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What Exactly are Hot Flashes?

Updated: Dec 6, 2023


menopause woman with hot flashes



Hot Flashes


For me, hot flashes were initially not a problem. Around age 50 I would wake up around 5:00 AM feeling warm and I would have trouble getting back to sleep, but it was tolerable. A few years later I started feeling ward during the day time. Eventually, warm turned to hot. Heat would start radiating up my chest until my whole head felt like it was burning up. The heat would come in waves and they started coming more frequently until it felt like the hot flashes were back-to-back.


The Science

Although the exact cause if hot flashes is still under discussion and research is ongoing, I will share three major theories which contribute to our understanding. Normally, changes in core body temperature are communicated to the brain by heat and cold-sensitive fibers in the brain and spinal column, deep body tissues, and skin. Deep body temperature sensors are located in the gastrointestinal tract and other internal organs. It is during perimenopause and menopause when this system is disrupted. Body temperature dysregulation appears to result from a disruption or miscommunication in the complex signaling and information processing between core body temperature, brain, and peripheral vasculature.


Hot flashes, also called hot flushes or vasomotor symptoms, are the most common menopause symptom. Vasomotor means causing or relating to the constriction or dilatation of blood vessels. The vasomotor center of the brain regulates blood pressure by controlling the heart rate and the diameter of the blood vessels. So, hot flashes happen in the body, but are controlled by the brain. And no, you’re not crazy. As many as three out of four women experience hot flashes.


Some women begin having hot flashes before menopause, when they are still getting a period. The frequency of hot flashes can range from 5 per year to 50 per day, with great variations among individuals or even within an individual. Hot flashes are a sudden feeling of heat in the upper part of your body. Your face and neck may become red. Red blotches may appear on your chest, back, and arms. You may also get heavy sweating during hot flashes or cold chills after the hot flashes. Some women get more cold chills (also called cold flashes) than hot flashes.


Your Body’s Thermostat

Hot flashes may feel like a full-body experience, but they’re regulated by the busiest of brain regions — the hypothalamus. There is a wealth of evidence that the hypothalamus is hormone responsive. Your hypothalamus is the part of your brain responsible for regulating body temperature, along with appetite, and sleep cycles.


Your body temperature is regulated by a thermostat in the hypothalmus of your brain. The hypothalmus operates within set thresholds - an upper threshold for heat and a lower threshold for cold. Between these thresholds is a “thermoneutral zone” within which sweating and shivering do not occur. Normally, your body is capable of maintaining body temperature within a few tenths of a degree above or below 37C.


Warm-sensitive neurons (nerve cells) in the hypothalamus continually monitor your core temperature. The neurons increase or decrease their neural firing rate in response to temperature shifts. If you’re too hot your neural thermostat will signal your blood vessels to vasodilate, you’ll flush red, start sweating, and your heart may beat faster. Or, if you’re too cold, your neural thermostat will signal to your body to shiver, seek warmth, or go looking for a spare sweater.


During menopause, your upper ‘hot’ threshold level moves down and the lower ‘cool’ threshold moves up, so your neural thermostat narrows. As a consequence, you become much more sensitive to even tiny variations in core temperature — you’ll sweat and shiver more easily. Another area of research that has been studied which may contribute to hot flashes is chemical changes in the brain caused by changes in estrogen during the menopausal transition period. Two chemicals in the brain which have been studied are adrenaline and serotonin. Both of these are involved in thermoregulation and both have shown to be responsive to estrogen.


Are hot flashes dangerous?

Hot flashes can take a toll on a woman’s body. The increased heart rate at the beginning of a hot flash can really take a toll on a woman’s heart. Research has found intense hot flashes are associated with an increase in C-reactive protein, which is a marker of future heart disease, and to a blood biomarker that might predict a later diagnosis of Alzheimer’s disease.


How to Manage Hot Flashes

Hormone replacement therapy has long been the standard treatment for hot flashes and night sweats; however, because of the dangerous side effects and complications, there is a need for a safe and effective nonhormonal treatment for vasomotor symptoms to complement existing approved therapies.


There are a variety of natural remedies for hot flashes. Black Cohosh has been used for centuries by indigenous peoples for a variety of women’s health issues, including hot flashes, menstrual issues, and childbirth. I have personally used it and it seriously reduced the number of hot flashes I was experiencing. Black Cohosh has no known side effects.

*This is an affiliate site, meaning that I earn a small percentage when readers purchase products from the links found here. All products mentioned are from brands that I know and trust.


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