Uncategorized Hot Flashes & Night Sweats


We all have a different experience

Some people call them flashes, and some call them flushes. Whatever you call them, they’re no fun and a royal pain in the . . . well, you get the idea. Everyone is different! This is one of the most confusing aspects of menopause because when you ask your friends about whether they’re feeling hot at night or warm throughout the day, it’s likely that their experience is completely different.  You see, we all receive our very own unique and personal ticket for the hormonal roller coaster of menopause. This makes it even more difficult to know if these weird temperature changes are menopause or something else entirely.


It’s hard to feel cool and confident when your underarms are like faucets or Niagara Falls and you’re sweating through your clothes within seconds of putting them on. Or maybe your face turns bright, beet red, and sweat appears on your forehead or upper lip as soon as you take your first sip of hot coffee in the morning or are about to jump on a Zoom call, makeup running down your face.


We’re definitely hot around menopause, but it’s not the “I’m turned on” kind of hot, it’s the “100 percent humidity, I’m sweaty and sticky and miserable, don’t touch me, I want a cold shower,” kind of hot.


What it feels like

For women who’ve never had a hot flash or a night sweat, it’s similar to what you’d experience if you were in a pleasant room at the perfect temperature and you suddenly stepped into a sauna or steam room. There’s one important difference though: for many women, the heat starts from inside your body, then radiates outward to the surface. Women describe hot flashes as an intense feeling of searing heat that comes on abruptly and out of nowhere. It’s as if they have a coal-fired furnace in their chest pumping out lava hot heat faster than the speed of light.


Everyone is different

How each woman experiences hot flashes and night sweats in menopause differs widely. Some women find that the heat smolders slowly at their chest or waist level and then rapidly picks up speed as it travels upward to their face and head and brings with it drenched underarms. With these temperature changes, whether it’s day or night, many of us feel our hearts pounding or racing and this leads to more worry about whether this is menopause or a heart condition. The anxiety is real and often triggers another hot flash. 


Many women notice a roaring or rushing sensation in their ears. It’s like nothing they’ve ever experienced and it can be very upsetting. Some women describe a little sensation of heat that starts at the back of their necks and then suddenly flashes upward encompassing their entire head and scalp. Others feel heat radiating from their chest to their arms and hand. I used to feel as if my skin was sizzling like bacon in a pan and always expected to see steam rising when I washed my hands.


Not everyone feels hot though!  Some women feel chills and shiver. Some feel so cold, that they can’t seem to get warm, and then when they do get warm, they have a hot flash and then another round of chills. 


Night sweats are often more bothersome than hot flashes because they derail restful and rejuvenating sleep, leading to exhaustion, irritability, mood changes, difficulty focusing, and brain fog.


Why do we have Hot Flashes and Night Sweats?

In perimenopause and menopause, our estrogen levels decline which has an enormous impact on our brain’s internal thermostat, located in the hypothalamus. It goes a bit haywire and just gets very mixed up. The hypothalamus is very sensitive to the fight or flight stress hormone, norepinephrine. This is what is released when we’re running away from danger, let’s say a saber-tooth tiger. 

Here’s what happens.  When anything triggers the release of norepinephrine from stress to drinking hot coffee, the brain gets the signal to run away from the threat. So our hearts pump faster, blood vessels near the surface of the skin expand and dilate and our sweat glands activate. This is all designed to help us to cool off quickly and run away from the threat. But it doesn’t work that way in menopause. 

Instead of cooling off, we feel warmer with a flush or flash of intense heat and sweating, shivering, and chills.

We also know that another neurotransmitter also plays a role here, Serotonin, which is our brain’s feel-good neurotransmitter. Serotonin helps us feel happy, calm and wards off depression, and it also helps blunt or decrease the effect of norepinephrine on the temperature center. Unfortunately, this is another area where there’s an interconnection between the body and mind, because in menopause, as estrogen levels decline, so do serotonin levels. 

With lowered serotonin levels, not only are women more likely to be depressed or anxious, but they also are more susceptible to Hot Flash and Night sweat triggers.


Your narrowed thermostat

Before menopause, when estrogen levels are higher,  we have a very wide thermostat, meaning that we can have lunch in the intense heat of Arizona and not sweat, or hike on a cold day in Alaska and not shiver.  

But in and around menopause, just drinking a cup of hot coffee, eating a spicy meal,  having a glass of wine, or reading a stressful email will trigger a hot flash or night sweat.  



There are a few things that often trigger the release of the fight or flight stress hormone, norepinephrine that leads to a hot flash. Here are just a few:


Hot drinks

Hot showers

Stress –


Spicy food


Too many clothes

Hot weather or warm rooms

Fatty foods




Double Whammy

Here’s the thing about triggers, they can lead to an immediate hot flash and can also make you more likely to have 1 or more night sweats that night. 


Sudden menopause from surgery or chemotherapy

If you’ve had surgery to remove your ovaries or are undergoing chemotherapy that impacts your ovaries, the sudden loss of estrogen can lead to very intense hot flashes and night sweats that come on immediately. This can be especially upsetting if you weren’t expecting these physical changes on top of trying to recover from surgery or deal with the side effects of chemotherapy.



When it comes to treating hot flashes and night sweats one size never fits all. But there are effective and safe treatments. There are numerous remedies that range from yoga breathing and herbs to a soy metabolite, S-Equol, and other non-prescription, hormonal and prescription options. You can learn more in my eGuide Remedies and Relief.

Nurse Barb

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Disclaimer: The information provided on this site is intended solely to serve as a guide to Perimenopause and Menopause and to provide basic evidence-based information about the symptoms, long and short-term impact to health, the causes, as well as the risks and benefits of various treatment options.

This site does not claim to prevent, cure or treat any medical disorder or disease. It is designed to inform and support decisions that should be made with your own personal licensed healthcare provider. It is not intended as a substitute, nor should you use this as a substitute for the medical advice and/or gynecologic care given by your own licensed healthcare professional. It is your exclusive responsibility to seek medical care as needed. No pharmaceutical or medical device companies contribute to the content or the cost of providing this education.

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