Menopause

3.2. Hot flashes and sweats

Hot flashes and sweats are called “vasomotor symptoms”. Hot flashes happen when the blood vessels just under the skin suddenly open up more widely. That means more blood can flow through and this feels like a surge of heat. This wave of heat hits very suddenly, usually starting from the chest, neck and face. The heat wave goes through the whole body, often in the direction of the head, arms or legs. Hot flashes can make the skin red, and can cause outbreaks of sweating that are sometimes major. Many women feel a strong racing of the heart at the same time. This is usually not a sign of heart problems. Some women also feel very unwell during a hot flash.

Karin

"When it started it felt as though my head would explode and my heart pounded at the same time. Once when I was drinking coffee with some women, I really felt as though my heart was going to jump out of my chest. I didn't know what was happening. But before you could grasp what was happening, it was already over...

Sometimes I found it unpleasant, when I had to serve customers in summer. But it didn't smell at all. If I sweat when I'm being physically active, then it smells differently than having a hot flash."

Hot flashes last on average about three minutes. They can however last longer. For some women, this can be for up to an hour [8], [10]. After a hot flash a woman can sometimes have a short chill [10].

From a half to two-thirds of women will have hot flashes and sweats during the menopause [10], [11], [19]. But often the problem is only mild and does not cause much bother. But for some women hot flashes can become so severe that their daily activities, work or sleep are seriously disturbed.

Maria

"I had hot flashes too, mostly in the night. But it wasn't very often. When I had them, I found it very unpleasant, especially at work. At first I would feel very warm, then hot and then I would break out in sweat."

Susanne

"I thought to myself: “You won’t be able to stand this for long.” I was really worried that I would get sick. I had to work. If I had a hot flash during an interview, I wouldn’t feel clean and I would lose confidence. It became clear to me that getting through the menopause naturally was going to be an unfulfilled dream for me."

Hot flashes come more often at the start of the menopause [11], but usually go away over time [9], [10], [11]. For most women, hot flashes will stop within one or two years all by themselves. For about one-third of women they last for up to five years, and for only a few women they will go on for longer than that [20].

Karin

"In the beginning the hot flashes were dreadful. It is hard to explain. All at once, 20 minutes later, you get the next one. It is a bit like getting contractions when you are in labour.

It has been three years since I menstruated. But I still have the hot flashes. Sometimes there is a bigger gap, then they come again in short intervals. I don't have them every quarter hour, though, which is how it was in the first year."

What causes hot flashes

Hot flashes are probably led by a centre in the brain that regulates body temperature. When the body temperature climbs too high, this centre can temporarily open the blood vessels under the skin more widely. This process is called vasodilation. It enables the body to get rid of heat and so help reduce body temperature. The skin experiences that as a wave of heat. Researchers suggest that the reduction in hormone production by the ovaries might somehow affect this temperature regulation system, but the precise cause of hot flashes is not really understood [8].

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