The Troubling Ups and Downs of Hot Flashes

Are My Hot Flashes Getting Worse? 

Many women going through perimenopause and menopause find themselves asking this question: Are my hot flashes getting worse? The disturbing and frustrating answer for many women is, potentially yes, but this does not mean that there are no answers and potential hope at the end of the hot flash tunnel.

What Are Hot Flashes? 

Hot flashes are one of the most troubling symptoms of many women’s perimenopause and menopause journeys. A woman will often feel overwhelmingly hot and flushed during a hot flash – often turning red across her chest, neck, and face – irrespective of the air temperature. In addition, hot flashes can also lead to an accelerated heart rate and a feeling of stress or anxiety. 

For most women, these hot flashes can be relatively minor. On the other hand, some women are debilitated by their hot flashes, finding it almost impossible to carry out day-to-day tasks or finding it nearly impossible to sleep since many women experience their worst hot flashes at night. Also, some women may experience hot flashes for years. There are reports of regular hot flashes happening for up to a decade.  

Worsening Hot Flashes 

Some women report relatively consistent hot flashes once they start experiencing them. But, other women often tell their doctors that their hot flashes are becoming more intense or worse. Is this possible? Can your hot flashes get worse? 

The answer is, unfortunately, yes. Some people may experience spikes in or a worsening of their hot flashes. This can be experienced as either more intense symptoms with each hot flash or more hot flashes each day. 

There are several potential reasons that could explain these spikes that you are experiencing. 

Reason #1: Ongoing Hormonal Fluctuations

The first and most likely, explanation is hormone levels. As you enter perimenopause, estrogen and other hormone levels begin to dip. But, this drop-off is not constant or consistent. There may be fluctuations. While going through this journey, your body may struggle to adjust to these fall-offs. 

If you experience a seeming spike in your symptoms and are not in hormone replacement therapy, this may be a good time to have that conversation with your doctor. However, make sure to discuss both the positives and negatives of this treatment option since HRT can have unintended consequences

The other good news is that our bodies are skilled at self-regulating. Over time, we will adjust to these changing hormone levels, and the hot flashes will dissipate. Some supplements can make a world of difference, too, in addressing hormonal fluctuations. 

It’s Not Always Menopause: Before Your Period Hot Flashes

You should also know that you don’t have to be going through menopause to experience hot flash symptoms. A woman in her 20s can experience hot flashes before her period, which is another time when your estrogen levels dip. The drop in estrogen impacts the part of your brain that controls internal temperature, AKA, your hypothalamus. These hot flashes tend to be milder but may get worse as you transition into perimenopause and menopause later. 

Reason #2: Food and Diet Play a Role 

Even though hormone level fluctuations likely play the most prominent role in worsening symptoms, you should not overlook the part that diet and nutrition play in spiking hot flashes. Some foods are more likely to trigger hot flashes, and many of the culprits are the usual suspects. For example, spicy tacos for dinner may wake you up hours later with a particularly brutal hot flash. Also, your morning cup of coffee that seems like a necessary pick-me-up may be keeping you up at night with hot flashes. Caffeine is a known trigger, even though the exact science behind this link is slightly murkier. 

While we are talking about triggers, it is important not to overlook the role that both alcohol and cigarettes may play in worsening your hot flashes. Eliminating or dramatically reducing your use of these items could help eliminate many of your most troubling hot flash symptoms. 

Reason #3: Our Symptoms Change During the Day 

Just like hormone levels fluctuate over time, they also change over the course of the day. Changes in hormone levels at night can make hot flash symptoms much more intense. The best way to address this is to be prepared. Know that it may happen. It may also be helpful to get your bedroom ready for this. Go to sleep at a comfortable temperature with not too many sheets or blankets. If you wake up drenched in sweat from a hot flash, make sure to change your clothes so that you don’t get chilled. 

There Are Many Other Reasons, Too

Even though the three reasons mentioned above explain the vast majority of seemingly sudden spikes in hot flash symptoms, they may not explain all cases. Stress is also commonly associated with hot flashes spike, for example,  If you are continuing to experience troubling and/or worsening symptoms, make sure to make an appointment with your doctor. There may be other medical reasons underlying your symptoms. 

But Before You Visit Your Doctor, Consider This 

Before heading to your doctor, you may want to start keeping a menopause diary. This diary allows you the opportunity to track your period, as well as any troubling symptoms, such as hot flashes, that you may be experiencing. Noting and tracking these symptoms can help you see if they are, in fact, getting worse. 

This diary can also be a good starting point for your medical provider if he/she wants to think about any potential interventions or order any diagnostics or bloodwork. One diagnostic test that they may order is a Vitamin B-12 level. B-12 deficiency can worsen hot flashes or any type of autonomic dysfunction. Similarly, even without a deficiency, adding more healthy B-12 vitamins into your diet could alleviate hot flash symptoms. 

Understanding Worsening Hot Flashes

Hot flashes are a troubling perimenopause and menopause symptom for many women. Unfortunately, some women report that these hot flashes get worse before they get better. This could be due to the body struggling to adapt to fluctuating hormone levels, or it could be due to diet and lifestyle choices. Other medical issues may play a role, too, in these symptoms. If you are concerned about your symptoms, keep track of them in a menopause journal, and do not hesitate to reach out to your medical provider.