If you’re in menopause or perimenopause, you’re probably no stranger to a hot flash.

Sometimes lightly referred to as “power surges,” hot flashes send a rush of heat through your upper body.

If they’re especially strong, hot flashes can cause red blotches on your skin, a racing heart, and sudden, drenching sweats. And for many people, hot flashes are accompanied — perhaps even caused — by anxiety.

A hot flash is a sudden feeling of intense heat that isn’t caused by something external.

We’re not exactly sure why a hot flash starts.

It may be that changing estrogen levels disrupt your body’s thermoregulation (ability to warm up or cool down). As a result, the blood vessels near your skin open up and your skin temperature suddenly rises (though your core temperature doesn’t).

After the flush, sweat evaporates from your skin, delivering a welcome cooling sensation. The swift change can literally leave you feeling dizzy.

Yes and yes.

The relationship between anxiety and hot flashes may be a chicken and egg situation.

In one older study, researchers followed 436 premenopausal women for 6 years and found that anxiety was not only a symptom of hot flashes, but that people with anxiety were 3 to 5 times more likely to have hot flashes.

When researchers returned to that same cohort in 2016 to analyze their symptoms at the 14-year mark, they were able to confirm the strong relationship between anxiety and hot flashes.

In the 2016 study, researchers distinguished between affective anxiety (emotional worry) and somatic anxiety (anxiety with physical symptoms such as stomach upset, headache, fast heart rate, and dizziness).

People whose anxiety was emotional didn’t have a greater risk of hot flashes. But having physical anxiety symptoms was a strong indication that hot flashes would happen throughout menopause.

Childhood abuse survivors experience more hot flashes

Researchers in a 2008 study suggest there’s a connection between childhood abuse or neglect and the tendency to have hot flashes during menopause. They concluded that the effects of child abuse persisted well into midlife.

A number of other conditions and behaviors can increase the likelihood that you’ll experience hot flashes.

Here’s what we know:

  • Alcohol, caffeine, and spicy foods are common hot flash triggers.
  • Some prescription medications may cause or worsen hot flashes, including those used in chemotherapy.
  • Cigarette smoking is associated with midlife hot flashes.
  • Radiation therapy for cancer treatment may also cause hot flashes and night sweats.

Menopause is often described as a roller coaster ride. Your anxiety levels can peak and plunge as your body’s hormone production fluctuates.

While you may not be able to do much about the up-and-down hormones, you can certainly take advantage of proven anxiety-reducing strategies.

Here are some options to consider:

Rest is key

When hot flashes become night sweats, and anxious thoughts lead to insomnia, sleep may be delayed or interrupted.

The relationship between sleep disturbance, anxiety, and menopause is well-researched.

Talk with a healthcare professional about ways to make sure you get the recommended amount of rest every night.

Exercise helps

There’s no such thing as outrunning menopause. However, a growing body of evidence does suggest that physical movement both prevents and treats anxiety.

Both cardio (aerobic exercise) and strength training are recommended during menopause — not only because they reduce anxiety, but because they can keep you from losing bone strength and gaining extra weight as your body changes.

Talk about it with someone you trust

Menopause can raise a number of thorny issues — changes to your body image, sex life, and identity; dealing with the shift in fertility; and reacting to the societal expectations around menopause.

And those are just a few things that can arise.

People in many cultures feel additional anxiety about discussing symptoms openly.

You may find it helpful to talk about your symptoms and any other menopause-related issues with an online or in-person therapist. Cognitive behavioral therapy has been found to be especially effective for treating anxiety.

If one-on-one therapy doesn’t appeal to you, you might see whether there’s a support group devoted to menopause or anxiety issues nearby.

Take good care of yourself — mind and body

If looking back on the hormonal upheaval of your teenage years fills you with compassion, lavish lots of care upon yourself now.

Eat rainbows of healthy vegetables and muscle-building protein — which are vital as you get older.

Take time and space to create things. Numerous studies have shown that art, music, drama, and dance help people prevent and manage stress.

And consider taking a mindfulness course. In a 2012 study involving 110 women in menopause, those who learned to notice the sensations in each part of their bodies, to meditate, and to perform gentle stretching exercises were bothered less by hot flashes than those who did not.

If your hot flashes are barely noticeable, you may decide to accept them as unpleasant but natural.

If, on the other hand, hot flashes are keeping you up at night, causing you severe anxiety, or otherwise interfering with your work or home life, there are a range of treatment options for you to consider.


Hormone replacement is sometimes recommended as a way of reducing symptoms of menopause.

Hormone therapy balances the levels of estrogen and progesterone in your body. They’re often prescribed at low doses for short periods to avoid causing other health problems.

It’s important to understand that hormone replacement therapy has risks. People who take estrogen and progesterone during or after menopause may have a higher risk of certain kinds of cancer, cardiovascular disease, stroke, and dementia.

There is some evidence, though, that early use of hormone therapy (within the first 10 years after menopause) can be beneficial and may not present as many health risks as researchers once thought.

Specific combinations of hormones can also lower the risks associated with hormone therapy.

If you’re thinking about hormone replacement to reduce your anxiety or hot flashes, talk with your healthcare provider about your medical history to decide whether it’s appropriate for you.


If hormone replacement therapy isn’t the right choice for you, your healthcare provider might prescribe one of these medications to relieve your menopause symptoms:

  • antidepressants (paroxetine and others)
  • antiseizure medications (gabapentin and pregabalin)
  • blood pressure medications (clonidine)
  • antispasmodics used for bladder control (oxybutynin)


Zumba is your friend. Or several brisk laps in the pool, if cool water sounds better.

When researchers in one study tracked hot flashes among menopausal women participating in a 16-week cardio fitness regimen, they found that those who exercised experienced fewer hot flashes as a result.

This may be because the brisk exercise improved circulation and boosted the body’s ability to regulate its temperature.

Natural remedies

Although solid research on the effectiveness of natural remedies for menopause symptoms is limited, there’s some evidence that black cohosh and evening primrose oil may help reduce the severity of hot flashes.

Some researchers have found acupuncture is an effective hot flash treatment, but the evidence is conflicting on whether or not it helps.

Before you try any natural remedy, it’s a good idea to talk with a doctor or healthcare provider to see if it will have an interaction with any other medication you’re taking.

Practical considerations

Managing hot flashes may be a little easier if you change some of the habits that seem to strengthen or trigger them.

You may want to try:

  • limiting foods and beverages that trigger them
  • choosing clothes made of cotton or wicking material, and wearing layers you can remove when sweating starts
  • putting cotton sheets on your bed
  • using a fan in your bedroom at night
  • eliminating cigarette smoking

Hot flashes and anxiety are both common symptoms of menopause. When you have a hot flash, you may feel anxious — and when you’re anxious about something, you may suddenly experience a hot flash.

There are a number of medical treatments, including hormone therapy, that can reduce hot flashes and anxiety.

There are also nonmedical alternatives that may reduce anxiety and hot flashes, including lifestyle changes, natural remedies, and talk therapy.

While hormone therapy may be the most effective treatment, there are significant risks to weigh.

Menopause, anxiety, and hot flashes are all connected, so it may take a multifaceted treatment approach to resolve symptoms and ease your transition.