Brief overview
- Description: Partly severe heat episodes due to dilating blood vessels and increased blood flow, common during menopause, often accompanied by pressure in the head, discomfort, palpitations, sweating.
- Causes: In women, often during menopause, less often in men due to declining testosterone levels; diabetes, hyperthyroidism, allergies or tumors; medications; certain foods/drinks (strong spices, hot foods, hard-to-digest foods), coffee, tea or alcohol consumption, obesity
- When to see a doctor? In case of severe menopausal symptoms and if other causes are suspected.
- Diagnosis: Doctor-patient consultation, physical examination, further examinations depending on suspicion, such as determination of thyroid hormones, allergy tests, colonoscopy.
- Treatment: Depending on the cause; in case of menopause e.g. herbal preparations, physical procedures such as mud baths, hormone replacement therapy; in case of other triggers: Treatment of the underlying disease
What are hot flashes?
Most women report four to five hot flashes per day, but up to 20 times a day is also possible. How long they last varies from person to person. Usually they last only a few minutes, sometimes longer. They often announce themselves by a feeling of pressure in the head or a diffuse discomfort. This is followed by rising and falling waves of heat that flood the upper body, neck and face.
When sufferers are suddenly overcome by such a heat wave, it is because the blood vessels dilate and blood flow to the outer regions of the body increases. As a result, the skin reddens, the skin temperature rises and sweat breaks out. Later, the whole thing is reversed: Due to the sweating and the drop in core body temperature, those affected often start to feel cold after a hot flash.
If the cause of hot flashes is the menopause, they occur most frequently at the beginning. Over time, they slowly decrease and usually disappear on their own after a year or two.
Causes of hot flashes
Most often, hot flashes are related to hormonal changes such as menopause. The exact mechanism of how hot flashes occur during menopause is still unclear. However, it is certain that hormonal changes play an important role.
Experts suspect that hot flashes are triggered by an increased release of stress hormones such as adrenaline. And that this in turn is due to the drop in estrogen levels during menopause. Put simply, the falling estrogen level seems to cause a malfunction of central thermoregulation in the brain.
In addition to menopause, hot flashes occur in the context of various diseases, including:
- Hypoglycemia in diabetes: sweating is a symptom of low blood sugar in this case.
- Allergies: Hot flashes sometimes occur due to the allergic reaction.
- Malignant tumors of the endocrine system: Here, the cancer forms from hormone-producing cells mostly in the gastrointestinal tract. Such tumors are sometimes accompanied by seizure-like hot flushes.
Some medications are also among the possible triggers of hot flashes: Drugs for hormone-sensitive breast cancer put women through menopause – so hot flashes are possible with these drugs, even in young women. Medications include:
- Antiestrogens: drugs like tamoxifen block the docking sites for estrogen on any cancer cells that may still be present – making it impossible for them to multiply.
- Aromatase inhibitors: These block estrogen production in muscle and fat cells.
But hot flashes may also occur as a side effect of other medications such as corticosteroids (cortisone) as well as calcium channel blockers.
There are other possible triggers such as lifestyle factors that promote hot flashes. Examples include:
- Certain foods and beverages, such as: Coffee, black tea, alcohol, highly spiced foods, foods that are difficult to digest, foods and drinks that are too hot.
- Obesity
- stress
- wrong clothes (too thick, materials made of synthetic fibers)
What are the causes of hot flashes at night?
Each of the possible diseases mentioned above and especially menopause in some cases also lead to hot flashes in the evening or at night. Heat attacks are usually accompanied by night sweats, some of which are extremely severe, and interfere with sleep.
In addition, in some cases a high room temperature in the sleeping environment leads to hot flashes at night – a cause that is quickly remedied by a cooler room temperature in the bedroom.
What do hot flashes in men mean?
