Hot Flashes

What it is

Hot flashes are sudden waves of heat that rise through the chest, neck, and face, accompanied by flushing, sweating, and sometimes palpitations and chills toward the end. They last from seconds to minutes and can recur several times a day; at night, they appear as night sweats that interrupt sleep. They're the most common symptom of perimenopause and menopause, affecting about three in four women, and can persist for years. They result from the drop in estrogen, which alters temperature control in the brain. When severe, they impair sleep, mood, concentration, and work. The gynecology team at Femi Saúde evaluates each case and offers hormonal and non-hormonal treatments.

Most common symptoms

• Sudden heat in the chest, neck and face
• Skin flushing and heavy sweating
• Night sweats that wake you up and soak your clothes
• Palpitations and a feeling of anxiety during the episode
• Chills at the end of the episode
• Insomnia, irritability and daytime fatigue

Causes and risk factors

• The drop in estrogen during the transition to menopause
• Surgical removal of the ovaries
• Chemotherapy and medications such as tamoxifen
• Premature ovarian insufficiency
• Triggers such as heat, alcohol, caffeine, spicy food and stress
• Thyroid disorders and other causes, more rarely

How it is diagnosed

Diagnosis is clinical, based on the description of the episodes, their frequency, their impact on sleep and daily routine, and the menstrual stage in which they appear. The gynecologist reviews personal and family health history, medication use, and cardiovascular and breast cancer risk factors, which guide the choice of treatment. Blood tests such as FSH and estradiol can support the assessment in younger women or those with irregular cycles, and thyroid hormones rule out other causes. Routine tests, such as mammography, Pap smear, and metabolic panel, are updated before starting hormone therapy.

How we treat it at Femi Saúde

Menopausal hormone therapy is the most effective treatment for hot flashes and, when started in healthy women in the first years after menopause, has a favorable safety profile; the gynecology team at Femi Saúde determines the route, dose, and duration individually. For those with a contraindication or who prefer not to use hormones, non-hormonal options are available, such as fezolinetant, which acts on the brain's temperature-control center, and certain antidepressants and other medications at low doses. Complementary measures include managing triggers, a cool environment, layered clothing, physical activity, and cognitive behavioral therapy. Follow-up is periodic and the plan is reviewed according to the response.

What we offer