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Hot flashes: causes and treatment

by Josephine Andrews
Published: Last Updated on 244 views

Most women associate hot flashes and sweating directly with the menopause (climacteric). In fact, almost all menopausal women are plagued by unwanted heat attacks. They are among the five most common menopausal symptoms. Those affected are suddenly hit by heat waves several times a day. You blush and your heart beats faster. Read what else can be behind the hot flashes apart from the menopause and what you can do about it.

quick overview

  • Description: Bouts of heat due to dilating blood vessels and increased blood flow, common during menopause, often accompanied by pressure in the head, discomfort, palpitations
  • Causes: including hormonal changes during menopause, coffee, tea or alcohol consumption, spicy, very hot or difficult to digest food, stress, obesity, certain medications, diseases such as hyperthyroidism , diabetes, allergies or tumors
  • When to the doctor? in severe menopausal symptoms, suspected causes other than menopause
  • Diagnosis: consultation with the patient (anamnesis), physical examination (e.g. gynecological examination if menopause is suspected), further examinations depending on the suspicion, e.g. determination of thyroid hormones, allergy tests, colonoscopy , etc.
  • Therapy: depending on the cause; in menopause eg herbal preparations (with black cohosh, lady’s mantle , etc.), physical procedures (eg mud baths, acupuncture), hormone replacement therapy ; if there are other triggers, the underlying disease is treated
  • Self-help: including airy natural fiber clothing, maintaining or achieving normal weight, easily digestible and lightly seasoned food, relaxation exercises, cool sleeping environment

Hot flashes: description

Hot flashes are not uncommon in women going through menopause . Up to 90 percent of all menopausal women experience the unpleasant flare-ups. However, not every woman is affected by hot flashes with the same frequency, duration and intensity. Some women suffer more, others less.

Hot flashes can attack menopausal women three to 20 times a day. They last a few minutes, sometimes longer. They are often announced by a feeling of pressure in the head or a diffuse discomfort. This is followed by ascending and descending waves of heat that flood the upper body, neck and face.

When such a heat wave suddenly overwhelms you, it is because the blood vessels suddenly dilate and the blood flow to the outer (peripheral) regions of the body increases. As a result, the skin reddens, the skin temperature rises and the women break out in a sweat. Later, the whole thing is reversed: Due to sweating and the drop in core body temperature, the affected women often start to freeze after a hot flash.

The hot flashes are often accompanied by heart palpitations. However, this is not a sign of heart disease, but a natural reaction of the circulatory system. The heartbeat usually calms down quickly. The heat flares can also occur at night and rob women of their sleep. Hot flashes are most common at the beginning of the menopause, after which they slowly decrease. They usually go away on their own after a year or two.

Hot flashes: causes and possible diseases

Hot flashes are most commonly associated with menopause. However, there are other potential triggers such as lifestyle factors, medications, and certain medical conditions.


The exact mechanism by which heat flares occur during menopause is still unclear. What is certain, however, is that hormonal changes play an important role: Experts suspect the trigger to be an increased release of stress hormones such as adrenaline . And this, in turn, could ultimately be due to the drop in estrogen levels associated with menopause. To put it simply: the increasing lack of estrogen appears to be causing the central thermoregulation in the brain to malfunction.


In addition to hormones, other factors can also promote hot flashes. They are more related to lifestyle. Examples are:

  • coffee, black tea, alcohol
  • heavily seasoned foods
  • difficult to digest food
  • too hot food and drinks
  • overweight
  • stress
  • too warm sleeping environment
  • wrong clothes (too thick, not made of natural fibers)


Some medicines are also possible triggers of hot flashes: Medicines against hormone-sensitive breast cancer put women into menopause – this means that hot flashes are possible with these medicines, even in young women.

  • Antiestrogens: Drugs such as tamoxifen or toremifene block the docking sites for estrogen on any cancer cells that may still be present – ​​so they can no longer multiply.
  • Aromatase Inhibitors: They block estrogen production in muscle and fat cells.
  • GnRH analogues: In a roundabout way, they ensure that the ovaries release less estrogen.


