When it comes to menstruation, there’s one thing that’s almost always guaranteed: one day, you’ll go through menopause and your period will stop. You hear stories about the symptoms and side effects of menopause, and you wonder how you’ll manage.

It’s okay to feel worried, especially when you’re at the whims of your fluctuating hormones. Knowing why you get certain symptoms, like hot flashes, and how to manage them is the first step to giving yourself peace of mind (and body). So what’s causing you and 8 in 10 women to get hot flashes?

Keep reading to learn more about the causes of hot flashes, their symptoms and how you can treat them with (and without) medicine.

What are hot flashes?

Hot flashes are sudden feelings of warmth or heat in the upper body – your face, neck and chest. The discomfort can range from mild to severe, but they’re usually a symptom most commonly associated with menopause.

Hot flashes typically start during perimenopause, which begins for most people in their mid-40s. During this time, your hormones start to fluctuate, which can cause symptoms like vaginal dryness, painful sex and sleep problems – in addition to hot flashes. Hot flashes may begin when you start skipping periods, but it’s more common for them to start in the year after your last period, which marks the beginning of menopause.

Hot flashes usually happen every day, and while it can feel like they go on forever, they can last anywhere from one minute up to an hour. They can also happen at any time of the day or night. For some, night flashes can feel worse because you may wake up drenched in sweat – but they’re no different from the hot flashes you’re feeling throughout the day.

Hot flashes aren’t something that’ll go away overnight. On extremely rare occasions, they can last as long as 20 years, but on average, you may experience hot flashes anywhere from 4-10 years.

What causes hot flashes? For most, it’s perimenopause or menopause

Hot flashes are one of the most common symptoms of perimenopause and menopause. But hot flashes can be caused by a range of other conditions, medications and treatments.

Menopause and changes in estrogen levels may cause hot flashes

There’s no concrete answer to the cause of hot flashes, but it’s thought that hot flashes are related to your fluctuating hormone levels during menopause. When your body goes through menopause, there’s a significant decrease in the amount of estrogen it’s producing. This decrease affects your hypothalamus.

Found in your brain, the hypothalamus regulates your body temperature. This is helpful in situations like when you exercise – as your body temperature rises, the hypothalamus will signal your body to begin cooling down, which is why your face might get red and you might start sweating.

You expect to feel flushed and sweaty while exercising, but during perimenopause, your hormones can trick your brain into thinking your body is too hot even when it’s not. Then your body goes through the process of trying to cool down, even if all you’re doing is calmly sitting in a meeting or sleeping.

Other causes of hot flashes

Hot flashes can also be a side effect of hyperthyroidism, prescription medication, and some cancers and cancer treatments.

If you think you’re experiencing hot flashes – whether it’s menopause-related or otherwise – see your primary care doctor or a women’s health specialist for diagnosis and treatment.

What are the risk factors of hot flashes?

There may be certain risk factors that increase your chances of getting hot flashes. One study found that in women 45-54 years old, factors that can increase your odds of hot flashes include:

  • Being in perimenopause – the years before menopause where your menstrual cycle changes
  • A history of smoking
  • Symptoms of depression
  • A history of using oral contraceptives

While there is no certainty on whether a history of drinking alcohol and caffeine will increase the likelihood that you’ll experience hot flashes, they may trigger the symptoms.

There may even be a connection between anxiety and hot flashes. While doctors can’t say for certain that anxiety can cause hot flashes, some research shows a link that hints at a history of anxiety and the possibility of menopausal hot flashes.

Symptoms that commonly occur with hot flashes

Hot flashes do more than cause a sudden feeling of warmth and heat in your body. Along with your hot flashes, you may experience menopause symptoms that include:

  • Clammy skin
  • Chills
  • Sweating
  • Flushing
  • Heart palpitations
  • Anxiety

Treatment for hot flashes

Hot flashes are uncomfortable, and while there’s no way to completely prevent them, your doctor can recommend treatment to help you manage them and give you some relief. Your treatment options may include hormonal medication, nonhormonal medication and lifestyle changes.

Treating hot flashes with hormone therapy

Remember – hot flashes are thought to be linked to your body’s decrease in estrogen production. To counteract this, your doctor may prescribe estrogen-based medications to balance your hormones and manage your symptoms. Your doctor may prescribe:

  • Estrogen: This is the main hormone used in hormone therapy for managing hot flashes and other menopause-related symptoms. It can be taken orally or topically as a patch, gel or cream. Your doctor may prescribe estrogen by itself, but only if you’ve had a hysterectomy.
  • Estrogen and progesterone: Your doctor will likely prescribe a combination of estrogen and progesterone if you still have a uterus because taking estrogen on its own can lead to an increased risk of uterine and breast cancers. This combination can be taken orally or via an intrauterine device (IUD).
  • Estrogen and bazedoxifene: A newer treatment combines estrogen and bazedoxifene, a drug for preventing osteoporosis. The decrease in estrogen that’s linked to both menopause and hot flashes is also linked to a decrease in bone density and an increased risk of developing osteoporosis.

Treating hot flashes with nonhormonal medicine

Instead of prescribing a hormonal medication, your doctor may recommend nonhormonal options. These medicines can balance and block chemicals in your brain – like serotonin and epinephrine – that trigger hot flashes. This helps reduce both the frequency and severity of your hot flashes.

Nonhormonal medications for treating hot flashes include:

  • Antidepressants or selective serotonin reuptake inhibitors (SSRIs)
  • Anti-seizure medications like gabapentin
  • Blood pressure medications like clonidine

Managing hot flashes with lifestyle changes

No one knows why some women experience hot flashes while others don’t, but certain lifestyle changes can help manage your symptoms. To treat your hot flashes, you can try:

  • Avoiding food and drinks that trigger hot flashes (alcohol, caffeine, spicy foods and hot drinks)
  • Quitting smoking
  • Maintaining a healthy weight and eating a balanced diet
  • Managing stress
  • Relaxation exercises
  • Wearing easily removable layers
  • Lowering the temperature so it’s cooler, especially at night

While medication may seem like the most effective treatment management, adopting these lifestyle changes can make a difference in giving you some relief from your hot flashes.

Relief is on its way

Menopause is a fact of life. It’s not a question of if it’ll happen, but when. It’s totally normal, and while you may experience a few uncomfortable symptoms, you’re not alone. You can’t control whether or not you get hot flashes, but you can take steps toward relieving your symptoms and making your life a little more comfortable.

If you think you’re experiencing hot flashes, schedule an appointment to talk to your primary care doctor or women’s health specialist.