Hot flashes and stress
By far, the most common cause of hot flashes is a stress reaction that causes epinephrine and norepinephrine release into the blood stream. This in turn causes increased blood flow and thus increased heat. A hot flash may ensue to get rid of the heat.
The trigger can even occur during deep REM sleep (presumably from dreaming).
Take off your blankets
The next most common cause of a hot flash is just simply that the body is too warm. This can happen at night with thermal blankets or by just sitting with a portable computer on your lap for awhile. We have radiant heat panels at our house that overshoot the thermostat and often cause our family to have night sweats when they come on.
How can I know if the hot flashes mean I am menopausal?
We know that women have hot flashes in the decade before menopause. They certainly are not as frequent as during the menopause but we cannot predict them and cannot know for sure if they are due to low estrogen at the moment.
When we measure estrogens or measure FSH, the brain hormone that becomes elevated when the ovaries finally fail, they are usually in normal ranges.
If you are still having normal, regular menses, then asking the doctor to request blood studies for menopause is not likely to yield results. The doctor should check the TSH level for hyperthyroidism however.
Alternatively, if your menses are irregular, you should ask you doctor to check for possible menopause or low estrogen state. Remember that smoking can lower blood estrogens; thus women who smoke will have more hot flashes in the perimenopausal period.
What can be done to lessen or stop hot flashes or night sweats that are not due to low estrogens?
First of all, I would say that if hot flashes or night sweats are less than once a week, you might just ignore them. They are not harmful and at that frequency, they do not usually represent a disease process.
If they are more frequent, you might try the following:
- Avoid any foods, alcohol or caffeine within 3 hours of going to bed
- Avoid exercise, hot liquids or smoking within 3 hours of going to bed
- Drop the evening thermostat by about two or three degrees without adding more covers
- Wear light bed clothing
- If you feel stressed out from daily work or family events, take at least an hour before bedtime for some relaxation activity ( if you cannot "afford" an hour before bedtime to do this, there's your answer)
- Examine and try to avoid individual triggers (i.e., strong emotions, caffeine, alcohol, cayenne, occlusive clothing, heat).
- Use fans during the day.
- Wear clothing made of natural (i.e., cotton) materials.
- Practice deep, slow abdominal breathing, taking six to eight breaths per minute: Practice 15 minutes in the morning and evening, and use this technique in conjunction with "premonitions" of hot flashes. This can produce a 50% decrease in hot flash frequency.
- Exercise or walk, swim, dance or bicycle every day for 30+ minutes but not within 3 hours of bedtime
If the above measures are not successful to stop night sweats and hot flashes almost entirely, then you should see your doctor to be evaluated for menopause or thyroid disease as well as other possible conditions.
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