Hot flashes are a common complaint in many people. Hot flashes are felt like sudden feeling of warmth in the body, which is felt more intensely over the neck, face or chest and sometimes in the palms and feet. It is a feeling of suddenly being warm in certain areas and may also be followed by sweating in some cases.
This feeling of hot flashes can appear in episodes and not necessarily continuous. It is usually seen as a brief period of around 30 seconds to few minutes, when the hot flashes may be actually felt. This may last for a day or two and may be followed by no complaints for some time. Hot flashes may recur again after some time and may run its course of complaints for some time.
Hot flashes in women can be seen during any phase but are very common around the time of menopause, most probably attributed to the hormonal changes in their body. It is not always experienced by all women, but some may feel hot flashes during early menopause and the transitional phase. While it is common to observe hot flashes in women, it is not unusual to note hot flashes in men. Yes, men too, at times can experience hot flashes, which can also be commonly related to changes in men hormones.
What Causes Hot Flashes?
Hot flashes are believed to occur in women around menopause and sometimes in men, most probably due to hormonal involvement. The feeling of warmth in the body and particular areas is commonly noted when people experience hot flashes. While the exact cause of hot flashes is not clearly understood, it is believed that the warm feeling may occur due to dilation of blood vessels in the given area or body part, possibly as a response to hormonal changes.
Some studies suggest that approximately 85% women experience hot flashes before or after menopause. The duration of hot flashes is not fixed and may vary from person to person. In women, symptoms of hot flashes may be noted few years prior to menopause and may persists for few years after that. Some women experience hot flashes for few months while some may have complaints for some years. However, it is not necessary that all women approaching menopause or who have had menopause will always experience hot flashes. Similarly, the number of episodes in those years is also not fixed and may appear differently in different people. Hot flashes in men are also felt like a warm feeling in the head or other areas and may be similar to that in women.
What Causes Hot Flashes in Women?
Hot flashes in women are most commonly seen around menopause. This is the period, when women experience hormonal changes and some changes do occur in their bodies. Commonly known as ‘change of life’, menopause results in decreased levels of estrogen in the body. Estrogens are women hormones and are mainly involved in performing female related functions. Reduced levels of estrogen can trigger the hypothalamus, situated in the brain, which is in control of temperature regulation in the body, in addition to other functions like sleep, appetite and sex hormones.
While the concept is not exactly clear, it is thought that the drop in the estrogen levels affects the hypothalamus. Due to being triggered, it senses that the body is feeling too hot, when in reality, the body is actually normal and not hot. However, as the hypothalamus feels so, it releases signals that are normally released when the body becomes hot. It causes rapid beating of the heart, dilatation of blood vessels supplying the body, mainly the skin under the head, neck, face and chest. This is followed by triggered sweat glands that cause sweating.
This explains the feeling of warmth in the body parts, hot feeling and redness. When the dilated blood vessels, return to normal and the trigger is over, the body regains its normal feeling. This occurs when the episode is over and there is sweating and a cold feeling in the previously heated body parts.
This system of releasing heat is otherwise activated when the body feels hot, which protects the body from overheating during heat, like in summer. Hence, in summer or when the body feels too hot, there is feeling of warmth, heated sensation or burning and sweating followed by cool feeling. The same phenomenon occurs in some people, when there is imbalance in hormonal levels, particularly estrogen in women. A drop in estrogen, confuses the body system about the temperature of the body and causes activation of the hypothalamus resulting in a response, normally seen in case of overheating. This ultimately results in hot flashes, which are experienced only by that person, even when it is not hot for all others around.
Reduction in estrogen levels can occur in women experiencing natural menopause. It is also common in those having undergone surgical hysterectomy or removal of uterus and the related structures, which usually contribute to the production of estrogen hormone. Some women, may be prescribed certain hormonal medications that can cause reduction in estrogen levels.
In some women, hot flashes can also occur due to certain medical conditions that affect the normal temperature control, managed by hypothalamus. Some of these conditions include carcinoid syndrome, which being a type of endocrine tumor, can cause increased secretion of a hormone called serotonin. This can cause hot flashes in women. In some cases, hot flashes in women may also be noticed in those women suffering from certain infections or cancers, which are associated with fevers and excessive sweating.
What Causes Hot Flashes in Men?
The concept of hot flashes commonly reminds of women, but that’s not the case. Hot flashes can be noted in men as well. Some studies suggest that although less men may experience hot flashes than women, for some men, hot flashes can be as troublesome as it is in women. Just as women experiencing hot flashes are affected by decreased estrogen, men experiencing hot flashes can be affected by changes in testosterone levels in men. In contrast to women, men do not experience a sharp decline in their hormones with aging. In most men the testosterone hormones may decrease very little as they grow older and have sufficient stores so as to not cause much problems. Hence, most men do not experience hot flashes on growing old and only a few, who may have conditions influencing testosterone levels may be affected.
Severe testosterone deficiency in male menopause or andropause can influence the hypothalamus and cause response to control the wrongly sensed overheating. The attempt to cool the body results in hot flashes in men followed by sweating and cold feeling.
