What to Do About Hot Flashes

One of the most distressing things about going through breast cancer treatment can be the onset of menopause and the hot flashes that go with it. In this post I'll give you some helpful tips on dealing with hot flashes and avoiding triggers.

What exactly are hot flashes?

If you have had a hot flash then I don’t have to tell you what they feel like.  But for some of you, they are something you still have to look forward to, so let me explain what they feel like.  Most women describe a sudden feeling of warmth in their face, neck and chest associated with intense sweating and then sometimes chills.  Your heart rate can increase, and you may feel it “fluttering” (called a palpitation). You may feel tingling in your fingers or even light headed.  Some women have one a month, others have one every hour.

They are thought to be due to the changes in reproductive hormones associated with menopause, especially a drop in estrogen.  In women with breast cancer, this can occur more suddenly due to chemotherapy and estrogen blockers.  These hormonal changes can interfere with your body’s temperature regulation and make you very sensitive to changes in the ambient temperature. 

Hot flashes can begin in perimenopause and usually continue after menopause for one to five years.

While hot flashes are not really a serious medical problem, they can still interfere significantly with your life.  They can make you miserable at social outings or at work, especially if these situations are stressful since stress is a trigger for hot flashes.  Also, they can disrupt your sleep causing chronic insomnia which can lead to anxiety and depression.

They are more common in some women than in others.  African American women have more hot flashes than those of western European descent.  Asian women have the lowest incidence of hot flashes (which has led to conjecture about the role that soy plays in the etiology and management of hot flashes).  Women who exercise regularly have fewer hot flashes than women who are sedentary.  Obese women have more hot flashes.

They occur in up to 80% of women going through menopause and are more common in women who have had breast cancer.  Many breast cancer survivors are on Tamoxifen or an aromatase inhibitor and both of these types of drugs have hot flashes as a common side effect.  Just because hot flashes are a natural part of aging, it doesn’t mean you have to like them.

There are many triggers for hot flashes that should be avoided if possible.  These include:

·      Smoking

·      Alcohol

·      Hot foods (spicy and hot temperature)

·      Hot weather

·      Hot tubs or hot baths

·      Diet pills, caffeine

·      Stress

·      Fatigue

You may have others.  Keep a journal to discover your triggers so you know what situations, foods, and circumstances to avoid.

This leads us to the role that lifestyle changes can play in the management of hot flashes.  If you already didn’t have enough reasons to not smoke, this might be the one that tips you over the edge.  If you are a smoker, stop.  Nothing good comes of smoking and it’s a trigger for hot flashes.  You should avoid excessive alcohol since that is a common trigger. From the list I just mentioned, stress and fatigue can also be managed with lifestyle changes.  You may need to take extra time to prepare for what are commonly stressful situations for you, both at work and at home.  Do your best to get plenty of rest, and avoid the temptation to burn the candle at both ends.

 So, what are the lifestyle changes that you can make to reduce hot flashes:

·      Don’t smoke or drink

·      Manage stress

·      Exercise regularly

·      Eat a healthy diet and maintain a healthy weight

·      Have a relaxation practice:  Practice meditation, breathing exercises, yoga, visualization.  Anything that helps you relax overall.

 Other common sense tips to manage hot flashes include:

·      Dress in layers, things you can peel off

·      Don’t wear heavy fabrics such as wool, no turtlenecks, no tight clothing

·      Avoid synthetics or silk as they will tend to stick to your skin when you sweat

·      Do wear cotton

·      Keep ice water on hand

·      Lower the thermostat, use fans

·      Wear cotton pajamas and change as needed

·      Cotton sheets

·      Cool bath or shower before bed

·      If humidity is a problem, get a dehumidifier

·      Cool pillows (Chillow)

Besides the above changes and precautions, there are several prescription medications that are used to treat hot flashes, and that list will likely change depending on when you read this.  The meds vary in effectiveness and their side effects.  What works for you may not necessarily work for someone else.  But if you have tried all the above measures for avoiding and managing hot flashes, and you still feel like you need something more, then ask your doc about a prescription medication.  Since hot flashes generally get better on their own, every few months you should talk with your doc about trying to come off the medication, but don’t discontinue it on your own.  Some of these medications need to be tapered and not stopped suddenly.

Now you know what hot flashes are and what causes them. Try some of the simple steps such as avoiding triggers and adopting the above-mentioned lifestyle changes to decrease their occurrence and severity.