hormone Replacement Therapy is one solution women chose to help manage their symptoms of the menopause.

There are also more natural treatments that may help relieve some of the menopause symptoms, such as Black Cohosh which is known for relieving hot flushes and night sweats.

Read more on Natural HRT Alternatives.

Other Health Effects Of Menopause

Even if you aren’t troubled by hot flushes and sweats, Dr Currie stresses it’s important to know about the other health effects of the menopause.

“Even though some symptoms will resolve themselves, long term oestrogen deficiency can be associated with vaginal and bladder problems as well as increased risk of osteoporosis and heart disease. Making diet and lifestyle changes will improve your later bone and heart health. This includes stopping smoking, maintaining a healthy weight, increasing exercise and reducing alcohol,” she suggests.

For more information on the symptoms of the menopause read our comprehensive Guide To Menopause Symptoms.

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