In addition to menopause, hot flashes can occur as part of various diseases, including:

  • Overactive thyroid gland (hyperthyroidism): If the organ produces too much of the hormones thyroxine (T4) and triiodothyronine (T3), this accelerates the metabolic processes and leads to hot flashes, sensitivity to heat, rapid sweating and warm and moist skin.
  • Low blood sugar in diabetes: Sweating is a symptom of low blood sugar levels.
  • Allergies: The allergic reaction can cause hot flashes.
  • Tumors of the endocrine system (carcinoids): Here, the cancer from hormone-producing cells usually forms in the gastrointestinal tract. Such tumors can be accompanied by hot flashes.

Hot flashes: when do you need to see a doctor?

Menopause is generally associated with unpleasant symptoms. These include sleep disorders , depressive symptoms, loss of libido, weight gain and heat flares. Hot flashes usually only cause moderate symptoms. However, if the flare-ups (and possibly other menopausal symptoms as well) are so severe that they significantly affect everyday life and quality of life, you should consult your doctor for advice.

If menopause cannot be the reason for the hot flashes, you should also consult a doctor. It is important to rule out possible diseases such as hypothyroidism , diabetes, allergies or tumors as the cause.

Hot flashes: what does the doctor do?

Women with hot flashes are best advised to see their gynecologist, as in most cases menopause is the cause of the unpredictable sweating. If menopause is not the cause of hot flashes, you should see your family doctor first. If necessary, they can be referred to a specialist (e.g. an allergist if an allergy is suspected).

investigations and diagnosis

The doctor will first have the symptoms described in detail in the anamnesis interview. A gynecologist will also inquire about any menstrual disorders. In addition, information about lifestyle, possible underlying diseases and medication can also be helpful, especially if menopause is unlikely to be the cause of the hot flashes.

At the gynecologist’s, the interview is followed by a gynecological examination. Otherwise, a routine physical examination can be carried out (e.g. with blood pressure measurement).

A blood test can also provide clues as to the cause of the hot flashes. Measuring the female sex hormones allows conclusions to be drawn as to whether a woman is going through menopause or not. If an overactive thyroid is suspected, the doctor will pay particular attention to the readings of the thyroid hormones.

If an allergy is considered to be the cause of the hot flashes, allergy tests can provide certainty. Examinations of the gastrointestinal tract (e.g. by means of colonoscopy, computer tomography or magnetic resonance imaging ) can identify hormone-producing tumors as the cause of the hot flashes.


Many women going through menopause want to treat hot flashes gently. Herbal medicine recommends, for example, black cohosh (Cimicifuga racemosa), preferably in the form of finished preparations (tablets) . Other plants such as red clover, soybean, sage , lady’s mantle and yarrow are also often used against hot flashes and sweating during menopause. Their effectiveness is partly unproven or disputed. However, some women report an improvement in symptoms after using such medicinal plants.

Physical therapy methods that can help with hot flashes during menopause are, for example, mud baths and cold – blooded foot baths or partial affusions. Kneipp treatments (e.g. alternating cold and warm showers) also provide some women with relief. Acupuncture is also said to be able to improve the symptoms – but this has not yet been scientifically proven.

If the hot flashes and other menopausal symptoms severely affect everyday life, doctors usually recommend hormone replacement therapy (HRT) . However, the regular intake of hormones should be treated with caution because it is associated with significant health risks. These include breast cancer, cardiovascular diseases and thrombosis. Women should therefore discuss the decision in detail with their doctor and carefully weigh the pros and cons.

If the cause of the hot flashes is hyperthyroidism, cancer or an allergy, the underlying disease must be treated . Then you can get the heat flares under control.

Hot flashes: You can do this yourself

A few simple measures can help relieve hot flashes and sweats:

  • Adapt your clothing to the changing temperature sensations: for example, wear two thin pieces of clothing on top of each other so that you can take off one of them if necessary. The motto here is: dress lightly!
  • Choose clothing made from natural fibers. With textiles made of pure plastic or mixed fabrics, you sweat even more.
  • Eat easily digestible foods such as lots of fruit, vegetables and salads.
  • Avoid spicy food – it will make you sweat even more.
  • Drink less coffee, black tea and alcohol, especially in the evening.
  • Get enough exercise: sometimes a walk in the fresh air helps.
  • Watch your weight. It is best to stay slim or try to shed excess pounds. Overweight people sweat more.
  • Learn a relaxation exercise, such as autogenic training, yoga, or progressive muscle relaxation . This counteracts stress, which can also trigger hot flashes.
  • Sleep in cool rooms and use cotton sheets. A warm environment prolongs the duration of hot flashes. A cool environment, on the other hand, can prevent or reduce hot flashes .

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