What causes hot flashes?

Dr. Julia Schlam Edelman
OBGYN (Obstetrician & Gynecologist)

Hot flashes can arrive hourly, daily, weekly, or monthly. Although hot flashes may occur in a cyclic pattern, they don't always appear on cue. We don't understand exactly why hot flashes occur, but there are common triggers—behaviors, circumstances or substances that commonly induce hot flashes. Hot or spicy foods were once thought to induce hot flashes; research does not support this idea. On the other hand, caffeine and alcohol definitely can trigger hot flashes. So can an upcoming period.

Dr. Suzanne B. Gilberg-Lenz, MD
OBGYN (Obstetrician & Gynecologist)

The actual cause of hot flashes is unknown, but they are generally associated with hormonal fluctuations caused by menopause, PMS, anxiety or even thyroid issues. Watch OBGYN specialist Suzanne Gilberg-Lenz, MD, explain this uncomfortable symptom.


Current theory suggests that the flushing, hot, tingling and sweating sensations during menopause may be due to a surge of the brain hormone gonadotropin-releasing hormone (GnRH), which has a direct effect on the part of the brain that regulates body temperature. This hormone is part of a group that controls ovarian hormone output. Normally, when ovaries are functioning at their reproductive levels, GnRH levels are low.

In menopausal women, the brain makes more of this hormone as a signal to the ovaries to return to their reproductive function. The increased GnRH resets the central heat regulatory center in the brain, which results in the blood vessels rapidly expanding in an attempt to reduce perceived overheating (vasodilation).

As menopause draws nearer, increasing amounts of hormones are released, causing increasingly severe symptoms, which can last up to five years if there is no estrogen replacement given, either by way of diet or medications.

Hot and humid weather, hot drinks, alcohol, stress, smoking, chocolate, spicy foods and foods with a high-acid content (e.g., citrus, tomatoes or strawberries) are all also known triggers of hot flashes during menopause.

Marcy Holmes, MSN, NP
Nursing Specialist

Hot flashes from perimenopause and menopause are often triggered by what I call the big bad four; Sugar, Caffeine, Alcohol and Stress! If you reduce the triggers you may reduce the frequency and intensity of hot flashes, naturally! Healthy diet effort, regular exercise, meditation with deep breathing thru the day as mini mental breaks are just a few easy things to implement on your own. You can also consider support programs, such as the Personal Program for Hormone Imbalance at, which offers nutrient packets, dietary guidelines, and a great herbal blend designed to help!  Learn more here:

If you are not sure why you are having hot flashes, certainly talk further with your trusted health care provider for reassurance no other cause is a factor, such as diabetes or thyroid issues.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Hot flashes during menopause can be triggered by environmental factors, foods and lifestyle. When a woman transitions into menopause she has less estrogen. Although we don’t totally understand hot flashes, we think that when a hot flash occurs, something with the thermoregulatory center in the brain is triggered that increases the body's core temperature very quickly. In an effort to cool you down, the body dilates blood vessels in the skin and you begin to sweat. Then you get cold when the air hits your wet skin and your core body temperature is reduced.

Many women say that hot flashes and facial flushes come more frequently when they are hot, overdressed or after eating spicy foods or drinking hot liquids. Alcohol, caffeinated beverages or tobacco smoking can also cause you to have more of them—so if you are getting frequent hot flashes, avoiding triggers is a good place to start.

Up to 85 percent of women experience a hot flash during midlife. Research shows women of color have more of them than Asian or Caucasian women. Some women never get them and some can have 10 per day or more. Women who have low estrogen levels are most at risk. It can happen because they are in menopause, or they are being treated for certain types breast cancer. Talk to your doctor about ways to minimize the frequency of hot flashes.

