What are Hot Flashes?

Hot flashes are the most common symptom of menopause and perimenopause. More than two-thirds of North American women who are heading into menopause have hot flashes. They also affect women who start menopause after chemotherapy or surgery to remove their ovaries.

What Is a Hot Flash?

It's a sudden feeling of heat and sometimes a red, flushed face and sweating. We don't know exactly what causes them, but they may be related to changes in circulation.

Hot flashes start when blood vessels near the skin's surface widen to cool off, making you break out in a sweat. Some women have a rapid heart rate or chills, too.

When they happen while you sleep, they're called night sweats. They can wake you up and may make it hard to get enough rest.

A hot flush is a hot flash plus redness in your face and neck.

How Long Will You Have Them?

That depends. About 2 in 10 women never get hot flashes. Others have hot flashes for only a very short period of time. Still others can have them for 11 years or more. On average, however, women get hot flashes or night sweats for about 7 years.

Prevention

There’s nothing you can do to avoid hot flashes around menopause. But you can stay away from triggers that may make them more frequent or more severe. Common ones include:

• Stress
• Caffeine
• Alcohol
• Spicy foods
• Tight clothing
Heat
• Cigarette smoke

What Can You Do

Stay cool. At night, a "chill pillow" filled with water or other cooling material might help. Use fans during the day. Wear lightweight, looser-fitting clothes made with natural fibers such as cotton.

Try deep, slow abdominal breathing (6 to 8 breaths per minute). Practice deep breathing for 15 minutes in the morning, 15 minutes in the evening, and when a hot flash starts.

Exercise daily. Walking, swimming, bicycling, and dancing are all good choices.

Plant estrogens, found in soy products, may have weak estrogen-like effects that could cut hot flashes. Doctors recommend you get your soy from foods like tofu and edamame rather than supplements. Some studies suggest black cohosh may be helpful for 6 months or less. Botanicals and herbs may have side effects or change how other medications work, so ask your doctor first.

Treatments

Some women can wait out hot flashes with no treatment.

If they're bothersome or causing trouble for you, talk to your doctor about taking hormone replacement therapy, or HRT, for a limited time, typically less than 5 years. This prevents hot flashes for many women. Plus, it can help other symptoms of menopause, including vaginal dryness and mood disorders.

When you stop taking HRT, the hot flashes may come back. Some short-term HRT can make you more likely to have blood clots, breast and endometrial cancers, and gallbladder inflammation.

If HRT isn't right for you, other treatments may offer relief. Prescription treatments include:

• Low-dose depression drugs like fluoxetine (Prozac, Rapiflux), paroxetine (Paxil, Pexeva), or venlafaxine (Effexor)
• Clonidine, a blood pressure medication
• Gabapentin, an anti-seizure drug
• Brisdelle, a paroxetine formula specifically for hot flashes
• Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashes

B complex vitamins, vitamin E, and ibuprofen may help, too.

It’s important to talk to your doctor before you take any new medication or supplements, including over-the-counter products.

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