Hot flash

Lore & Background

Hot flashes and night sweats are vasomotor symptoms, typically experienced as a feeling of intense heat with sweating and rapid heartbeat. The sensation of heat usually begins in the face or chest, although it may appear elsewhere such as the back of the neck, and can spread throughout the whole body. Some people feel as if they are going to faint. The surface of the skin, especially on the face, becomes hot to the touch, which is the origin of the alternative term 'hot flush' since the sensation of heat is often accompanied by visible reddening of the face. The hot-flash event may be repeated a few times each week or every few minutes throughout the day. Hot flashes may begin to appear several years before menopause starts and last for years afterwards. Some people undergoing menopause never have hot flashes. Others have mild or infrequent flashes. Those most affected experience dozens of hot flashes each day. In addition, hot flashes are often more frequent and more intense during hot weather or in an overheated room. Hot flashes can occur in males with low testosterone, in those with prostate cancer or testicular cancer undergoing hormone therapy with antiandrogens, and in castrated males. They can also occur in intersex people with disorders of sex development, especially when hormones are in flux or after surgical interventions not accompanied by supplemental hormones. Transgender men also commonly report hot flashes linked to hormonal changes from masculinizing hormone therapy.

Reader's Guide

Hot flashes are significant as the most commonly recognized symptom of menopause, affecting a large portion of the population undergoing hormonal transitions. The condition can severely impact quality of life, causing insomnia, mood changes, and impaired concentration. Research on hot flashes is mostly focused on treatment options, with the exact cause and pathogenesis not yet fully studied. Hot flashes are associated with declining levels of estrogen and other hormonal changes, but low estrogen alone is not the sole cause, as women who experience hot flashes have approximately the same plasma estrogen levels as women who do not. Treatment options include hormone replacement therapy, which may relieve many symptoms but carries risks such as increased risk of breast cancer, stroke, and dementia. Non-hormonal therapies include selective serotonin reuptake inhibitors like paroxetine, which became the first non-hormonal therapy approved by the FDA for menopausal hot flashes. Other treatments include clonidine, curcumin, and isoflavones. The legacy of hot flash research lies in the ongoing effort to understand its mechanisms and develop safer, more effective treatments for those affected.

Did You Know?

• Hot flashes may begin several years before menopause starts and last for years afterwards.
• Roughly one-third of females experience night sweating alone, while about one-third experience night sweats in combination with hot flushes.
• Some menopausal females may experience a second type called 'slow hot flashes' or 'ember flashes' that are less intense and last around half an hour.
• Transgender men commonly report hot flashes linked to hormonal changes from masculinizing hormone therapy.