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Nonmenopausal Hot Flashes: What’s the Mystery Cause?

What are hot flashes?

For many women, the term “hot flash” brings one thing to mind: menopause. But hot flashes can have causes other than the end of a woman’s menstrual cycle. Understanding other causes could help determine whether or not your hot flashes are a signal that you’re heading toward menopause.

Symptoms of hot flashes include:

  • sweating
  • feeling overheated or warm, particularly in the upper body
  • redness of the skin on the face, neck, ears, chest, or other areas

It’s common to feel cold or get chills as the hot flash subsides.

You may experience a feeling similar to a hot flash when your body temperature rises. Using heated blankets, a hot water bottle, or even just keeping the temperature too high in the house can cause this sensation. You may feel flushed and warm and mistake your symptoms for hot flashes. Taking a cool shower to lower your body temperature can help restore your body to a more comfortable temperature.

Medications and foods you consume

Hot flashes may be a side effect of some prescription medications. Raloxifene (Evista), commonly prescribed for osteoporosis, may cause skin flushing and hot flashes. You may also feel flushed after taking tramadol, a prescription pain reliever. However, this side effect is rare.

Hot flashes are also a common side effect of both chemotherapy and tamoxifen (Nolvadex, Soltamox), which is used to treat breast cancer. Both hot flashes and night sweats are common and can be caused by the cancer itself or the treatment. Chemotherapy can sometimes trigger menopausal reactions, like hot flashes.

Some over-the-counter medications can also cause symptoms that mimic those of menopause-related hot flashes. Check the labels of all medications you take. Also, be sure to discuss symptoms with your doctor.

Certain spicy foods — particularly hot peppers — are a common culprit. Foods that pack a fiery punch can dilate blood vessels and stimulate nerve endings. These biological changes create a feeling of extreme heat. Alcohol, for some people, also has an effect similar to hot flashes. This response can develop at any point in a person’s life.

Stress and emotional causes

The exact cause of emotional “hot flashes” is not certain. But it is understood that this type of flushing happens more often in women than in men. Your body may release the stress hormones epinephrine and norepinephrine when you’re stressed, nervous, or upset. These hormones pump up blood flow and produce a warming sensation throughout the body.

Similar to blushing, “flushing” can result from a variety of factors — from stress to spinal cord lesions and migraine headaches. Flushing causes entire sections of your body to turn red and feel extremely warm.

Health causes of hot flashes

Hot flashes can be hormonal, even when they’re not related to menopause or perimenopause (the transitional period from regular menstruation to menopause). Doctors believe that the hypothalamus plays a role in hot flashes.

The hypothalamus is the section of the brain that regulates body temperature. The natural drops in estrogen throughout the menstrual cycle, or that happen as a woman ages, can often cause the hypothalamus to malfunction. Hypothalamus dysfunction can be treated with hormone replacement therapy (HRT). Eating disorders, head traumas, and genetic disorders are other possible causes.

It’s easy to mistake a fever or other conditions for hot flashes. Some infections that cause fever, like those in the urinary tract, may be the true cause of the “hot flash.” Carcinoid syndrome is an illness in which a tumor releases chemicals into the body. The release of chemicals creates symptoms that are very similar to hot flashes.

The sensation of overheating is also a symptom of hyperthyroidism. Also called overactive thyroid, this condition occurs when the thyroid gland produces too much of the thyroid hormones. Hyperthyroidism can have a variety of causes, including Graves’ disease and thyroiditis. Hyperthyroidism is usually marked by other symptoms. These can include a sudden weight loss and a change in bowel patterns.

Treatment for hyperthyroidism often depends on the cause. Generally, beta blockers or antithyroid medications are used to relieve symptoms. Surgery may be necessary in extreme cases to remove the malfunctioning areas of the thyroid gland.

HRT is often used to treat hot flashes caused by menopause. But not all women can or should undergo HRT. Alternatives include natural remedies like evening primrose oil or St. John’s wort. Therapies like acupuncture, or other prescriptions can also address symptoms. You can also add phytoestrogens, which are found in foods like beans and peas, to your diet. 

Other methods of reducing hot flashes include:

  • getting more exercise
  • avoiding spicy foods
  • limiting alcohol consumption
  • stopping smoking

Hot flashes and pregnancy

Hot flashes are a frequent side effect of pregnancy. They’re particularly common in the first and second trimesters. Some women will continue to experience hot flashes even after delivering their babies. This is caused by a significantly decreased estrogen level, which occurs during pregnancy.

To deal with hot flashes while pregnant, keep rooms cool and wear loose clothing. Rinse your face with cold water when needed, and try to avoid hot and crowded areas.

Postmenopausal hot flashes

Though hot flashes are most often associated with the perimenopause, postmenopausal hot flashes are still common. Some experts believe that lifestyle factors, such as diet and physical activity, could have an effect.

One study found that women who had undergone a hysterectomy were more likely to have postmenopausal hot flashes than those who hadn’t.

Postmenopausal woman on HRT are less likely to experience hot flashes than those who aren’t.

Outlook

Menopause usually occurs when a woman is in her early fifties. Menopause is defined as the time when a woman ceases to have a menstrual cycle. This is diagnosed when a woman has completely stopped having a menstrual period for 12 months. Perimenopause is the time leading up to the final menstrual period.

On average, perimenopause starts about four years before the final menstrual period. This means you can begin experiencing hot flashes years before your menstrual cycle completely ceases. Your doctor will likely take all your symptoms into consideration and assess your age, family history, and lifestyle before making a diagnosis. You should tell your doctor about any other symptoms you may be having, including the following:

  • a change in weight
  • fevers
  • fatigue
  • insomnia
  • irregular heartbeats

Keep a hot flash diary to help your doctor diagnose your symptoms. Take note of each incident, including what food you ate prior to the incident. A symptom journal of this kind can help determine which lifestyle changes you can make. It will also help you avoid triggers and alleviate symptoms.

Remember that there are many other causes of hot flashes. This list is not comprehensive. If you experience flushing or hot flashes that are repetitive or don’t resolve, see a healthcare provider.

Q&A

You asked, we answered

  • What treatments are available for hot flashes?
  • Treatment for flushing, or hot flashes, depends on the cause. Seeing your healthcare provider for an exam and diagnosis is the first step in managing hot flashes. In people who are more prone to experiencing hot flashes or flushing, it may be helpful for them to avoid triggers like spicy foods, hot beverages, or alcohol. Wearing layers than can be changed easily, lowering the temperature in the home, and having a fan on while sleeping, along with avoiding triggers can further improve perimenopausal hot flashes. Perimenopausal hot flashes can be managed with prescriptions if the symptoms are severe enough. Many perimenopausal women try natural, or herbal, remedies, but the research to recommend or support them is limited. Your healthcare provider can discuss management of perimenopausal hot flashes or provide a referral for you.

    - Kimberly Dishman
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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