Hot flashes

Also called: hot flushes, heat surges, waves of heat, flashing, going red in a meeting

It starts somewhere in your chest and it is at your face before you have decided anything. In a meeting, in the car, standing in a checkout line. It is not anxiety, though it can set anxiety off, and it is not something you are doing wrong. Your body’s thermostat has genuinely changed its settings.

What is actually happening

There is a part of your brain, the hypothalamus, that decides what counts as too hot. Estrogen helps set that range, and as estrogen swings the range narrows — so a change of half a degree, which used to be nothing, now reads as an emergency. Your body does what it does in an emergency: opens the blood vessels near the skin and sweats, all at once. That is the flash. Nothing is going wrong. The alarm is set too sensitive.

How common this is

Around 80% of women have hot flashes or night sweats at some point in the transition, and for the median woman they last around seven years — considerably longer than most women are told to expect.

The Menopause Society; SWAN

If you try one thing

Finding your triggers

One week of noticing what comes before a flash. Costs nothing and often does more than a supplement.

Not a treatment — a week of noticing. Your thermostat is set too sensitive, and what tips it over is personal: alcohol for one woman, hot drinks for another, a stressful meeting for a third. A week of knowing which is yours costs nothing, and it often takes out a share of them before you buy anything.

For one week, note what happened in the hour before each flash. The usual suspects are spicy food, alcohol, caffeine, and stress — but yours may not be any of those, which is the point of looking.

Log it in Guía the moment it passes, before you carry on.

On a hard day: Note one flash, not all of them. A single data point is still one more than none.

When you might notice

You will have a pattern in about a week.

Roughly what it costs

Free

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The rest for this

What to say to a doctor

Hormone therapy is the most effective treatment there is for this, and the risk picture for women starting it under 60 or within ten years of their last period is far better than the 2002 headlines left behind. Ask about it by name. If hormones are not an option for you, ask about the newer non-hormonal prescriptions for hot flashes — they are recent enough that not every provider raises them first.

Guía is not a doctor. This is what to bring so the appointment goes somewhere.

Living with this is hard on the people close to you, and explaining it is its own job.

A page you can send them instead

Something else bothering you

Guía is not a doctor and none of this is medical advice. It is here so you can have a better conversation with someone who is. Who made this

Which of these is for you?

Three questions and Guía puts the ones that fit your symptoms into a plan — in the right order, with the smaller version for the days you cannot. Free, and there is nothing to buy.

Answer three questions

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