Making Sense Of Women's Health

Hot Flushes and Night Sweats: What They Are and What Helps

Roberta Bass Season 1 Episode 44

Hot flushes and night sweats are two of the most common — and often most frustrating — symptoms during perimenopause and menopause, affecting around 80% of women. But even though they’re common, there’s still a lot of confusion about what causes them, when to seek help, and what actually works.

In this episode, Roberta explains:

  • What hot flushes and night sweats feel like — and why they happen
  • How hormone changes affect the brain and body temperature regulation
  • When flushes might not be caused by menopause and need medical review
  • Evidence-based strategies that can reduce symptoms, including breathing techniques, strength training, and diet
  • Supplements with scientific support, like sage, magnesium, and red clover
  • How to improve sleep and manage triggers like stress, caffeine, and alcohol
  • When to seek extra help — and what support is available

Whether or not you’re considering HRT, there are many ways to reduce hot flushes and feel better day to day. Book a Menopause MOT to start your personalised plan.

🔗 Book a Menopause MOT: https://thriveandshinewomenswellness.co.uk/peri-and-post-menopause

📧 Share this episode or leave a review to support other women on their menopause journey.

www.thriveandshinewomenswellness.co.uk

Supporting Women's Health Transitions with Education, Physiotherapy, Mentoring, Pilates, and Hypnosis.


Hi and welcome back to Making Sense of Women's Health. I am Roberta Bass, a Women's Health Physiotherapist, a Pilates instructor, a menopause mentor and a remedial hypnotist. And today we are going to be talking about hot flushes. They are one of the most common and often frustrating symptoms of perimenopause and menopause.

With summer approaching and the temperatures getting hotter outside, they can feel even harder to manage. So in this episode I'll explain why they happen, why they're often worse in warmer weather, and the evidence-based strategies from paced breathing to strength training that have been shown to help. So let's start with what they actually are.

So hot flushes or flashes as the Americans call them and night sweats, collectively known as vasomotor symptoms. And they affect around 80% of women normally during the perimenopause transition, but sometimes they can continue.

That means that four in five women will experience at least some episodes of sudden heat, sweating or flushing. But, and this is really important if you go to the GP, you don't have to be getting hot flushes to be perimenopausal. So that 20% of women will not be experiencing them. And often when you go to the GP, they ask you one of their first questions is, are you having hot flushes?

And you say no and they dismiss the fact that you might be perimenopausal. But menopause presents so differently for every woman and hot flushes are just one of the possible symptoms among many and the GP needs to be looking at all symptoms not just the most common ones.

A typical hot flush is short-lived. It's like a wave of heat, usually in the upper body or face and can last for 30 seconds, about five minutes. It may include sweating, flushing, a racing heart or even some anxiety. And when they happen at night, they're often called night sweats and they can disrupt sleep, sometimes without you even realizing it at first.

And sometimes after having a hot flush, because the body works to correct that temperature change, you may then go the complete opposite and be really cold afterwards. So we go from hot to cold, sweating to shivering quite quickly. And they are believed to occur because of the fluctuating estrogen levels that affect the hypothalamus, which is our brain's thermostat. And your brain becomes really sensitive or hypersensitive to small changes in core body temperature and overreacts by trying to cool you down.

But just a quick note before we continue, sometimes hot flushes and night sweats aren't always linked to menopause. So if you're experiencing sudden severe or unexplained symptoms, it really is important to consider other causes as well.

Night sweats in particular can sometimes be a sign of other things such as infection, overactive thyroid or certain cancers such as lymphoma or even due to medications. If you're also noticing things like unexplained weight loss, persistent fatigue or swollen lymph nodes, please go and speak to your GP. It probably is nothing serious but it really is best to check.

But now back to menopause-related hot flushes. So as you can imagine, summer can often make things feel worse because the temperature outside rises, your core body temperature rises too. And for women in perimenopause, your body is already more sensitive to even the slightest change.

Plus summer often brings other things with it — more time outside in the heat, often dehydration. It might be that you're going out and drinking more alcohol when you're meeting up with friends or going to the pub. Might be that you're having more sugar or spicy foods.

