The 3 questions I always get asked about hot flushes

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Menopause Advisor
Ask Eileen

28 August 2017

Read the full video transcript below

Today's topic

Hello, and welcome to my weekly video blog. And today, on A.Vogel Talks Menopause, I'm going to be talking about hot flushes. Now, I know that there are those of you who've been watching for a very long time, and you'll probably be thinking, "But she's talked about hot flushes so many times." I have indeed, but I'm going to look at it slightly differently today. We get asked more questions on hot flushes than practically all other menopause symptoms put together.

The top three questions

And what I've noticed over the years is there seems to be three main questions, the top three questions, if you like, that I get asked on practically a daily basis. And I thought that maybe it's time that I went over these, and maybe you will learn something new from it or maybe there will be something in here that will help you with your particular types of hot flushes if you get them.

1 - What causes hot flushes?

So, the number one question is, what causes hot flushes? Well, there's three main reasons why you can get hot flushes.

Hormonal fall

One is just the hormonal fall itself. So as your oestrogen starts to fall, it can affect a gland in the brain called the hypothalamus, and that's our temperature controller. And if that goes slightly offline, then it ends up thinking that the body is too hot and you suddenly get a hot flush or you'll suddenly get a sweat or a night sweat.

So, this particular situation can happen at any point, it can happen in the peri-menopause and also during the menopause and slightly afterwards as well.

Now, falling oestrogen can also affect the behavior of our blood vessels. And in really simple terms, what that means is that if you get a sudden drop in oestrogen then that can actually trigger the blood vessels into spasming. And that spasming and opening up can then cause a hot flush or a night sweat. So that's reason number one, it's purely a reaction to the way that our own hormones are falling at whatever time we are in the peri-menopause or in the menopause.

Weakening of areas of our health including a stressed nervous system

The second reason is that the falling hormones can affect any area of our health at all. It could be anything from the joints, to digestion, to mood, to skin, to our hair and our nails.

But one of the main things that happens is that the falling oestrogen can weaken certain areas of our health as well, and one of the main areas that gets affected, whether we like it or not, is the nervous system.

So anything else that affects our nervous system through the menopause will stress the nervous system further and that can then trigger hot flushes and night sweats. So just as an instance, stress will pull down our nervous system, too much coffee, too much alcohol, too much sugary foods. We can look at lack of sleep, we can look at worry, we can look at being too busy, and we can look at dehydration. 

All these things which most of us will experience on a daily basis can stress the nervous system further. Very often that will trigger a chemical response which includes adrenaline, and that can then trigger our hot flushes and our night sweats.

New health issues

The other thing that can happen in the menopause as well is that other health issues that we've not had before can start to creep in. Now, the main culprits would be things like low vitamin D, it could be thyroid function, it could be vitamin B12, and for some women, even low iron can trigger flushes. So all these independent health issues can appear around the peri-menopause and the menopause and after the menopause. And these by themselves can each be a contributory factor to hot flushes.

What can you do?

So in this whole scenario, what are you looking at doing to help yourself with hot flushes?


We've obviously got things like the herb sage, you could look at our Menopause Support to help to very gently balance oestrogen levels.


Remember all that the things that you might be doing wrong, you know, the dehydration. So remember the water, all these other health issues as well.

Checks to ask your doctor about

The really important thing here is that if you're getting a number of these symptoms, especially if they've come on quite quickly, ask your doctor to check you for the low vitamin D, B12, the iron and the thyroid function because if it's any of these, then the normal hormonal remedies will not help. These symptoms need to be treated individually or as a group, depending on if you've got one or more of them.

So it's really important to get these things checked out by your doctor. And I would honestly recommend that the minute you hit the peri-menopause and the minute your period stopped for good, get these things double checked by your doctor. They're all easily sorted and it could make a huge difference to the way you go through the rest of the menopause.

2 - Why do I get hot flushes so long after my periods have stopped?

Now, the second question is, why do I get hot flushes so long after my period has stopped? And we've sometimes had women who, you know, their periods have stopped in their early 50s and they're now in their mid-60s or even early 70s and they're still experiencing hot flushes or night sweats.

