Why Do Women Get Hot Flushes?

You may think flushes are just confined to menopause, but there can be other reasons too.


This is often a cry from the heart, as in ‘why me’, but certainly the majority of women do experience hot flushes, or night sweats and there can be a number of reasons and not just because of menopause.

Also flushes are not confined to just heat from any or all parts of your body, but women can also experience red, blotchy skin, sweating, and a rapid heartbeat.

These are all a result of your body trying to cool down, so why does it happen?

1. Hormone levels

Unfortunately women are subject to hormonal fluctuations their whole lives, from puberty to post menopause but certainly it kicks up several notches from perimenopause onwards.

Both progesterone and oestrogen declines and our internal thermostat resets and cooling measures start to kick in sooner. But certainly not just women experience this as a man might get hot flushes as his testosterone level drops in middle age, especially if he’s had a certain kind of prostate cancer treatment.

Many women also experience flushes during pregnancy and an overactive thyroid gland, perhaps from Graves’ disease or after giving birth, or something else that’s causing high levels of thyroid hormone may also do it.

2. Exercise

Your body temperature naturally rises when you work hard. To keep up, your cells burn more fuel, which makes extra heat. Your body sends more blood closer to the skin to cool it off, and evaporating sweat helps bring your temperature down.

That’s why it’s important to drink water when you work out. If you exercise regularly, your body gets used to that heat you make, and your core temperature can get a little higher before you react.

3. Fever

Your body fires up when it’s fighting germs. And that rising body temperature will trigger a part of your brain called the hypothalamus to start the cooling process and bring your temperature back to normal.

Obviously you need to call your doctor if your fever is high and continuing or if you also have a bad headache, breathing problems, or can’t stop throwing up.

4. Allergic reaction

A hot flush is common when your immune system releases cells to try to fight off something it sees as a threat, or alien to your body. If mild it can be something a response to a food or other substance and you can check your reaction. For instance I flush every time I drink red wine, even a small amount as clearly my body doesn’t like it so I stopped drinking it.

However there can be a much more serious reaction called anaphylaxis as the substance is life threatening to the body, for instance with a peanut allergy. There are often other symptoms like stomach pain, hives, and breathing problems, too and this type of response needs urgent immediate medical attention.

5. Neurological disorders

Your autonomic nervous system controls things you don’t have to think about, like your breathing, heart rate, blood pressure, body temperature, and sweating. Anything that throws off how it works can cause flushing.

That includes Parkinson’s disease, epilepsy, MS, and spinal injury and nerve damage.

6. Migraine and cluster headaches

These painful and sometimes disabling headaches can also interfere with your autonomic nervous system. Your brain isn’t processing messages from the nerves in your head and neck about touch, pain, temperature, and vibration correctly.

Your “fight or flight” response may kick in, which gets your blood pumping and can cause flushing.

7. Medications

I know that at menopause many women can end up on multiple medications: HRT or antidepressants for menopause symptoms are common as are the thyroid issues that can arise at this time.

Flushing can be a side effect of many drugs. Some heart and blood pressure medicines, including calcium channel blockers and nitroglycerin, and high doses of steroids can affect your hormone balance.

Chemotherapy drugs and painkillers from aspirin to opiates are also prone to induce flushing, as many men have found with treatment for prostate cancer.

8. Food and Additives

The problems with MSG (monosodium glutamate) which is common in Chinese cookery can certainly trigger a flush or low allergic reaction are well known so do check the menu before ordering.

If you like spicy food then be aware that chilli peppers contain capsaicin, which confuses your nervous system to react like you’re being burned. Sulfites and sodium nitrate (in meats like salami and cured ham) may also cause flushing if you are sensitive to it.

9. Blushing

A great feature of Regency heroines, this can be more common in women, but it happens to men, too. It could be that blushers are more sensitive about what others think of them. People who blush easily often respond to stress with a racing pulse, dry mouth, and trouble thinking clearly.

Even a small, healthy emotional response can set it off. Your nervous system gets triggered, your blood vessels widen, and the resulting rush of blood into your skin raises its temperature so you get red cheeks, and often the throat and chest are affected too.

10. Rosacea

This skin condition isn’t blushing, although it may look like it. Flushing is one of the first signs of a flare, often with a burning, stinging, or itchy feeling. Your face may swell up, too, around the sides of your nose above your mouth.

You can control rosacea by avoiding your triggers and with careful skin care, sun protection, and perhaps help from your doctor.

11. Alcohol

Both alcohol and one of the chemicals that results when your body breaks it down will widen the blood vessels that supply your skin. Fermented drinks like beer and wine may have other chemicals — histamine, sulfites, or tyramine — that have a similar effect.

If your liver doesn’t process alcohol well, or if you drink while you’re taking certain medications, your hot flushes may be worse.

12. Carcinoid tumours

These rare, slow-growing cancers can make hormones or mess with yours. They are usually found in your stomach and digestive system, appendix, or lungs.

Red meat, chocolate, alcohol, exercise, or stress might trigger the hot flashes. You could also have purple spidery veins on your nose and upper lip, diarrhea and cramps, a hard time breathing, or a racing heart.

Helpful information:

The best way to deal with unwanted flushes is to track what is causing then. If your hormones are out of balance then address that by supplementing with progesterone or a combined progesterone and oestrogen cream to get them under control.

If you think it may be a food or substance allergy then keep a diary with notes about your episodes and what you were doing, eating, and feeling, and any medications you had taken. Then look for a pattern to see if it is physical or emotional and then you can start to see how best to deal with it.