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Has this ever happened to you?
You’re just going about your normal day – maybe grocery shopping, in a meeting at work, or just sitting on the couch enjoying a movie with the family.
Then, it hits.
Your face, neck, and chest start heating up. You feel too warm, like someone yanked the thermostat up to 100 degrees. It feels like the hottest day of summer, even if the AC is blasting cold.
Your breathing increases, your heart beats faster, and you begin to sweat. Sometimes it’s just a light dewy sweat, and sometimes it’s so intense that your clothes get soaked and your hairline becomes wet.
Sound familiar? If so, you may be experiencing hot flashes (hot flush).
Hot flashes are an uncomfortable and irritating symptom of hormone imbalance. They most often affect women and typically strike during perimenopause and menopause, though they may also affect women of all ages due to other factors like chronic medical conditions and certain medications.
Hot flashes in women can be very interruptive and detrimental, striking at inconvenient times and interrupting important moments. Read on to learn more about what hot flashes are, why they happen, and some strategies to help manage them.
A hot flash is a phase of intense and unusual warmth, which often feels like it’s radiating from the face, neck, and chest. They can last anywhere from 30 seconds to ten minutes, and longer on rare occasions.
Hot flashes can be intensely uncomfortable and can keep you from living life normally, including waking you up throughout the night as hot flashes come and go.
Symptoms of hot flashes in women include:
The amount of hot flash episodes in women can vary, but they may occur as often as daily for up ten years leading into menopause. If hot flashes occur during sleep, they are called night sweats.
Night sweats can interrupt your sleeping patterns, make it difficult to return to sleep, and cause long-term sleep deprivation.
Hormonal deficiencies related to Estrogen and Progesterone have been identified as the root cause of hot flashes in women.
The hypothalamus is often considered the body’s “thermostat” because it regulates internal temperature. When hormone levels (particularly estrogen) fluctuate, it seems to confuse the hypothalamus, which interprets the change as the body being too warm. This leads the hypothalamus to trigger a reaction to cool it down – otherwise known as a hot flash.
Once the hypothalamus sends the signal that the body needs to cool down, the nervous system takes over and secretes biochemicals to begin this process. These biochemicals include prostaglandin, serotonin, and norepinephrine, which make your blood vessels dilate (leading to more heat on the skin and a flushed effect), as well as cause your heart to pump faster and your glands to release more sweat.
In normal circumstances, this process is a welcome relief from the heat. Think of the summer under a hot sun when the breeze cools the sweat on your skin. However, during a hot flash, your body is malfunctioning and starting a process that isn’t necessary – which is why it’s so uncomfortable.
The majority of women experience hot flashes during perimenopause (the years leading up to menopause) and menopause, since that’s the time when hormone imbalance is most common.
But women of any age can experience hormone deficiencies for other reasons. Causes for a hormone imbalance outside of menopause include:
Regardless of your age, hot flashes and night sweats are a telltale sign of hormone imbalance. If you are experiencing this symptom, comprehensive testing can help you identify the root cause of the issue, so you can seek treatment and begin your journey to feeling better and ideally minimize unwanted symptoms like hot flashes.
Hot flashes in women are easy to identify – but they are harder to manage. Here are some tips you can employ to ease your hot flash episodes and even avoid them altogether.
This step is especially important in the summer months when the weather warms up, since changes to internal body temperature are more likely to trigger hot flashes during these times.
Because hot flashes are overreactions to slight increases in your core temperature, cooling down your environment can help you avoid these reactions. If you’re in control of the thermostat, you can keep it a few degrees cooler than normal to ensure you avoid overheating. You can also set up a fan to blow cool air on your face and neck, since this area is often impacted by hot flashes.
Some women who struggle with night sweats say it helps to add a window air conditioner in the bedroom to keep it extra cool at night, as a way to improve their sleep.