Hot flashes in men, like in women, are sometimes due to age-related hormonal changes. Production of the hormone testosterone decreases in men over the age of 40, leading some to experience symptoms such as hot flashes, as well as sexual aversion and sleep disturbances. This type of testosterone deficiency is what doctors call late-onset hypogonadism.
In men, there are also other possible causes of hot flashes, such as the diseases mentioned above (for example, diabetes), medications, or the various lifestyle factors such as increased body weight, certain foods or drinks, or certain eating or drinking habits.
What do hot flashes in women mean?
In most cases, hot flashes in women after a certain age are due to menopause. Nevertheless, the other possible causes mentioned above are also possible in women.
Menopause as a whole is associated with unpleasant symptoms. These include sleep disturbances, depressive symptoms, loss of libido, weight gain and hot flashes.
As a rule, hot flashes cause only moderate discomfort. If the episodes and possibly other (menopausal) symptoms significantly affect your daily life and quality of life, it is advisable to seek medical advice.
Even if causes other than menopause are considered for the hot flashes, it is important that you consult a doctor. It is important to rule out possible conditions such as hyperthyroidism, diabetes, allergies or tumors as causes.
Hot flashes: Examinations and diagnosis
Women with hot flashes are best to see their gynecologist, because in most cases menopause is the cause of the unpredictable sweats.
Medical history
The doctor first takes your medical history (anamnesis). To do this, he first asks you to describe your symptoms in detail. A gynecologist will also inquire about any cycle disorders.
In addition, the interview will provide the doctor with information about your lifestyle, any underlying diseases and any medications you are taking. This is helpful for diagnosis, especially if menopause is unlikely to be the cause of the hot flashes.
Examinations
At the gynecologist’s office, the interview is usually followed by a gynecological examination. Otherwise, a physical examination such as a blood pressure measurement is sometimes routinely performed.
If an allergy is a possible trigger of the hot flashes, allergy tests provide certainty.
Examinations of the gastrointestinal tract (e.g. by means of colonoscopy, computer tomography or magnetic resonance imaging) help to identify hormone-forming tumors as the cause of the hot flashes.
What helps against hot flashes?
The treatment of hot flashes depends on the cause. In most cases, hot flashes in women are due to menopause. Many sufferers look for a gentle way to treat hot flashes.
Herbal medicine recommends various plants for hot flashes during menopause, such as black cohosh (Cimicifuga racemosa), as well as red clover, soy, sage, lady’s mantle and yarrow. These are often taken in the form of tablets or as a tea. Their effectiveness is partly unproven or controversial. However, some women report an improvement in symptoms after using such medicinal plants.
When hot flashes and other menopausal symptoms extremely interfere with everyday life, doctors usually advise hormone replacement therapy (HRT). Women should carefully discuss the benefits and risks of taking hormones on a regular basis with their health care provider. The decision to use therapy depends on individual factors such as age, pre-existing conditions and risk factors.
The reason hormone replacement therapy needs to be weighed so carefully is that long-term hormone supplementation may be associated with an increased risk of breast cancer, cardiovascular disease and thrombosis.
If hot flashes occur due to another condition, such as hyperthyroidism, cancer or an allergy, the doctor treats the underlying condition. As a rule, the therapy also alleviates or eliminates the hot flash symptom.
What you can do yourself against hot flashes
- Adjust your clothing to the changing temperature sensations and wear thinner layers of clothing on top of each other. This way it is possible to take something off as soon as you notice that you are getting too warm. The motto here is: Dress airy!
- Choose clothes made of natural fibers such as cotton, merino wool or silk. Textiles made of pure synthetics or mixed fabrics usually absorb sweat only with difficulty or not at all.
- Eat easily digestible foods, such as plenty of fruits, vegetables and salads.
- Avoid strongly spiced food – this 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. Try to stay slim or get rid of excess pounds. Overweight people often sweat more.
- Sleep in cool rooms and use cotton bedding. A warm environment prolongs the duration of hot flashes. A cool environment, on the other hand, will prevent hot flashes or at least lessen them.
