Hot flushes: how to cope
Hot flushes are the most common symptom of the menopause but there are a range of medical treatments and self-help techniques to beat the heat.
Not all women experience hot flushes going through the menopause, but most do. Three out of every four menopausal women have hot flushes. They’re characterised by a sudden feeling of heat which seems to come from nowhere and spreads through your body. They can include sweating, palpitations, and a red flush (blushing), and vary in severity from woman to woman.
Some women only have occasional hot flushes which don’t really bother them at all, while others report 20 hot flushes a day, that are uncomfortable, disruptive and embarrassing.
Hot flushes usually continue for several years after your last period. But they can carry on for many, many years – even into your 70s or 80s. They’re probably caused by hormone changes affecting the body’s temperature control.
Causes of hot flushes
Most women going through a natural menopause experience hot flushes. But there are other causes of hot flushes, including:
Breast cancer treatment – according to Cancer Research UK, seven out of 10 women who’ve had breast cancer treatment have hot flushes, and they tend to be more severe and frequent than those of women going through a natural menopause. This is because chemotherapy and tamoxifen tablets reduce oestrogen levels.
Prostate cancer treatment – men having treatment for prostate cancer can also have hot flushes, sometimes for years. Hormone treatment causes hot flushes in men by lowering the amount of testosterone in their body. Read advice for men with prostate cancer on how to tackle hot flushes.
What does a hot flush feel like?
Women often describe a hot flush as a creeping feeling of intense warmth that quickly spreads across your whole body and face ‘right up to your brow’ and which lasts for several minutes. Others say the warmth is similar to the sensation of being under a sun bed, feeling hot ‘like a furnace’ or as if someone had 'opened a little trap door in my stomach and put a hot coal in’.
Watch these videos where women describe what a hot flush feels like.
Hot flush triggers
Hot flushes can happen without warning throughout the day and night, but there are well-known triggers, including woolly jumpers, especially polo necks; feeling stressed; drinking alcohol or coffee; or eating spicy foods.
Treatments for hot flushes
Many women learn to live with menopause-related hot flushes, but if they’re really bothering you and interfering with your day-to-day life, talk to your doctor about treatments that may help.
The most effective is HRT which usually completely gets rid of hot flushes. But other medicines have been shown to help, including vitamin E supplements, some antidepressants, and a drug called gabapentin, which is usually used to treat seizures.
Note that doctors recommend that you don’t take HRT if you've had a hormone dependent cancer such as breast or prostate cancer.
Complementary therapies for hot flushes
Women often turn to complementary therapies as a ‘natural’ way to treat their hot flushes.
There have been small studies indicating that acupuncture, soy, black cohosh, red clover, pine bark supplement, folic acid, and evening primrose oil may help reduce hot flushes.
However, the research is patchy, the quality of the products can vary considerably, and the long-term safety of these therapies isn't yet known.
It’s important to let your doctor know before you take a complementary therapy because it may have side effects (for example liver damage has been reported with black cohosh) or mix badly with prescription medicines (red clover is unsuitable for women taking anticoagulants).
Be aware, too, that soy and red clover contain plant oestrogens so may be unsafe for women who have had breast cancer.
Self help remedies for hot flushes
Try these everyday tips to ease the overheating:
cut out coffee, tea, and stop smoking
keep the room cool, use a fan – electric or handheld – if necessary
if you feel a flush coming on, spray your face with a cool water atomiser or use a cold gel pack (available from pharmacies)
wear loose layers of light cotton or silk clothes so you can easily take some clothes off if you overheat
have layers of sheets on the bed rather than a duvet so you can remove them as you need to and keep the bedroom cool
cut down on alcohol
sip cold or iced drinks
have a lukewarm shower or bath instead of a hot one
change the timing of your medicine. If tamoxifen is causing your hot flushes, Cancer Research UK suggests taking half your dose in the morning and half in the evening
Is a hot flush anything to worry about?
Hot flushes are generally a harmless symptom of the menopause. But very occasionally they may be a sign of a blood cancer or carcinoid (a type of neuroendocrine tumour).
See your doctor if, in addition to hot flushes, you've been unwell with, for example, fatigue, weakness, weight loss or diarrhoea.