Hot Flashes - Learn your triggers
Estimated Reading Time: 6 minutes
Are you struggling with hot flushes (aka ‘hot flashes’) and wish you knew what was causing them? When you know the common triggers, it can help you to work out yours, so that you can minimise or even prevent annoying hot flushes.
You know the feeling…..suddenly and for no apparent reason, you feel very warm and the flush washes through your body like a wave.
If you’re anything like me, you know that hot flashes (or flushes) are annoying and sometimes embarrassing, especially if they come with a case of the sweats!
You know the feeling…..suddenly and for no apparent reason, you feel very warm and the flush washes through your body like a wave. In the extreme, your skin might also turn red, and you might become sweaty all over and want to rip your clothes off!
Hot flushes often wake me up at night and leave me red-faced (literally) at important work meetings. I also commonly experience night sweats. Not cool!
While people are usually understanding and accommodating, it is pretty annoying to turn red and start fanning yourself, and to have to constantly adjust your temperature to stay cool and comfortable. I have lost count of the number of Zoom meetings I’ve hosted where I’m taking my cardigan off, then putting it on again!
That motivates you to do something about it. For me, with some reading and experimenting, I now understand the main causes of hot flashes and have worked out my own triggers for them. This has been liberating! I want to share these insights with you so that you can take charge of your own internal ecosystem, too.
Common causes of hot flashes
During perimenopause and menopause, changes in your hormone levels (specifically, oestrogen) can cause hot flashes in some women, because it makes your internal ‘thermostat’ more sensitive to temperature changes.
This was certainly one of the first symptoms I experienced in perimenopause which has loyally stuck with me into post-menopause. Some women experience hot flashes for up to 10 years! Ladies, strap yourself in.
It can be tempting to ignore them, but hot flashes can be caused by more serious underlying health conditions like underactive thyroid, overactive thyroid, diabetes, and primary ovary insufficiency.
If those things have been excluded, then it’s back to the old hormonal changes.
Other factors that can trigger hot flashes can include what you eat and drink (spicy food, hot food, hot drinks, caffeine, alcohol), tight clothing, stress and anxiety, and being in a warm room, car or environment.
What can trigger these hormonal changes, and result in hot flashes? Well, the research shows that hot flashes can occur or are more likely to occur if you are:
a smoker
overweight or obese according to your body mass index (BMI)
a person of colour
Other factors that can trigger hot flashes can include what you eat and drink (spicy food, hot food, hot drinks, caffeine, alcohol), tight clothing, stress and anxiety, and being in a warm room, car or environment.
Medications that can cause hot flashes include some osteoporosis drugs (i.e. raloxifene), some breast cancer drugs (i.e. tamoxifem) and some pain relievers (i.e. tramadol).
Once I understood these basics, I was able to experiment with different things to find out what had the biggest effect on my hot flashes, and then to make lifestyle changes to reduce the flashes.
What surprised me was that I found triggers that were NOT on the ‘typical causes’ list - and I highly recommend exploring this for yourself.
Over about 8 weeks, I kept a rough diary of what I did during the day and at night, settling on a few key things that I needed to manage better.
Here’s how it worked.
Exploring my triggers for hot flashes
Once I knew the ‘typical’ causes of hot flashes I worked out which ones were relevant for me.
Once I knew the ‘typical’ causes of hot flashes I worked out which ones were relevant for me.
It immediately became obvious that too much coffee, alcohol, stress and hot meals at night were triggers for my hot flashes.
With a bit of experimenting, I discovered that I could avoid hot flashes by having no more than two single-shot coffees per day - or less on very stressful days.
When exploring alcohol, I compared nights of drinking alcohol versus not drinking alcohol. On drinking nights, hot flashes were more likely to happen and they were more severe.
A big discovery was that when I was stressed - e.g. working past 3pm, having too many meetings in a week, or having too much work on - I was more likely triggered to have a hot flash during the day or night, irrespective of anything else.
