How Do Hormone Changes Affect Perimenopause Hot Flashes? (And How To Get Relief)

During perimenopause, the transition period from your reproductive years into menopause, the hormone amounts produced by your body change significantly.

Changing hormone levels are behind many of the perimenopause symptoms that you may experience, including hot flashes. 

Here’s a look at what hot flashes are, how they’re related to perimenopausal hormone changes, and some tips to help deal with the discomfort they can cause.

What are perimenopause hot flashes?

Hot flashes, hot flushes, night sweats (nighttime hot flashes), or the more scientific vasomotor symptoms—all are names for one of the most well-known symptoms of perimenopause and menopause.

Hot flashes are also the most common perimenopause complaint. Up to 80% of U.S. women experience them, and one in four report having hot flashes every day.

Perimenopause hot flashes are a sudden feeling of intense heat in your head, face, neck, chest, and upper back. They can be accompanied by:

• Sweating
• Flushing in the face and neck
• Blotches on the chest, back, and arms 
• Accelerated heart beat
• Cold chills following the hot flash

Hot flashes generally begin early on in perimenopause, often increasing in frequency and severity towards the end of this transition period. Women experience hot flashes for around 10 years on average. The timeline can, however, vary depending on when symptoms start – hot flashes may not last as long if they start later, and vice versa.

How are hormone changes and perimenopause hot flashes related?

During perimenopause, your body’s production of reproductive hormones, like progesterone and estrogen, decreases significantly. 

While we still don’t understand what exactly causes hot flashes, we do know that they’re connected to these changing hormones. Research suggests that lower estrogen, in particular, plays a role. 

Here’s how hormone changes affect hot flashes. 

Two areas impacted by perimenopausal hormone changes are the:

• Thermoneutral zone: the range in external temperature where body temperature remains stable without triggering an internal response, like sweating or shivering 
• Hypothalamus: the part of the brain that functions as the body’s thermostat

Lower levels of reproductive hormones cause the thermoneutral zone to narrow. Decreased estrogen causes the hypothalamus to become more sensitive to small changes in body temperature. 

What are the results of these hormone-driven changes? A smaller thermoneutral zone makes your body more sensitive to external temperature. Then, an overreactive hypothalamus means that even the slightest changes in body temperature can trigger a dramatic reaction as your body tries to regulate itself. That reaction is—you guessed it—hot flashes.

Estradiol, a type of estrogen produced by the ovaries and most prevalent during the reproductive years, may be particularly related. Estradiol dips dramatically during perimenopause, and this study found that decreasing estradiol levels were a significant risk factor for perimenopausal hot flashes.

Still, all women experience hormonal changes during perimenopause, but not all experience hot flashes—meaning there are likely other biological causes behind this symptom, as well, including genetic and lifestyle factors. 

Tips for dealing with perimenopause hot flashes

For some people, hot flashes may not be a particularly troubling perimenopause symptom. For others, though, hot flashes can be anything from very uncomfortable to absolutely unbearable.

Either experience is completely normal! For those with the short end of the hot flash stick, there are tricks and treatment options that may help you deal with hot flashes and alleviate symptoms.

Here are some non-medical strategies to help make hot flashes less uncomfortable:

• Keep portable fans with you and use fans in your bedroom for night sweats
• Drink small amounts of ice water before bed
• Avoid common triggers like spicy foods, alcohol, caffeine, and hot beverages 
• Dress in layers so you can remove clothing if a hot flash hits
• If you smoke, try to quit, as research has shown smoking to be a risk factor

Certain dietary changes may also offer relief. Eating foods with phytoestrogens, a chemical compound found in plant-based foods like soy and legumes, may mimic the effects of estrogen on the body. This in turn may help reduce the frequency and severity of hot flashes. However, more research is needed.

Medical treatments for hot flashes aim to supplement and stabilize the hormones in your body. Options include:

• Hormone therapies: estrogen therapy or combination estrogen and progesterone therapy
• Paroxetine: an antidepressant approved for treating hot flashes

Perimenopause hot flashes and hormone changes: the bottom line

During perimenopause, hormone changes can cause some uncomfortable symptoms, including hot flashes.

Hot flashes are linked to drops in reproductive hormones, which make your body more sensitive to temperature and more prone to overreact to even the smallest changes. 

While perimenopause hot flashes can be incredibly frustrating, some strategies may help you make them a bit less unbearable. Consider keeping your doctor informed about any hot flash treatment that you’re considering, medical or otherwise. They can help you weigh the risks and benefits, and figure out what treatment could be right for you.