Often we get disrupted sleep and sometimes higher stress levels, especially during the summer holidays if you're having to deal with kids at home, still trying to work and keep the house — and all of these things are known triggers.

So let's look at how we can reduce some of these triggers and how we can improve our hot flushes.

Now one of the simplest ways that research shows is actually to do some paced breathing. So this is slow controlled breathing and it can reduce the frequency and severity of hot flushes. One of the simplest ways to do this is if you count on your fingers, counting from one to five each time, bringing one of the fingers out. So you'd count with your thumb one, two, three, four, five as you are inhaling and then exhaling going back again — five, four, three, two, one as you exhale. Or you might do counting for four as you breathe in and for six as you breathe out, or even things like square breathing.

Anything where you are mindful and slowing your breathing down can be really helpful. Evidence shows if you can do this five to ten minutes daily or when a hot flush starts, it can really decrease the severity and frequency.

You could also pair it with other things that help to reduce your stress levels, such as calming music or guided relaxation.

Coming on to our nutrition. Now certain foods are going to make hot flushes worse, particularly caffeine, although I know that's a drink, and alcohol — also a drink — but spicy foods and anything with loads of sugar, all of those things are a known trigger. And processed foods and really heavy meals can also increase your core temperature.

So the best thing is for any menopause symptoms is trying to switch to a Mediterranean-style diet. And if you try and get lots of different plant foods in — if you can aim for 30 different ones in the week — and that can include herbs and spices, lots of different fruit and veg, anything that's plant-based, then that can be really beneficial.

Also adding some phytoestrogens. So these are types of estrogens that are found in some foods. So things like flax seeds, chickpeas and soy. Soy is a bit of a debatable one depending on the source of it because the way that they get soy can put lots of chemicals in it. If it's a nice organic type then it might be okay, but definitely flax seeds and chickpeas are really good because they give you that plant-based type of estrogen.

Also, if your estrogen is too high — particularly flax seeds — they can bind onto the receptors of the estrogen and give you a slightly weaker form of estrogen. But then it actually helps to reduce the overall estrogen because you're getting a weaker form rather than the stronger form if it's too much within the body. So it helps to balance it either way. If your estrogen is too low, it helps to give you a bit of extra. If it's too high, it helps to reduce it.

So it's a good idea to try and include some of those in the diet. Also having some oily fish twice a week — so salmon or tinned mackerel — can be really helpful. Using olive oil, having some nuts and seeds gives you lots of good healthy fats. Reducing your meat intake, particularly red meat because that is high in our omega-6 — which is not necessarily our good omega. We want our omega-3 — and it can cause inflammation within the body. And certainly any processed foods or processed meat is probably going to be one of the worst things, as well as anything that's really high in sugar.

Changing the diet, going for a more Mediterranean-style, can support the hormone balance, really helps with gut health and also helps with your nervous system function.

Exercise — particularly strength training. Studies have shown that women who engage in regular resistance training — this doesn't have to be weightlifting, this could be body weight, resistance bands — but any kind of resistance training can actually experience up to 50% fewer hot flushes.

So it's trying to aim for two or three strength sessions a week. That could be Pilates, it could be body weight exercise, resistance bands — lots of different things or the same thing — but trying to get a few sessions in the week. And if you combine that with aerobic activities like walking — particularly out in nature — cycling or swimming, that can be really beneficial and give you better results.

Stress. Now stress is a major trigger for hot flushes. It activates the fight-or-flight response, which raises your heart rate, increases your core temperature and can directly trigger a flush.

Particularly if you have a hot flush and you become really stressed and anxious about it, we are then being anxious and stressed every time we think we might get one. And therefore it raises our cortisol levels, raises our temperature, so it's likely to trigger one.

So you get in a vicious cycle of being stressed about having one, the stress then causes one, and then you're stressed about having more. Simple strategies that can help reduce your stress levels — things like journaling, yoga, stretching exercises like Pilates, Tai Chi, mindfulness or meditation, hypnosis, or taking up creative hobbies. I did an episode on this a couple of weeks ago. Things like drawing, gardening or crafting are really good to reduce your stress levels.

