Hot flushes, sometimes known as ‘hot flashes’ or ‘hot blooms’, are a common and uncomfortable symptom experienced by many during the menopause continuum. 

They are like unexpected, unwelcome guests that approximately 80% will invariably meet (1). These episodes, frustrating and often overwhelming, can disrupt your daily life, leaving you feeling exhausted and stressed (2). 

Thankfully, you don’t need to suffer. Understanding hot flushes and how to best manage them can empower you to handle them with confidence. Yes, it really is possible. 

What are hot flushes?

Hot flushes are no doubt one of the most recognisable symptoms of menopause. These sensations are characterised by sudden, intense heat in the face, neck, and chest, lasting from a few fleeting seconds up to an hour, though typically a flush will persist for 2 to 4 minutes (3). Individual experiences may vary, but these episodes may be accompanied by sweating, facial redness, nausea, agitation, palpitations, anxiety, and they may disrupt sleep, thus affecting your overall quality of life. 

On average, hot flushes may persist for seven years but can vary significantly in both duration and intensity over time (4). Night sweats can be similar to hot flashes but only happen at night and are accompanied by sweating (yes, very self-explanatory name). Both hot flushes and night sweats are often referred to collectively as vasomotor symptoms. 

What causes hot flushes?

While the exact cause of hot flushes remains largely unknown, it is generally believed that alterations in estrogen levels influence the brain’s temperature-regulating regions (5). 

Imagine it as a type of “misfire” where, in the absence of oestrogen’s moderating influence, the body’s thermoregulatory system becomes hyper-sensitive, reacting exaggeratedly to temperature changes. Because it is an overresponse and you weren’t that hot to begin with, with your body temperature now lower than needed, many experience post-flush chills. 

What triggers hot flushes?

While hot flushes are unpredictable and can happen at any point during the day, several factors can trigger hot flushes, including:

• Consumption of spicy foods, caffeine, and alcohol (6, 7)
• Smoking
• Experience of stress or anxiety
• Presence of certain health conditions, like overactive thyroid, diabetes, and tuberculosis

How can I manage hot flushes?

Hot flushes, though not dangerous, can undeniably impact one's quality of life. Around one in four report that they affect their quality of life (8). The good news? Relief and management strategies are within reach: 

Medical support for hot flushes:

• Hormone Replacement Therapy (HRT): HRT, also called menopausal hormone therapy (MHT) is the gold standard medical treatment and most effective form of medication for hot flushes (9, 10). Not only does it alleviate these discomforting symptoms, but it also provides ancillary health benefits such as improved bone health, and a reduced risk of various conditions including heart disease, osteoporosis, diabetes, depression, and dementia. Of course, the benefits of HRT need to be considered against any risks depending on your individual circumstances. 
• Antidepressants: Certain antidepressants can be effective in managing hot flushes. No, despite the initial impression and potential stigma, taking antidepressants does not mean that you have depression or that your hot flushes are all “in your head”. Instead, that the chemical changes that result in hot flushes appear to involve many of the same neurotransmitters that are involved in depression. These may include citalopram or venlafaxine (9)
• Other Medications: Other medicines that have been developed for other medical conditions, such as epilepsy, pain, and high blood pressure, but have also been found to have a beneficial effect on hot flushes may also be used as alternatives to HRT (11). This might include gabapentin and pregabalin and should be discussed with your healthcare provider to understand the potential side effects and benefits.

Self-care suggestions and natural relief for hot flushes:

• Stress-Reduction Techniques: Practices like mindfulness, deep breathing, clinical hypnosis, and Cognitive Behavioural Therapy (CBT) can help manage the anxiety and stress associated with hot flushes (12, 13). In particular, CBT can be effective in reducing the bothersomeness of hot flushes (14)and The North American Menopause Society recommends CBT as a safe, effective means of reducing negative reactions and helping you feel more in control of hot flushes Thankfully, both Clementine and Stella are your friends here.  
• Regular Exercise: Engaging in physical activity and maintaining a healthy body weight could potentially result in a reduction of hot flushes, although some research is conflicting (15).
• Wardrobe Choices: Dressing in layers of light, breathable fabrics can help you better regulate body temperature when you are experiencing a heat episode.
• Cannabis: Many women have tried cannabis for their menopause symptoms and although more research is needed, some data shows that it may be promising. A small 2022 survey of reported that 79% endorsed it to alleviate menopause-related symptoms (16).
• Limiting Caffeine and Alcohol: Reducing the intake of caffeinated and alcoholic beverages may help in managing hot flushes for some women (6, 7).
• Quit Smoking: Smoking is strongly associated with hot flushes (6).
• Keeping Cool: This might seem self-explanatory, but maintaining a cool environment, use fans, apply cold packs, or use cooling products to help manage your body temperature. Check out Kindra’s Cool Down Mist and BeYou’s Cooling Forehead Patches as great options for immediate relief.

While some find that dietary supplements and botanicals can reduce their hot flushes and night sweats, the UK NICE guidelines does not recommend these products as ingredients may vary, their safety is unknown and most have been poorly studied. They may also interfere with any other medicines you are taking. These may include black cohosh, pollen extract, vitamin E and evening primrose oil amongst others (17)

With the right approach, it is entirely possible to navigate through menopause comfortably and confidently.