What’s the first image that comes to mind when you think of a menopausal woman? For most of us, it’s probably a sweating fiftysomething, peeling off layers while simultaneously trying to open a window in mid-January. That’s what a hot flush looks like. It’s one of the most common symptoms of menopause – and probably one of the few that most people know about. 

So is it hot in here, or is it just me? 

What is a hot flush? 

A hot flush is best described as the feeling of heat rising through the body, followed by an urge to unclothe and cool down. Once it starts, it can’t be stopped – but there are ways to ease the sensation (take off some layers, open the window) as you wait for it to pass.  

What causes hot flushes? 

Like night sweats, hot flushes are the result of a sudden fall in oestrogen, which causes the hypothalamus (the region in your brain that controls body temperature, among other things) to think that you’re too hot.  

So what’s behind it? During menopause, there’s a dysregulation in the hypothalamic-pituitary-ovarian (HPO) axis, the tightly regulated system that controls female reproduction. One thing that happens is decreased ovarian feedback of inhibin and estradiol (considered to be the strongest of the three forms of oestrogen), which primarily manifests itself as an elevation in follicle-stimulating hormone (FSH). But it also means that your system becomes unable to maintain your temperature properly.  

If the hypothalamus receives a false signal that your body is too warm, it will try to cool you down by opening up the blood vessels (in a process called vasodilation) and the sweat glands. Vasodilation directs a greater flow of blood towards your skin’s surface – causing your face to grow red – to try and dissipate the excess warmth you’re feeling. You might start to sweat, too. 

What can you do about it? Wear layers you can easily remove – and try not to get too frustrated. Hot flushes will cease once your hormonal fluctuations settle down. It’s simply a matter of time. HRT can help, as it goes some way to stabilising hormone levels, thus avoiding the fluctuations that cause most menopausal symptoms.   

Top tips for dealing with hot flushes 

Just go with it 

There will be some days when there’s nothing you can do but let nature take its course. Just go with it. Try not to overthink the whole hot flush thing, or get too upset. A hot flush will pass. Lots of women say that it’s the stress of thinking that they might have a hot flush, rather than the flush itself, that causes them the most anxiety. Having a sense of humour about it can help – though that’s sometimes easier said than done. 

Watch your diet 

It might sound obvious, but hot and spicy foods can make hot flushes worse. Focus on foodstuffs that are high in antioxidants, such as fruit and vegetables – these help to control inflammatory processes in the body. 

Cut out caffeine, alcohol and cigarettes 

If you suffer from frequent hot flushes, it’s important to reduce or cut out caffeine, alcohol and cigarettes. All of these make symptoms worse. Try not to use them as a crutch to get through the day.  

Wear loose layers 

Don’t make it hard on yourself. Wear loose layers so you can easily adjust your body temperature. Take back control of your thermostat.  

Keep hydrated 

None of us drinks enough water. Two-thirds of our bodies are made up of H2O. For women, the recommended intake is 1.6 litres per day (that’s just under three pints). The more hydrated you are, the better equipped you will be to deal with hot flushes. 

Use a cooling spray 

If you’re prone to hot flushes, try keeping a cooling spray handy. If you don’t know, it’s exactly what it sounds like: a misting spray for face and body that refreshes and hydrates. Rosey Rain spray really helped me – you can find it HERE.