If you’re in a shared office space and cannot control the temperature, you can keep ice packs and cool drinks on hand to help maintain your temperature. You can also bring a small desk fan or handheld fan, either battery-powered or folded paper, to help you cool down.
You can get in the habit of wearing layers, as well – for example, a regular top and cardigan or blazer - so that you can comfortably remove layers throughout the day as needed. Breathable fabrics like cotton should be chosen over fabrics that trap heat, like polyester.
While hot flashes are caused by hormone imbalance, certain lifestyle factors can increase their frequency and severity.
Eating spicy foods, for example, can trigger your body’s cool-down response, which can lead to hot flashes. Caffeinated beverages increase your heart rate and can have a similar effect, as can salty, fatty, and sweet foods. There is evidence to suggest that a Mediterranean diet of whole grains and fresh fruits and vegetables may help curb hot flashes in women.
Nicotine is a stimulant and may also contribute to increased hot flashes, so it is recommended that women quit smoking to manage hot flash symptoms (as well as for overall good health). Similarly, alcohol can have a detrimental effect on those who experience hot flashes.
Certain heart and blood pressure medications may contribute to hot flash symptoms, but it is very important that you speak to your doctor prior to changing or stopping any of your prescription medications.
While hot flashes are a key sign of hormone imbalance, comprehensive blood testing is the only way to understand what’s happening within your body and take steps to rebalance. For most women, there are steps you can take to reduce or eliminate hot flashes through hormone restoration.
Hormone balance in complex, because hormones interact with and affect each other. Decreases in certain hormone levels can cause corresponding changes in other hormone levels. There are also precursor hormones, like DHEA, that can impact the body’s ability to create Estrogen and Progesterone (the two most common types of female hormones). Thyroid hormone imbalance can lead to hormone deficiency symptoms, as well, which is why it’s important to check your thyroid health as part of a thorough hormone assessment.
We recommend the following tests to understand your hormone balance, as well as your overall wellness and thyroid health, so we can diagnose your deficiencies accurately:
Some medical providers only recommend one or a few hormone tests to diagnose hormone deficiencies. Unfortunately, these tests often don’t provide enough information to truly understand the complex balance of hormones in the body and may lead to inadequate treatment.
It’s always best to comprehensively evaluate hormone levels and health.
Aside from strategies to help keep you comfortable, Bioidentical Hormone Replacement Therapy (BHRT) is one of the only ways to fully ease hot flash symptoms. This is because BHRT replenishes hormone levels, which stops the hypothalamus from overreacting and triggering hot flash attacks.
BHRT is an ongoing treatment that supplements key female hormones including Estrogen (often in the form of Estradiol) and Progesterone. An HRT protocol may also include DHEA, Pregnenolone, and Testosterone. Women’s bodies produce Testosterone at lower amounts than men, but it’s a very important hormone for maintaining sexual health, body composition, and more.
If hot flashes and night sweats are interrupting your life and daily activities, it is likely your body’s way of communicating that you have a hormone imbalance. You may be experiencing other symptoms of a hormone deficiency, including:
BHRT can address this imbalance to help ease hot flash symptoms, as well as the symptoms listed above.
There are many types of BHRT options available, including injections, capsules, implantable pellets, topical creams and gels, sublingual tablets, and more.
At Defy Medical, our providers have a decade of experience helping more than 15,000 patients pursue happier, healthier lives with therapies like hormone restoration. We can do the same for you.
Many doctors offer a form of BHRT for women, but not all of them are aware of the latest medical developments related to hormone restoration, and not all of them listen to you about your symptoms and adjust your protocol as needed.
We are up to date on the latest delivery systems and protocols, and we work closely with you to create an individualized plan. No one person is the same, which means every hormone therapy protocol needs to be tailored to suit your unique needs.
We also offer convenient telemedicine care with virtual appointments, doorstep delivery of medications, an online patient portal, and patient support via telephone and email. Our patients are busy go-getters who require accessible care when and where they need it. We work hard to provide that for you.