Why Are My Hot Flashes Getting Worse?

It’s a well-known fact of menopause: Your chance of getting hot flashes before, during, and after you pass through menopause are pretty high. Hot flashes, which are caused by changing hormone levels, are ubiquitous symptoms of menopause.

There, we said it. But you probably know that, anyway: Up to 75 percent of women are visited by these heat surges during the menopause transition.

And if menopausal hot flashes weren’t bad enough, just when you’re getting used to them, they can get worse—as in, arriving more frequently and/or hitting with more force.

You’re armed with a fan in every room, cold water by your side at all times and have given up wearing anything heavier than gauze. You’ve acclimated as well as possible to dealing with your overheated body. But now your thermostat is working overtime.

Hot flashes are stealthy like that.

“Nothing in life is to be feared…it is only to be understood.”

So said Madame Curie. So, we say, let’s figure out, rather than fear, the ferocity of the flash. If your hot flashes are getting worse, there must be a reason. Then just maybe by understanding what’s making your hot flashes strike with such fury, you’ll be better equipped to tame the flames.

At Alloy, we’re passionate about providing perimenopausal and menopausal women with the most up-to-date information and treatments for menopause and menopausal symptoms—including worsening hot flashes.

We offer hormone replacement therapy solutions, such as estradiol pills, evamist®/estrogen spray, gels, and patches, as well as non-hormonal treatments like paroxetine.

If you suffer from worsening hot flashes, consider taking our online assessment to learn the right solution for you, or continue reading to learn more about hot flash facts and reasons why your hot flashes may be getting worse.

Hot Flash Facts

·  Hot flashes are caused by declining estrogen levels, which are thought to cause your body’s thermostat (the hypothalamus) to react to slight changes in body temperature. When the hypothalamus senses your body is becoming too warm, it tries to cool it down through a series of events that results in a hot flash.

·  Hot flashes may spread throughout your chest, neck or face.

·  A hot flash can be brief and last a minute or two; or it can strike for as long as five minutes.

·  Hot flashes can be mild and barely noticed or can be drenching and barely tolerated.

·  Smokers usually suffer more severe hot flashes than non-smokers.

·  Overweight women are more prone to more frequent hot flashes.

·  Studies indicate that women with hot flashes might face a greater risk of heart disease and greater bone loss than women without hot flashes.

·  Both the intensity and predictability of hot flashes can vary with each day and be different for every menopausal woman.

·  Race can influence hot flashes: Asian women report having the least, and Black women the most.

·  Estrogen can help with hot flashes but may not be appropriate for everyone. The only non-hormonal FDA-approved treatment for hot flashes is a low-dose form of the antidepressant, paroxetine (Brisdelle).

Why are my hot flashes worse?

Just when you think your hot flashes couldn’t get any worse, they do — and now, you’re more drenched than ever. There are several factors that may be why your hot flashes are getting worse. This includes:

• Certain foods

• Caffeine, exercise

• Stress

• Clothing

• Alcohol

• Smoking

• Hot baths

• Weather

• Time of day. 

We go deeper into each of these hot flash triggers below:

1. Certain foods

Spicy foods like hot peppers, chili powders and cayenne may make hot flashes worse, since they contain ingredients that cause blood vessels to expand, and in turn, cause your body to heat up and experience excessive sweating. Instead, try consuming plant estrogens in the form of soybeans, chickpeas, lentils, fruits and veggies, which might help tame hot flashes with their weak estrogen-like effects.

2. Caffeine

You might love your coffee, but maybe it’s time to cut down on your consumption: A Mayo Clinic study published in the journal Menopause shows that caffeine might worsen hot flashes and night sweats. (On the other hand, the same study found a positive effect from caffeine in its ability to help with mood and attention.) What to do? Your best bet might be drinking caffeine in moderation and making friends with chilled caffeine-free herbal tea and decaf coffee instead.

3. Exercise

It’s good for your heart and overall health, but exercise increases your body temperature, which could lead to more hot flashes, according to a study published in the American Journal of Human Biology. If you do exercise, try to avoid workouts too close to bedtime to give your body time to cool down.

4. Stress or Anger

Similar to getting “red in the face,” negative emotions can provoke a hot flash by causing the blood to rush to your face. Manage stress with meditation, relaxation, deep breathing, yoga, tai chi, or a warm bath. (We happen to also know quite a few women who swear by chewing gum, hanging out with their pets or inhaling some lovely lavender to manage their stress.)

5. Tight or Heavy Clothing

When you wear tight (think turtlenecks) or heavy clothing (think unbreathable fabric like wool or nylon), your body heat has nowhere to go and can’t escape. So, instead of dissipating, it stays close to you, heating up your skin. This might be a good time to give the heave-ho to heavy fabrics and replace them with cotton, silk, or special sweat-wicking clothing made for the heat – at least for now.