In guided visualization or breathing exercises — particularly if you visualize when you are having a hot flush of a cool fluid or energy running over you. So it's trying to calm your body down. And if you combine that with breathing at the same time and try not to get anxious or stressed when you're having a hot flush, that can help to reduce the frequency because we're not getting that anxiety about having them. So it's not raising the temperature, not raising our cortisol levels.

Reducing stress isn't just good for hot flushes — it also helps to support your sleep, mood, and energy. And those will all in turn help with the hot flushes.

Speaking of sleep — if you are struggling with night sweats, make sure that your environment is good. That you've got a cool bedroom, layers, lightweight bedding that you can remove. Ideally, bamboo or cotton can be really helpful. Having a cooling pillow or a mattress topper that's cooling can be helpful. A fan by the bed or having a window open.

Also just thinking about general sleep hygiene — which I've spoken about many times — so if you want more details, go back and look at a different episode. But avoiding screens and alcohol before bed, or maybe having some cooling sprays or a cold flannel on your bedside table, and even chilling your pillowcase or pyjamas in the fridge an hour before bed can be helpful.

And if you are waking up regularly and having hot flushes or night sweats — is it the night sweat that is waking you up? Or are you waking up for a different reason and then having a hot flush? And if you can work out why you're waking, it might be that you need to address something else first. So there's another reason why you're waking and then it's that sudden waking up that causes our cortisol levels to rise, then your body temperature to rise, and then causes the flush. So it's working out which way around it is.

We've spoken about resistance training, but any regular movement can help improve your temperature control and helps to manage your stress. And they don't need to be long workouts — it could be 20 to 30 minutes of walking or Pilates or some light cycling is enough. And getting out in nature also gives you that stress management side of it as well. Ideally, we’re having three to five times of aerobic activity and two to three times of strength training, and adding something that’s maybe calming or balancing like the yoga or Pilates or some Tai Chi if you can.

Now I spoke about supplements last week or the week before and they can be helpful. Some women do find that certain supplements can reduce the frequency or severity of hot flushes. Although the results vary and they're not a guaranteed fix, evidence is again, as ever, limited. But there are a few that have some studies that back up using them — or at least trying them.

Sage is one of those. You can use that just in your food or you can have a sage extract. That has been shown in some studies to help reduce the frequency and intensity and it’s best used early on — so in perimenopause.

Magnesium has also been shown to reduce hot flushes in some women, especially if you are avoiding HRT. It also helps to support your sleep and your stress.

Folic acid — again some limited evidence that suggests it may reduce flushes, and possibly this is due to its effect on mood and neurotransmitters.

Black cohosh is one of the most researched herbal options. Evidence is mixed — some studies show it's beneficial, others don't. Trying it in the short term is generally safe, anything longer may not be.

Red clover — contains those phytoestrogens, so the plant-based estrogens — may help with mild to moderate symptoms, again especially in early perimenopause.

If you are considering taking any of them, make sure that you choose high quality brands. Be cautious with combinations, particularly if you're taking any other medication. It’s always worth speaking to your healthcare provider if you've got any other health issues.

Supplements aren't a one-size-fits-all and they can be helpful to some women, not to others. But they can be useful in a broader support plan — but they are not necessarily the cure on their own.

So when do we need to get further support? These things may be really helpful that we've spoken about today. But if your hot flushes or night sweats are affecting your life — affecting your sleep, confidence, relationships or mental clarity — please don’t think you just have to live with it.

Yes, HRT can be a safe and effective option for many women. But if you can’t take it or you don’t want to take it, there are other ways to feel better. And those are exactly the things that we explore within the Menopause MOT.

So this is a 90-minute one-to-one session where we look at your symptoms, your triggers, your lifestyle and your goals. We create a clear supportive plan tailored to you. So whether it's hot flushes, joint pain, mood, or just not feeling like yourself anymore — we can get to the root of it.

And we can do this appointment in person or online. The link will be in the show notes, or you can just visit the website and all the details will be on there.

Thanks for joining me today. And if you found this episode helpful, please do share it with your friends and leave a review — it really helps spread the word and support more women navigating this transition. And remember — you don’t have to be having hot flushes to be perimenopausal. Symptoms show up in many different ways, and every journey is unique. Take care and I’ll see you next time.