Lifestyle measures for hot flushes: healthy weight, triggers and smoking
A hot flush (a sudden wave of heat across the face, neck and chest) can be eased by keeping cool, avoiding triggers, exercising, a healthy weight and stopping smoking.
Remember
Keeping cool, cutting triggers such as caffeine and alcohol, stopping smoking and staying active at a healthy weight can ease hot flushes, but hormone replacement therapy (HRT, which replaces the falling oestrogen) is the most effective treatment when these steps are not enough.
A hot flush is a sudden wave of heat across the face, neck and chest, often with sweating. Hot flushes and night sweats together are called vasomotor symptoms (symptoms caused by unstable control of body temperature). They are thought to arise in the hypothalamus (the part of the brain that acts as the body's thermostat) as oestrogen falls. The range of body temperature that feels comfortable becomes narrower, so even a very small rise sets off a sudden release of heat.
Anything that adds heat can set off an episode, but the NHS advises regular exercise, and regular activity is not among the triggers to avoid. NHS advice is to keep the bedroom cool at night, wear lightweight clothing, and use a fan or have a cold drink. Several thin layers or blankets are better than one thick one, because they can be removed and replaced quickly. A trigger is anything known to set episodes off, such as hot drinks and spicy foods. The NHS lists spicy food, caffeine, hot drinks, smoking and alcohol as potential triggers to avoid or reduce.
Exercising regularly and keeping to a healthy weight are also on the NHS list of ways to ease hot flushes and night sweats. For women with obesity, weight loss can help hot flushes, particularly in early perimenopause (the years of irregular periods before the last one), but clinicians are advised to counsel women against extreme diets because of the potential for harm. The NHS also tells women not to smoke, because smoking can make menopause symptoms worse.
These measures are low risk and some women find them helpful, but they ease symptoms rather than remove them. HRT is the most effective treatment when symptoms are troublesome, and cognitive behavioural therapy (CBT, a talking therapy) can also help hot flushes.
Key facts
- Keeping cool
- a cool bedroom at night, lightweight clothing, and a fan or a cold drink when a flush starts; several thin layers are better than one thick one, because they can be removed and replaced quickly
- Potential triggers
- things to avoid or reduce, such as spicy food, caffeine, hot drinks, smoking and alcohol
- Exercise and healthy weight
- regular exercise and a healthy weight are on the NHS list of ways to ease hot flushes and night sweats
- Evidence for exercise
- the evidence for exercise on its own is limited (a review found it insufficient to show whether exercise treats hot flushes directly) and more limited than the evidence for weight loss in women with obesity
- Smoking
- smoking can make menopause symptoms worse, and the menopausal transition lasts longer in women who smoke
- Wider benefits of exercise
- regular exercise helps to prevent weight gain, and weight-bearing activity (such as walking, running or dancing, where the feet and legs carry the body's weight) helps protect against weakening bones
- Limits
- lifestyle measures ease symptoms rather than remove them, and HRT is the most effective treatment when symptoms are troublesome
Exam traps
- An evening drink may feel relaxing before sleep, but the NHS lists alcohol among the potential triggers for hot flushes and advises staying within the recommended limit, since alcohol may affect symptoms.
- Increasing caffeine to stay alert after poor sleep is more likely to worsen symptoms than help, because the NHS lists caffeine as a potential trigger for hot flushes; cutting it down is the helpful change.
- A crash diet is not the way to lose weight for hot flushes: clinicians are advised to counsel women against extreme diets because of the potential for harm, and a healthy weight comes from balanced eating with regular exercise.
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