Skip to main content
Medically Approved

What does a hot flash feel like and what can I do about it?

twitter share buttonfacebook share buttonlinkedin share buttonemail article button
CausesSymptomsPrevention and treatmentWhat else might it be?Summary
A hot flash can feel like an intense surge of heat on the chest, neck, and face, along with flushed skin and sweating. Hot flashes are typical of menopause but can happen for other reasons. Treatment can help manage them.
Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
Updated on April 12, 2023

Perspiration, night sweats, a sensation of intense heat coming from the inside of the body, a fast heartbeat, and a cold chill are all characteristics of a hot flash. You may also experience headaches, weakness, fatigue, faintness, and anxiety.

If you’re in your mid-40s and you notice these symptoms, you may be entering perimenopause — the years before menopause when hormonal changes start to happen. Hot flashes can begin in perimenopause and, in some cases, continue for several years after menopause.

You might also have hot flashes if you are taking hormonal therapies for cancer, have surgery to remove the ovaries, or have radiation therapy that affects the ovaries. Menopause due to medical treatment is called induced menopause, and it can occur at any age as long as the person is still in their reproductive years.

Hot flashes are one of the most common symptoms of menopause, but how they affect people can vary widely. 

What causes hot flashes? 

person with a hot flash
Photography by Dmitry Marchenko / EyeEmGetty Images

The exact cause of hot flashes is not entirely understood. But, they seem to appear when lower levels of the hormone estrogen change the way the body’s thermostat and vasomotor system work.

The vasomotor system uses special nerves to control the action of the blood vessels, and this affects blood flow.

The rapid fall in estrogen around menopause affects the body’s ability to regulate its own heat, leading to hot flashes, which doctors call vasomotor symptoms.

As a result, the body heats up. To dissipate this heat, the body increases blood flow to the skin’s surface. This can cause a red flushed face and perspiration. It can also affect the heart rate. A person may feel a cold chill after a hot flash.

Hot flashes are most likely to occur in the year before and the year after menopause. Menopause is when a person has had no periods for 12 months. In the United States, it occurs at the age of 52 years, on average.

Other causes

A range of medical conditions can also cause hot flashes, such as:

  • some tumors
  • hyperthyroidism
  • acromegaly

Some medications can trigger hot flashes, such as:

  • calcium channel blockers, used to lower blood pressure
  • chemotherapy
  • tamoxifen, a hormonal cancer treatment
  • some antidepressants
  • depo leuprolide (Leupron Depot), a hormonal therapy for endometriosis

If you have hot flashes that don’t seem to be due to menopause, it is a good idea to see a doctor.

Triggers

Hot flashes can happen for no apparent reason, but they can also occur in response to:

  • a warm environment
  • consuming hot drinks
  • emotional stress

Risk factors

Some factors may lead to more severe or long lasting hot flashes.

They include:

  • smoking
  • obesity
  • geographical origin
  • a sedentary lifestyle
  • having a history of premenstrual syndrome

It is unclear why people in some geographical areas, such as Turkey, are more likely to have hot flashes. Genetic factors may play a role.

Symptoms 

The symptoms of hot flashes and their severity vary between individuals, but they include:

  • intense heat sensation in the face and upper body 
  • redness on the face and neck
  • red blotches on the arms, back, and chest
  • sweating
  • cold chills
  • irregular heartbeat
  • anxiety
  • headache
  • weakness
  • fatigue
  • faintness
  • dizziness

Some people feel only a cold chill.

On average, hot flashes last up to 5 minutes, but this can vary. Their frequency and severity also vary. Some people have an occasional hot flash, some several times a week, and others 10 times a day.

Up to 74% of people have hot flashes during perimenopause. After menopause, 36% of people continue to have them for over 2 years and 36% for more than 5 years.

Prevention and treatment

Lifestyle choices and medications can help manage hot flashes.

Lifestyle choices include:

  • avoiding alcohol, spicy foods, and caffeine
  • avoiding or quitting smoking
  • managing body weight
  • wearing light clothes or dressing in layers that you can remove
  • carrying a hand-held fan
  • practice stress management techniques, such as meditation and deep breathing

Medications

Hormone therapy can help manage hot flashes by regulating estrogen and progesterone levels in the body. Examples include estradiol (Climara), a form of estrogen, and progesterone (Prometium).

Nonhormonal options include:

Supplements

Some people use natural or alternative remedies, such as black cohosh, phytoestrogens (which mimic the activity of estrogen in the body), and DHEA.

However, the National Institute on Ageing warns that these may be unsafe to use. It is best to speak with a doctor before trying them.

Get some tips for managing menopause symptoms.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Pill bottle with text 'Starts at $4'

Free prescription coupons

Seriously … free. Explore prices that beat the competition 70% of the time.

Get free card

What might they be mistaken for?

Hot flashes can share some symptoms with a panic attack or a heart attack. Understanding the difference can help you know what sort of action to take.

Other symptoms of a panic attack include:

  • a pounding or racing heart
  • trembling
  • difficulty breathing
  • fear or a sense of impending doom
  • numb or tingling hands
  • chest pain

Other symptoms of a heart attack include: 

  • chest pain
  • shortness of breath
  • pain in the jaw, arm, or shoulder

Anyone showing signs of a heart attack needs urgent medical attention. If you’re experiencing hot flashes regularly and you don’t know why, it’s best to speak with a doctor.

Are any heart attack symptoms specific to females?

Summary

Hot flashes can cause you to feel hot in your upper body. Your face and neck may become red, and your back and chest may develop red blotches. You may also sweat a lot, feel anxious, and have palpitations.

Hot flashes usually result from either natural or induced menopause, but some hormonal and other conditions can cause them, too.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

Article resources