How stress could be responsible for your hot flushes

Rose gold colored traditional electric fan in a home.

Hot flushes are an extremely common symptom of the menopause: three quarters of all menopausal women will experience them at some point.1 Hot flushes are sporadic, random, and sudden feelings of heat that overcome the whole body. As well as being uncomfortable they can cause dizziness, increased sweating, heart palpitations, and blushing, although symptoms vary from person to person. Although hot flushes are harmless, they can be incredibly difficult to live with. Some menopausal women report severe hot flushes in excess of 15 times a day, and around 10-20% of all postmenopausal women say they find their hot flushes very distressing.2 They can be embarrassing and disruptive to your everyday routine and can have a profound effect on your general wellbeing.

Although for most women hot flushes begin to occur after their last period, hot flushes are also common during  perimenopause, which begins several years before menopause, when a woman stills has her period.3 The exact cause of hot flushes is still relatively unknown, and it is difficult to pick out a singular definitive cause as there are multiple factors involved. During menopause, a woman’s hormone levels may rise and fall due to her ovaries producing less oestrogen. This hormonal imbalance is thought to be an important factor in why hot flushes occur.

Having said this, low levels of oestrogen do not cause hot flushes alone. It is believed that the sudden decrease of oestrogen that occurs during  menopause has an effect on the hypothalamus in the brain, which essentially acts as your body’s internal thermostat. Usually, when your hypothalamus detects the body is overheating, it triggers a series of involuntary responses such as vasodilation (which is when your blood capillaries dilate, causing your face to turn red, or “blush”) and increased sweating.

When the body is too hot, it is these responses that enable it to cool off and sustain a reasonable temperature, in a process called homeostasis. It is believed that the drop in oestrogen causes the hypothalamus to stimulate the release of hormones that trigger these unwanted hot flushes. While on a hot day this mechanism of action is important to stop you from overheating, when it occurs out of the blue at inconvenient times, it can be distressing.

What does stress have to do with it?

Stress is an important underlying factor in explaining what could be causing your hot flushes. It is an evolutionary response triggered by a perceived threatening stimulus that in turn triggers a series of bodily functions such as an increased heart rate and sweating. From an evolutionary perspective, this would have been advantageous as it would have allowed you to flee from a predator or aided in a physically demanding activity such as hunting.

Nowadays, non-threatening stimuli (such as work or family troubles) still trigger this same mechanism, causing a series of unwanted, involuntary responses. During the stress response, your adrenal glands are stimulated and produce adrenaline, which causes your heart rate to increase and your blood pressure to rise. This increased heart rate can raise blood pressure and cause a hot flush. While it is impossible to say “cut down on stress”, you could take up activities that are known to reduce levels of stress, such as exercise, meditation, or yoga. This may help in reducing the number of hot flushes you experience.

As well as ensuring you are keeping active, maintaining a healthy diet could be key in reducing your stress levels, which in turn could alleviate your hot flushes. While “comfort” foods make you feel better in the short term when you are feeling stressed, in reality these high-fat foods can make you feel lethargic and can have an adverse effect on your ability to cope with stress.4

As well as slowing you down, high-fat foods can increase cholesterol and consequently can cause an increase in blood pressure, which in turn raises your risk of having hot flushes.5 Cutting down on the amount of salt and fatty foods you consume will help reduce your blood pressure. Also making the switch from traditional comfort foods to high-fibre yet still carbohydrate-rich alternatives, such as baked sweet potatoes, may help you cope with stress. Eating fibre-rich carbohydrates releases serotonin, a neurotransmitter than can elevate your mood and help you cope with stress.

There are many other steps you can take to ensure you don’t suffer so many hot flushes. Firstly, stop or cut down on smoking, as it is known to increase both the severity and frequency of hot flushes.5 Smoking is known to have an effect on hormone levels in women, and it is believed that this causes an increase in prevalence of hot flushes.6 Also, being physically active and making sure you get enough exercise is shown to help.

While there are lifestyle changes you can make to reduce your hot flushes, there are some risk factors that you cannot do anything about. Race, for example, is also said to have an effect on hot flushes in menopausal women. Studies have shown that menopausal women of African descent have more frequent, intense, and longer hot flushes than Caucasian women. It is also shown that Hispanic women have more frequent, although less severe hot flushes than Caucasian women.7,8

Whilst in isolation hot flushes are inconvenient and uncomfortable, there are a number of secondary complications that can arise that can cause more severe problems. For example, hot flushes during the night can keep you awake and cause ‘night sweats’. This can subsequently lead to a lack of sleep which can lead to a host of medical problems as well as having detrimental effects on your general health and wellbeing. In some cases, hot flushes can also induce anxiety and could even trigger bouts of depression. If you feel that hot flushes are having a detrimental effect on your wellbeing, it is important to seek the advice of a doctor who could prescribe you medication to keep them under control.

References

  1. Cappelloni, ‘What do you want to know about menopause?’, [website], 2016, http://www.healthline.com/health/menopause, (accessed 20 March 2017).
  2. Ibid.
  3. Ibid.
  4. Physicians Committee for Responsible Medicine, ‘How to eat right to reduce stress’, [website], 2016, http://www.pcrm.org/health/health-topics/how-to-eat-right-to-reduce-stress, (accessed 20 March 2017)
  5. Sadeghi et al., ‘The correlation between blood pressure and hot flashes in menopausal women’, ARYA Atherosclerosis, vol. 8, no. 1, 2012, pp. 32-35.
  6. Boyles, ‘Menopause: Smokers have more hot flashes’, [website], 2012, http://www.webmd.com/women/news/20120503/menopause-smokers-have-more-hot-flashes#, (accessed 20 March 2017).
  7. Cappelloni, ‘What do you want to know about menopause?’.
  8. W. Freeman et al., ‘Duration of Menopausal Hot Flushes and Associated Risk Factors’, Obstetrics and Gynaecology, vol. 117, no. 5, 2011, pp. 1095-1104.

George Cooper BSc (Hons)

George attended Newcastle University, and graduated with a degree in Biomedical Sciences. Since graduating, he went on to work in breast cancer diagnostics, specialising in genomic testing and the ever expanding field of personalised medicine. He now works within medical education and communication, and as a freelance medical writer.

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