Judy Caplan
Nutrition & Dietetics Specialist

Most women going through menopause experience hot flashes. Hot flash intensity is very individual. Some women have only a few while others experience them constantly throughout the day. Fluctuation in hormone levels can trigger hot flashes. In menopause estrogen levels are diminishing causing all kinds of symptoms, one of which are hot flashes. Alcohol, chocolate, exercise, coffee and overheated rooms can trigger a hot flash. Even stimulants like tea can set off a hot flash. Sometimes hot flashes come on for no apparent reason other than a woman is going through menopause. It is said that Asian women who eat a traditional Asian diet have fewer hot flashes.

Although some believe that hot flashes are caused by illness, fevers, or even burning desire - the real causes for hot flashes are the sex hormones in women and men.

Testosterone levels in men and estrogen levels in women can fluctuate. If these hormones are suppressed, this can cause blood vessels to dilate. When the blood vessels dilate, more blood is able to rush through the body. The sudden increase in blood flow is accompanied by more heat, typically to the upper part of the body. An estimated 85 percent of all women will experience hot flashes at some point.

If you are experiencing hot flashes, you may want to discuss it with your doctor, especially if you are too young for menopause. There are other causes for hot flashes, including hyperthyroidism and some types of cancer.

Hot flashes are common occurrences during pregnancy, perimenopause and menopause. They are, in fact, the most common symptom of menopause.

They can be trigger or amplified by environmental factors, too. Alcohol, spicy foods, caffeine, nicotine, exercise, chocolate and fat can all trigger hot flashes.

A hot room, sleep deprivation, stress and medication can be other triggers.

The term “hot flash” describes a sudden onset of reddening of the skin over the head, neck and chest, accompanied by feelings of intense body heat and sometimes ending with profuse perspiration. It may be rare occurring or occurring every few minutes. They tend to occur more frequently at night and in times of stress. They tend to be less severe and less frequent in cooler environments compared to warmer ones. Women who are overweight tend to report more hot flashes, as well. 

Boston Women's Health Book Collective
Administration Specialist

Studies over the years have shown that women from various ethno-cultural backgrounds are affected differently by menopause. In the U.S., Study of Women's Health across the Nation (SWAN), a survey of 16,065 women aged forty to fifty five; African-American women reported hot flashes most frequently (45.6 percent), whereas Japanese-American women reported the lowest incidence (17.5 percent). After African- Americans, the next highest groups were Latinas at 35.4 percent, white women at 31.2 percent, and Chinese-Americans at 20.5 percent. In a separate study of 841 white women with physical disabilities in peri- and post-menopause across the United States, 64.9 percent reported having hot flashes.

Women with medical conditions may have high rates of hot flashes. As many as 90 percent of women who have had their ovaries removed, experience hot flashes. According to one study, hot flashes occur more often and are of greater severity in younger women who have experienced a sudden onset of menopause due to surgery, medical conditions, or treatments as compared to women who have experienced natural menopause. Thyroid disease, epilepsy, leukemia, and autoimmune disorders, among others, can also bring on hot flashes; women with breast cancer who have undergone chemotherapy or use medications such as raloxifene or tamoxifen may have a higher number of hot flashes.

Our Bodies, Ourselves: Menopause

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Our Bodies, Ourselves: Menopause


It’s estimated that 66 percent to 85 percent of women get hot flashes in midlife, during menopause. At least half of those women stop getting them within a year or two after their period ends. Another 20 percent to 50 percent of women continue getting hot flashes for years after, though they tend to become less intense as time goes by.

Hot flashes are triggered by fluctuating (changing) hormones during menopause. During this stage of life, a woman’s body makes less of the sex hormone estrogen, which affects the hypothalamus (this gland regulates your body temperature).

During menopause, while your estrogen level decreases, the hypothalamus gets confused and thinks your body is too hot. That signals your body to circulate more blood, and your sweat glands to produce more sweat to get rid of the heat.

Try to figure out what brings on your hot flashes, whether it’s certain drinks such as coffee or tea, the weather (maybe it’s hot outside), stress, or spicy foods. If you can identify the trigger and avoid it, that might help.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.