In one meeting, a single, stressful thought gave me instant heat and a red face, such that I had to run over to switch on the desk fan!
Another important discovery was that social anxiety could cause me to feel stressed which could lead to hot flashes during the day or night. For example, I was at a party on an already-hot night last summer, and I was feeling awkward talking to someone I didn’t know well. Then came the hot flush and sweating - luckily it was already a warm night!
Having worked out which of the known triggers for hot flashes were relevant for me, I decided to explore what else might affect me personally, that wasn’t on the known triggers list.
As most of my flashes occurred at night, I examined my afternoon and evening habits.
Going back to my alcohol experiment, it had seemed important to try different types of alcohol and amounts (do I really have to give it up?! Lol).
And I made a surprising discovery - my nighttime hot flashes (and sweats) were more likely to happen and worse after drinking wine, but sometimes I could get away with one glass of gin and soda with lemon and not have any flashes or sweats afterwards.
That got me thinking about whether sugar intake was an issue. Sugar isn’t on the ‘common causes’ list but seemed to be a logical place to explore next.
On 2-3 nights per week, I have a couple of squares of chocolate (which also contains caffeine - a known trigger), or some sort of dessert after dinner, like ice cream.
Turns out that nighttime hot flashes are more likely to happen at night if I eat a sugary dessert - for example, two scoops of ice cream.
My ‘winning formula’ was coming together!
Less than two coffees per day, and before midday, is pretty safe
Nights without alcohol or sugar work most of the time
Stress seems to be part of the problem even on alcohol- and sugar-free nights
This mostly nailed things, but not entirely. With some more experimenting, I learned that what I do in the three hours before bed can trigger hot flashes in the early part of my sleep. So, I made these changes:
I traded a later dinner for an earlier dinner (at least 3 hours before bed)
I eat until comfortable, not stuffed (overeating = hot flashes!)
I traded my scalding hot shower for a cooler shower before bed
I’ve learned a few things from all this experimenting.
Firstly, I know that a few specific things will likely cause hot flashes for me most of the time, so I’m better off avoiding them or accepting the consequences if I choose to do them anyway (like that glass of wine with my friend on a Friday, eating a late dinner, sugar and hot showers).
Secondly, I know that stress is my biggest hot flash trigger and can also make them worse. As a result, I’ve made changes to my work, lifestyle and my social habits to move mountains in this area.
Thirdly, I’ve started experimenting with starting up or being more consistent with other lifestyle habits to reduce hot flashes even further. Sometimes it’s the things you’re not doing that can help you deal with what’s going on.
Summary
It’s pretty clear that although the experts don’t understand the exact hormonal process that causes hot flashes, it is definitely related to oestrogen or possibly other factors.
There are several known causes of hot flashes, but if you do your own investigations you might uncover other triggers that are specific to you and your life.
A big positive of observing myself was that I started to accept responsibility for my choices. In other words, I could decide consciously whether to do certain things or not, and either accept that the flashes would come, or decide to avoid them.
It felt super empowering to know that I could take control. It went a long way to helping me accept menopause and all the trimmings.
What are your triggers for hot flashes? Let us know in the comments below.
References/Citations
Hot flashes (2022) Mayo Clinic. Mayo Foundation for Medical Education and Research. Available at: https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20352790#:~:text=But%20most%20research%20suggests%20that,flash%20%E2%80%94%20to%20cool%20you%20down (Accessed: March 15, 2023).
Faris, S. (2020) What's causing my hot flashes and how can I get rid of them?, Healthline. Healthline Media. Available at: https://www.healthline.com/health/menopause/hot-flash-causes#causes (Accessed: March 15, 2023).
Martin, L. (2021) Hot flashes: Causes, symptoms, treatments, and more, Medical News Today. MediLexicon International. Available at: https://www.medicalnewstoday.com/articles/hot-flash-causes (Accessed: March 15, 2023).
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