What's really happening
Hot flashes are sudden surges of heat that can leave you drenched in sweat, red-faced, and uncomfortable. They’re triggered by changes in your body’s thermostat, thanks to shifting hormone levels—especially estrogen. They may last seconds or minutes and can happen during the day or wake you up at night (hello, night sweats).
But why?
When estrogen drops, your brain’s thermostat gets hypersensitive. It thinks you’re overheating when you’re not—and tries to cool you down.
Scientific Breakdown
The hypothalamus, which regulates temperature, becomes more sensitive to small changes in body heat when estrogen levels fall. Even a slight shift in core temperature can trigger a full “cool down” response—blood vessels dilate, heart rate increases, and sweat glands activate. Neurotransmitters like norepinephrine and serotonin also fluctuate with hormonal shifts, further disrupting thermoregulation.
• ↓ Estrogen = unstable hypothalamus (body’s thermostat)
• ↓ Estrogen = less serotonin and norepinephrine balance
• Body reacts with vasodilation (blood vessels widen), heat, and sweating
Essentially…
Your brain is doing the right thing—just at the wrong time. It’s trying to cool you off… even when you’re not actually overheating.
See a doctor if …
• If hot flashes are frequent (more than a few a day)
• If they wake you up often or disrupt your life
• If you experience dizziness, fainting, or palpitations with them
• Thyroid issues
• Medication side effects
• Panic attacks (which can mimic hot flashes)
Frequently Asked Questions (FAQs) about
Hot Flashes
Q: Will these go away on their own?
They usually fade over time—but can last 7–10 years for some women.
Q: Is HT the only option?
No—there are nonhormonal meds and natural supports too.
Q: Can I take HT if I have a history of migraines or fibroids?
Maybe—talk to a provider about your specific history.
“I went from sweating through my clothes every day to maybe one flash a week. HT gave me my energy and confidence back.”
— FLUXX community member, age 48
FLUXX Recommendations
1. Consider HT—especially if symptoms are frequent and disruptive
2. Track your triggers (caffeine, alcohol, spicy food, stress)
3. Practice cooling techniques (breathwork, fans, dressing in layers)
Non-Hormonal Medications
• SSRIs or SNRIs (e.g., paroxetine, venlafaxine)
• Gabapentin
• Fezolinetant (new FDA-approved nonhormonal option)
• Black cohosh, evening primrose oil (limited but emerging evidence)
• Acupuncture
• Mindfulness-based stress reduction (MBSR)
Lifestyle Suggestions
• Avoid hot flash triggers (alcohol, spicy foods, tight clothes)
• Regular movement, stress reduction, hydration
• Cooling pillows, moisture-wicking sleepwear
Myth-Busting
No, estrogen does not cause cancer. The 2002 study that scared everyone? Misunderstood and since corrected.
Modern Guidance
HT is the most effective treatment, especially when tailored to your needs. Non-hormonal options (like SSRIs, clonidine, or Fezolinetant) can also work. Cooling strategies and avoiding triggers (like wine or spicy food) help too.
Ask yourself
• “How often are your hot flashes happening?”
• “Are you more bothered during the day or at night?”
• “Are you open to trying HT, or exploring nonhormonal options first?”
Ask your doctor
• “Could my symptoms be hormonal?”
• “What’s the safest way to try HT?”
• “Are there non-hormonal options that really work?”
HT is very effective for hot flashes and considered safe for most women under 60 or within 10 years of menopause.
