This is the most common menopausal symptom. Although the exact cause is unknown, body temperature control seems to be affected by falling oestrogen levels. Hot flushes can vary from a mild feeling of warmth in the face to more severe symptoms such as drenching night sweats that affect the whole body.
Hot flushes generally last for about 4– 5 minutes. During a hot flush you may feel sudden warmth in your face, neck and chest, and you may become flushed and perspire. Some women feel their heart beating faster (palpitations) during a flush.
If you have flushes at night, these may affect your sleep. Night sweats can disrupt your sleep pattern, especially if you need to change your night clothes and bedding.
It’s difficult to completely stop hot flushes and sweats, but their frequency or intensity can often be reduced. Using a combination of some of the approaches below is often most successful at controlling or reducing flushes.
Be aware of triggers
Certain situations may bring on or trigger a hot flush. For example, getting too warm, drinking tea, coffee or alcohol, or eating spicy foods. Keeping a record of when you have flushes can help you find out what triggers them, so that you can try to avoid these triggers.
Even if you don’t have obvious triggers, keeping a record can help to measure how much a treatment for hot flushes is helping.
Practical tips to help with hot flushes
There’s lots of practical advice available to help women cope with hot flushes. Here are a few tips:
- Wear natural fabrics, such as cotton, and dress in layers, so you can remove clothes as needed.
- Use cotton sheets and have layers of bedding.
- Keep the room temperature cool or use a fan.
- Have cold drinks rather than hot ones.
- Try some complementary therapies, such as controlled breathing, yoga, etc.
Medicines to help with hot flushes
There are different medicines that your doctor can prescribe to help reduce the severity and frequency of your hot flushes and sweats:
Antidepressants such as venlafaxine, paroxetine and fluoxetine may reduce the frequency and severity of hot flushes by about 50% (half) in some women. It generally takes 1-4 weeks for antidepressants to reduce hot flushes. Side effects of antidepressants can include headaches, feeling sick, reduced appetite, a dry mouth and constipation.
Paroxetine and fluoxetine aren't recommended for women taking tamoxifen, as they may interfere with its effectiveness. However, venlafaxine doesn't interact with tamoxifen so can be taken with it.
This is an anti-epilepsy drug that has been shown to be effective at reducing hot flush severity and frequency. Possible side effects include feeling very tired, drowsiness and dizziness.
Clonidine (Catapres®, Dixarit®)
Clonidine is a drug used to treat high blood pressure or migraines and can help reduce hot flushes and sweats in some women. It can take four weeks to work. Side effects can include constipation, a dry mouth and drowsiness.
Hormone replacement treatment (HRT)
Hormone replacement therapy replaces the hormones no longer being produced by the ovaries and can relieve symptoms such as hot flushes.
However, HRT isn’t recommended after breast cancer treatment because it contains oestrogen, which may increase the risk of the cancer coming back. Breast cancer guidelines do not recommend non-oestrogen types of HRT, such as Tibolone (Livial®) or low dose progestogens (megestrol acetate, norethisterone and medroxyprogesterone acetate) either.
Rarely, if a woman’s symptoms are severe and nothing else helps, HRT may be prescribed. This is only done after careful discussion with your cancer specialist to make sure you understand the possible risks as well as the benefits.