Hot flashes in men, resulting from andropause can present with warm feeling and night sweats in middle aged men. This may also be accompanied with lack of proper sleep, insomnia, delayed hair growth, weight gain or reduced metabolism. Some men may also experience palpitations, anxiety and restlessness.
Hot flashes may be seen in men who receive treatment for prostate cancer. Testosterone is believed to trigger and promote growth of prostate cells, hence it needs to be controlled as a part of the prostate cancer treatment. This type of treatment is called androgen deprivation therapy, which is given to reduce testosterone levels. While this treatment is effective in treating or controlling prostate cancer, the side effects of it result in decreased testosterone levels. A drop in testosterone levels can trigger the hypothalamus, which senses that the body is feeling hot. It tries to control the heated system by causing warmth and sweating in the body, more commonly the head, neck and face region. This can cause hot flashes in men.
Hot flashes in men occurring due to treatment related causes, often subside few months after the treatment is stopped. Studies report that most men treated with androgen deprivation therapy experience hot flashes. Also, some men, who have undergone castration due to prostate cancer, too can feel hot flashes and this can be as severe as hot flashes in women. Sometimes, conditions affecting the temperature regulation in body or hypothalamus can also result in hot flashes and night sweats.
Symptoms of Hot Flashes
Hot flashes present with a hot feeling or a feeling of warmth in the head, face, neck, chest and trunk region. It may be associated with a burning sensation under the skin in these areas. The area experiencing hot flashes appears red and the skin looks blotchy. Some people experience increased heart beats and an in-general hot feeling. This can be followed by sweating, most commonly around the head and the areas experiencing hot flashes, which is mostly accompanied by a cold feeling in these areas. This is usually the end of the hot flash episode.
Hot flashes can appear suddenly, last for some time and usually subside on their own. It may be more commonly felt at night and can be accompanied by profuse sweating in the head and neck regions. Men and women experiencing hot flashes may feel it for few years and it may stop on its own.
Sometimes, hot flashes may be accompanied with palpitations in the heart, feeling of pressure in head or around neck, dizziness, weakness or fainting. Hot flashes may be commonly seen during the night and can result in poor sleep or sleep disturbances, irritability and tired feeling during the day, poor concentration and memory or cognition problems.
However, if symptoms of hot flashes persist for a long time and are associated with other complaints or discomfort, it is advisable to seek medical opinion.
Hot flashes are commonly believed to be a result of hormonal changes, both in men and women. Most theories revolve around this concept and it can be explained for hot flashes in men and women, both.
Risk Factors for Hot Flashes
Not everyone experiencing menopause or andropause has hot flashes. Along with the causes of hot flashes given above, there are certain risk factors which can make a person more prone to experiencing hot flashes.
These risk factors for hot flashes include:
- Smoking – This is an important risk factor and people who are involved in smoking are likely to increase their chances of having hot flashes. Smoking, due to various reasons, can influence the way the body functions and can sometimes contribute to the risk of hot flashes.
- Being overweight – Overweight and obese people, meaning those with a higher Body Mass Index (BMI) are at an increased risk of experiencing hot flashes. Being overweight can increase the risk of hormonal imbalance and can affect other bodily functions as well.
- Sedentary life – Physical activity is important to maintain good health. Most people who are physically inactive and lead a sedentary life, increase their risk of having hot flashes. Being physically active helps to keep the body healthy and ensures proper functioning, thereby getting less affected by influencing factors. Regular exercises and physical activity can help keep many illnesses away and decrease the risk of some health concerns like hot flashes.
Diagnosis of Hot Flashes
Hot flashes in both women and men are often a symptom or a complaint and not a condition. It is either a result of hormonal imbalance due to aging, as a side-effect of certain treatments or due to other underlying medical conditions. A thorough medical history about the complaints of hot flashes, evaluation of other associated complaints and other existing illnesses can help to understand the condition of hot flashes. Physical examination maybe performed to examine certain areas and to co-relate with the history and clinical complaints.
As a part of investigation, blood tests may be performed to assess the hormone levels for hot flashes in men and women. Measuring levels of estrogen and if, required other hormones in women. A hormone named Follicle Stimulating Hormone (FSH) is elevated during menopause, may be measured. Assessing levels of testosterone in men, may be helpful and any additional tests may be done, if required. Additional blood tests to determine presence of certain infections, markers for certain types of cancers and other relevant tests may be performed as appropriate.
- Mayo Clinic – Hot flashes: https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20352790
- WebMD – Hot Flashes: What Are They? https://www.webmd.com/menopause/guide/menopause-hot-flashes
- Cleveland Clinic – Hot Flashes: https://my.clevelandclinic.org/health/symptoms/17732-hot-flashes
- Medical News Today – Hot flashes: Causes, Symptoms, and Treatments: https://www.medicalnewstoday.com/articles/317080
- Harvard Health Publishing – Menopause-related hot flashes and night sweats can last for years: https://www.health.harvard.edu/mind-and-mood/menopause-related-hot-flashes-and-night-sweats-can-last-for-years