Now, there are a very few women for whom the menopause and the peri-menopause and the post-menopause will drag out. For most women, once you have not had any periods for two years, you should start to see your symptoms gradually easing off. And by the time you're three or four years through the menopause, for most women, your hormones will have stabilized and you should be feeling absolutely fine.

If after all this time, 10, 15, 20 years you are still getting hot flushes, you are still getting night sweats, it is very unlikely to be hormonal. What can happen, unfortunately, is that over the years, your nervous system -  now, I just talked about the nervous system getting stressed in the menopause - for some women, that adrenal stress or nervous system stress does not resolve itself and it carries on and on and on and on. And this doesn't get better on its own, it's something that needs to be looked at and it needs to be well supported.

So, for a lot of women who are in their 60s and 70s, who are still getting the hot flushes or the night sweats, then we say, "Look at the state of your adrenals. See what's going on in your life."

It could also be these health issues that I mentioned before, so that's your low vitamin D, B12, thyroid and iron. If it is adrenal stress, then the best thing that you can probably do is look at acupuncture. Absolutely fabulous. Herbs such as Maca, Ashwagandha or ginseng can be wonderful adrenal support as well.

The other thing, obviously, if you're still getting the hot flushes and the sweats, you can still look at sage. After eight, nine years, we tend not to recommend going back onto hormonal remedies because if it's not anything to do with the hormones, then these remedies are really not going to help you.

3 - Why am I suddenly getting hot flushes/night sweats?

Now, question number three is for those groups of women who are maybe in their late 50s, 60s, 70s or 80s, who suddenly start to get hot flushes and night sweats. Again, they've just maybe started out of the blue.

This can be a combination of things. Again, it can be the stress, it can be anxiety, it could be the fact that you've had quite a tough menopause to start with and over the years your nervous system has just got gradually weaker and weaker.

What can you do?

Go to your doctor

It could also be to do with all these other health issues. So that's your vitamin B, D, iron and thyroid. So again, if you're in this situation, ask your doctor to test for these things just to see what was going on. 

Look at the point your symptoms started

For this situation, it's a good idea to look at the point where these symptoms started. What was going on in your life? Were you really tired? Were you really worried? Did you have an emotional, physical shock? Was there anything else going on in your life that could have stressed your nervous system, that then resulted in the hot flushes and night sweats coming back?

And the interesting thing is, very often you will find a clue. So we're looking at anything about a year, six months before these symptoms started because it can sometimes take your body a little while to catch up with any kind of emotional or physical stress. Again, in this situation, get these things checked out by your doctor.

Stress remedies

You're looking at stress remedies. So things like our Passiflora, AvenaCalm, if there's sort of low mood involved as well. If you're not on any other medication, then you could look at the herb Hypericum.

Check your lifestyle

So, hopefully this has given you a little bit of an insight into these other areas of hot flushes. For all of these situations, whether you're suffering in the peri-menopause, the menopause, post-menopause or even years down the line, then one of the best things to do is have a check of your lifestyle.

Are you doing too much? Are you working too hard? Are you sleeping well? Because all of these things can affect the hot flushes. Are you drinking plenty of water? Are you getting plenty of magnesium? Are you relaxing? Because again, these can help hot flushes. 


And one last thing, which is probably quite important, for those of you who have been on HRT, especially if you're in your 60s and 70s and you've been told to come off HRT, coming off HRT can trigger hot flushes and night sweats, and it's just part and parcel of the way your body's reacting to suddenly being without this level of hormones from your HRT.

What can you do?

You would treat this as you would hot flushes and night sweats. Generally, you could look at the sage, you could look at the magnesium and you could look at acupuncture.

So hopefully this has given you a little bit of insight, and I will look forward to seeing you next week on A.Vogel Talks Menopause.

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As the A.Vogel Menopause expert, I recommend Menoforce® Sage tablets and Menopause Support to help you through this stage of your life

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Did you know?

You won’t get the menopause the minute you turn 50! The average starting age is actually between 45 and 55 and it can often depend on a number of factors including hereditary, weight and health, however every single woman will have an individual menopause.

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