Feelin’ The Heat? Here’s Your Hot Flash Survival Guide

By Dr. Tara Allmen, Author of Menopause Confidential

This post is sponsored by Vertical Pharmaceuticals, LLC. Fab Over Fifty is partnering with Vertical Pharmaceuticals, LLC to address menopause symptoms and treatment options, vitally important subjects for our community. Dr. Tara Allmen is Board Certified Gynecologist and Nationally Certified Menopause Practitioner (NCMP) and a paid spokesperson for Vertical Pharmaceuticals, LLC.

When I was 45 years old, I was out to dinner with my husband and a friend when suddenly, I became intensely hot, sweaty and uncomfortable. The hotter I got, the more agitated I became. Finally, I turned to my husband and asked, “Is it hot in here?” When he said “No,” I questioned the obvious: Could this be a hot flash? Am I going through menopause? I’m way too young! My husband joked that he knew a good doctor I should see…ME! Very funny. So, when women say to me, “You don’t understand how terrible my hot flashes are. I completely soak through my nightgown and sheets,” my answer is, “I am there too, sisters!”

Up to 75 percent of menopausal women experience hot flashes, which makes them the most common symptom¹. “Hot flash” is the most frequently searched menopause topic on the internet and the average woman will have hot flashes for several years, some suffering for as long as 10 years.

What’s a hot flash anyway?

Before I share the wonderful news about the many options available to treat hot flashes and night sweats, it’s certainly worth knowing what a hot flash really is and what triggers it. The first part is easy to answer: A hot flash is a sudden feeling of heat that typically starts in your upper chest area and moves to your head. First, you feel warm, then hot, and then you literally become red in the face (aka a flush). A hot flash can last for up to five minutes, and is sometimes joined by a fast heart rate, which can be scary the first time you’re experiencing these symptoms. Some of you may also experience cold chills immediately after a hot flash, which is your body’s way to regulate its internal temperature and return you to a comfortable zone. The whole cycle can take up to 30 minutes. And then there’s the (night or day) sweating, which can range from mild to profuse perspiration.

What can trigger a hot flash?

We figured out how to get a man to the moon, but we still have no earthly idea what causes a hot flash. We do know that some women seem to have more sensitive internal ‘thermostats,’ and only feel comfortable within a limited temperature range. When something happens to raise your core body temperature, such as entering a warm room or exercising, you leave this zone and your body will likely respond with a hot flash. Strange as it sounds, the flash actually is a cooling mechanism. When the brain senses that you’re too warm, it starts to cool you down by dilating blood vessels at the surface of your skin. If you need to cool down even more, your brain sends out a signal to add in sweating! Other hot flash triggers include hot or spicy foods, alcohol, caffeine, stress and being overweight, which isn’t good for you even if you never have a single hot flash.

Now for ways to reduce your discomfort

When the first hot flash hits, many women are initially inclined to try one of the dozens of over-the-counter solutions from the nearest health food vitamin store. And, if that one doesn’t work, they’ll try another, and another. But, how do you know what will work for you, and how long to try it before deciding whether it’s helping? Every package boasts that the ingredients inside will absolutely do the trick, from Chinese herbs and black cohosh to fish oil capsules. And, many healthcare professionals simply aren’t versed on all of the alternative options to treat hot flashes, or other menopause symptoms, so they won’t be able to help you decide.

Or, perhaps you should sign up for yoga or try acupuncture.  A friend told you that works! All of these remedies can have some effect for a limited period of time, but your symptoms will often return with a vengeance. Countless women show up at my office lugging a box full of half-empty bottles asking for help.

Thankfully, The North American Menopause Society (NAMS) experts agree that hormone therapy is the most effective treatment for menopausal symptoms such as hot flashes².  Certain behavioral methods including maintaining a healthy body weight, refraining from smoking, reducing stress and watching food triggers have also been proven to help reduce hot flashes.

Hormone-replacement therapies

Now for the issue of hormone replacement therapy (HRT), which means just what it says: It replenishes your depleted hormones, especially estrogen, with new estrogen. HRT is available in a variety of forms, including pills, patches, gels and vaginal preparations and if you’re generally healthy which form you choose may be a personal decision based upon what best fits your lifestyle. How do you know if hormone therapy is right for you, and which is the best method to deliver it? Simply, you’ll know only by consulting a physician who is knowledgeable in treating menopausal women – like me. Many gynecologists are not up-to-date on the specific subject of menopause, because it’s not a priority in medical school or in post-graduate programs, or because their focus is on pregnant women.

Most menopausal women in the United States are not using hormone therapy, either because they are afraid of the risks or have no idea where to begin. Another unfortunate fact; many others are now turning to hormone therapy preparations prescribed by “alternative” medical professionals and custom compounded in a pharmacy. You should be cautious and ask questions, as these therapies do not undergo the same regulations as FDA approved treatment options.

If you start treatment within 10 years of your last menstrual period, and don’t have other risk factors, estrogen therapy is an acceptable treatment option for hot flashes and night sweats3. I urge you to meet with a doctor who knows her (or his) stuff, to discuss your options.

This is not a time to procrastinate. Now is the time for daily exercise, good nutrition, a healthy body weight, stress reduction, and avoiding smoking. The most important decision you can make for yourself at this stage of life is to invest in your own health and wellness and talk to your doctor about estrogen replacement therapy today.


¹ The North American Menopause Society.  The Menopause Guidebook. 8th ed. Mayfield Heights, OH: The North American Menopause Society; 2015.

²,³https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/the-experts-do-agree-about-hormone-therapy

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