6. Alcohol

Drinking alcohol causes your blood vessels to dilate, or expand, making you feel warmer (red wine is a particular culprit). Although drinking alcohol is associated with some benefits, like cardiovascular health, the key is to drink moderately, because besides worsening your hot flashes, alcohol can also increase your risk of breast cancer. Your call.

7. Smoking

It increases your heart rate, which can cause an upsurge of hot flashes. All the more reason to toss your butts.

8. Hot baths and showers

Sure, they can be relaxing. But they can also heat up the inside of your body and pave the way for more hot flashes. Try cooling down the water temp the next time you want to relax with a soak or shower.

9. Hot Weather

Heat and humidity increase your body temperature, and in doing so, can bring on more hot flashes. Wearing layers, drinking cold water and seeking shade can help tame the heat both inside and out. And of course, the most obvious: Stay indoors, preferably planted in front of a fan or air conditioner, on the dog days of summer.

10. Nighttime

Many women have the question: why are hot flashes worse at night? Hormone levels fluctuate during the day, rising and falling with each hour. Many women experience the worst effects of these changing levels at night, when nighttime hot flashes can make it especially challenging to sleep. Be armed by keeping your bedroom cool (recommended temp for best slumber is somewhere around 65 degrees Fahrenheit), using a fan, and sleeping in light PJs or nothing at all to avoid any sleep disturbance.

The Role of Vasomotor Symptoms

Vasomotor Symptoms (VMS) occur in about 80% of perimenopausal and menopausal women. Estrogen helps to regulate the body's temperature, so when the levels of this hormone drop, as it does during menopause, it can cause the body to react to small changes in temperature, leading to hot flashes and night sweats. 

Other vasomotor symptoms can include chills, flushing, and a rapid heartbeat. These symptoms can be uncomfortable, distracting, and frustrating. Frequent night sweats can interfere with sleep, which can contribute a whole host of related health problems, including weight gain, daytime alertness, anxiety and depressed mood. VMS is also related to increased risk of cardiovascular disease, diabetes, high blood pressure, high cholesterol, and atherosclerosis.

There are various treatments available, including lifestyle changes and medications, including HRT or low-dose Paxil. These treatments can help to alleviate symptoms like hot flashes and improve the quality of life during this stage of a woman's life.

How Alloy Can Help

If your menopausal hot flashes are getting worse, know that you aren’t alone — and that you don’t have to suffer. Alloy can help you find a healthcare practitioner who understands and can help you consider your treatment options.

Explore our available solutions for menopausal symptoms or take our online assessment to discover a personal treatment plan.

Sources:

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2. "Hot flashes - symptoms and causes". Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20352790

3. "Menopause". Medline Plus. https://medlineplus.gov/menopause.html

4. Avis, Nancy E et al. “Duration of menopausal vasomotor symptoms over the menopause transition.” JAMA internal medicine vol. 175,4 (2015): 531-9. doi:10.1001/jamainternmed.2014.806

5. "Menopause FAQS: Hot Flashes". Menopause. https://www.menopause.org/for-women/menopause-faqs-hot-flashes

6. "Menopause: Non-Hormonal Treatment & Relief for Hot Flashes". Cleveland Clinic. https://my.clevelandclinic.org/health/articles/15223-menopause-non-hormonal-treatment--relief-for-hot-flashes

7. Romani, William A et al. “The association between physical activity and hot flash severity, frequency, and duration in mid-life women.” American journal of human biology : the official journal of the Human Biology Council vol. 21,1 (2009): 127-9. doi:10.1002/ajhb.20834

8. Bansal, Ramandeep, and Neelam Aggarwal. “Menopausal Hot Flashes: A Concise Review.” Journal of mid-life health vol. 10,1 (2019): 6-13. doi:10.4103/jmh.JMH_7_19

9. "Hot Flashes: What Can I Do?". NIH. https://www.nia.nih.gov/health/hot-flashes-what-can-i-do

10. Ohayon, Maurice M. “Severe hot flashes are associated with chronic insomnia.” Archives of internal medicine vol. 166,12 (2006): 1262-8. doi:10.1001/archinte.166.12.1262

11. "Drink to Your Health at Menopause, or Not?". The North American Menopause Society. https://www.menopause.org/for-women/menopauseflashes/exercise-and-diet/drink-to-your-health-at-menopause-or-not

12. Deecher, D C, and K Dorries. “Understanding the pathophysiology of vasomotor symptoms (hot flushes and night sweats) that occur in perimenopause, menopause, and postmenopause life stages.” Archives of women's mental health vol. 10,6 (2007): 247-57. doi:10.1007/s00737-007-0209-5

13. Avis, Nancy E et al. “Vasomotor Symptoms Across the Menopause Transition: Differences Among Women.” Obstetrics and gynecology clinics of North America vol. 45,4 (2018): 629-640. doi:10.1016/j.ogc.2018.07.005