What’s the Link Between Hot Flashes and Breast Cancer?

Hot flashes develop when estrogen and progesterone levels begin to change before and during menopause. It’s thought that these hormonal fluctuations may disrupt the thermoregulatory center in your brain, leading to changes in heat production.

While hot flashes increase in frequency during the 2 years after you start menopause, they can last for 7 to 11 years or longer.

One 2016 review revealed an increase in breast cancer risk in those who had higher estrogen levels. Additionally, researchers found up to a 50 percent reduction in breast cancer risk in people who experienced menopausal vasomotor symptoms (VMS) like hot flashes and night sweats.

Also, a 2018 study of postmenopausal women with persistent VMS found a higher risk of breast cancer diagnosis but a reduced risk of related death. This may suggest a longer presence of hormones influencing the subsequent development of breast cancer.

While more clinical research is needed to determine whether hot flashes could provide a concrete indicator of a reduced breast cancer risk, such menopausal symptoms do indicate a decrease in lifetime exposure to the hormones (estrogen and progesterone) that may be associated with this cancer.

It’s also important to note that researchers have found VMS in individuals post-breast cancer diagnosis. In such cases, the onset of VMS may also be attributed to tamoxifen, a type of estrogen modulator used in breast cancer treatment.

While hot flashes may be associated with a lower risk of breast cancer, there are still treatment options if you want to reduce their occurrence.

If you’re interested in treatment for hot flashes, your doctor will likely recommend nonhormonal methods first. These may include:

• low dose antidepressants, with the Food and Drug Administration (FDA) approving paroxetine (Paxil) as a treatment for hot flashes
• clonidine, a type of high blood pressure medication
• certain drugs used to treat epilepsy and pain, such as gabapentin and pregabalin
• cognitive behavioral therapy (CBT), a type of psychotherapy

In some cases, hormone replacement therapy (HRT) may be recommended if your hot flashes and other symptoms of menopause significantly impact your overall quality of life.

Hormone replacement therapy (HRT)

However, HRT isn’t appropriate for everyone. It may increase your risk of developing breast cancer as well as the following:

• blood clots
• heart disease
• stroke
• gallbladder disease
• osteoporosis
• dementia

If your doctor does recommend HRT, they’ll likely start with the lowest, most effective dose. It’s important to discuss all of the potential risks versus the benefits with your doctor.

Complementary therapies

In addition to medical treatments, you can ask your doctor about certain complementary therapies for hot flashes. These include:

• acupuncture
• aromatherapy
• massage
• reflexology

Herbal remedies and supplements

While some herbal remedies and phytoestrogens are marketed to people experiencing hot flashes, it’s important to discuss these with your doctor before using them.

Herbs and supplements may potentially interact with medications you take, and there’s a lack of clinical evidence supporting their efficacy. Additionally, some herbal remedies may cause liver damage.

Lifestyle changes

To help manage hot flashes, you can also:

• try to maintain a moderate weight
• dress in layers
• carry a portable fan
• limit alcohol and caffeine
• avoid spicy foods
• try to quit smoking, if you smoke

While the development of breast cancer depends on a variety of factors, the risk of receiving a breast cancer diagnosis may be higher if you:

• were assigned female at birth
• carry certain genetic mutations, which make up about 5 to 10 percent of all cases of breast cancer
• have a family history of breast cancer
• have a personal history of benign (noncancerous) or malignant (cancerous) breast conditions
• previously had radiation treatments to your chest area
• started menstruating before age 12
• were exposed to diethylstilbestrol (DES) during pregnancy
• started menopause after age 55

Lifestyle factors that may increase your risk

Some lifestyle factors that may also increase your risk of developing breast cancer include the following:

• having overweight or obesity, particularly after menopause
• drinking alcohol
• not getting enough physical activity
• taking hormonal birth control
• taking HRT for menopause
• never breastfeeding

Other potential — but unproven — risk factors

Other possible, but not yet proven, risk factors for breast cancer may include:

• eating a high fat diet
• night shift work
• exposure to environmental chemicals, such as pesticides and plastics
• tobacco smoke exposure

Hot flashes occur before, during, and after menopause as estrogen and progesterone hormones start declining.

While the exact relationship still requires further clinical research, some studies have revealed a link between hot flashes and a reduced risk of developing breast cancer.

Hot flashes alone don’t decrease the risk of breast cancer developing, but they may indicate a lowered lifetime exposure to hormones that do contribute to cancer risk.

In the meantime, if you’re currently experiencing hot flashes, you may consider talking with a doctor about treatment options that could help you find relief without contributing to your overall breast cancer risk.

It’s also important to understand your own personal breast cancer risks to help reduce the chances of its development.