5 common hot flush triggers

Eileen Durward
Ask Eileen

17 April 2017

Read the full video transcript below

Today's topic

Hello, and welcome to my weekly video blog. And today, on A.Vogel Talks Menopause, I'm going to be revisiting hot flushes. Now, I know we've talked about these on a number of occasions, but it never does any harm to go back over things. And I'm going to look at hot flushes from a slightly different stance this week.

Now, about 25% of women will not get hot flushes at all during their menopause. But the situations that can trigger hot flushes can also trigger other menopause symptoms as well. So for those of you who are sitting there going, "But I don't get any hot flushes," please watch along, because there may be some self-help tips for you, too.

What is a hot flush?

Now, what exactly is a hot flush? Because sometimes understanding what's happening can give us a greater control over how we can deal with the situation. In normal circumstances, if your body gets a bit too hot, the blood vessels in the surface of the skin will start to open up. Blood will come through, and the heat from the blood will be dissipated into the air. And that's the way that you will lose the heat. If you're extra hot, then sweating can be triggered as well, and it's the evaporation from the skin that cools you down.

How the hypothalamus causes hot flushes

Now, the problem is in the menopause that this can go a bit wrong. In the brain, we have a gland called the hypothalamus. And the hypothalamus is...it's a bit like a master gland. It rules over its own little kingdom in the body, making sure everything is working properly. And it looks after our hormones. And the problem is that when our sex hormones, which is our oestrogen, progesterone, and testosterone, start to fluctuate during the menopause, the other areas where the hormones are involved very often get put under pressure.

So your poor, old hypothalamus is trying to juggle everything. It's trying to keep everything in balance. And the problem here is that the hypothalamus also regulates your temperature.
So when everything is going wrong, and the hypothalamus is looking all over the place trying to keep everything in a nice balance, it can sometimes think that your body's too hot when it's not. And when that happens, it goes into a panic mode. And it will be like, "Oh, no. The body's getting too hot. I've got to do something. Emergency. Emergency."

So the cooling process, which normally takes a little while, is sprung into action. So very quickly your blood vessels will open up, very quickly you'll get a rush of blood, and that's your hot flush. And if the hypothalamus is extra testy, then what will happen is it will also trigger the sweating as well. So you end up getting a hot flush with sweating, or you might get a night sweat in the middle of the night. And, you know, this can go on all the time.

Sage to the rescue!

The herb Sage is known to help support the hypothalamus and reduce/stop hot flushes and night sweats which is why I recommend Menoforce Sage Tablet.

A convenient one-a-day dosage, Menoforce Sage tablets are made from extracts of freshly harvested sage herb and are suitable to take together with HRT.

Find out more about Sage for hot flushes and night sweats

How your nervous system can cause hot flushes

So one route by which we can have hot flushes triggered is directly because of the hormonal imbalance going on. But the other area that we can get hot flushes from is from our nervous system. And if you think about it, the times when maybe we're a bit nervous, or we're scared of something, very often we'll get a little bit of a sweat on, or we'll start to feel a bit hot and clammy.

And that's just the way the nervous system can actually interfere with your temperature control. So, in the menopause, we know that the nervous system is going to be pulled into absolutely everything, because of all the other changes that are going on in the body as well.

5 common hot flush triggers

And certain things can overstimulate the nervous system, and that will then trigger your hot flushes. So I'm going to look at five of them today. These are the common ones that go on.

1. Anxiety

We've got anxiety itself. So we know from experience that anxiety is number 3 in our top 10 list of menopause symptoms. And you can end up being in a state of anxiety practically the whole day. You can wake up in a state of anxiety, and that means that your nervous system is being pressurised the whole time. And very often an anxiety attack will actually accompany or precede a hot flush or a sweat.

2. Stimulants

We have got the stimulants, so that's things like your caffeine, your alcohol, your fizzy juices, and high salt and sugar foods. And we know that these can give your nervous system a really quick hit. It revs your nervous system up.
And it's amazing how many women say to us that they they've realised that after drinking a cup of coffee, 10 minutes later, they get a hot flush.

Or if they have a sugary bun or a piece of cake, they end up getting hot flushes. So these things can trigger your hot flush or your sweats within maybe 10 - 15 minutes of taking them.

3. Low blood sugar levels

We've also got low blood sugar levels, and this can stress the nervous system and trigger another flush. And for those of you who are really interested... just the other week, I posted a blog about low blood sugar levels, and it's quite an interesting topic. So do have a look if you haven't seen it already.

4. Dehydration

We've got dehydration, and this can be a real, vicious circle. Hot flushes and night sweats will dehydrate you, and dehydration will put your nervous system into panic mode, and that will then trigger more hot flushes or night sweats.

5. Lack of magnesium

And we also have, last but not least, is our magnesium. And we know that falling oestrogen can interfere with the absorption and the availability of magnesium. And your nervous system practically runs on magnesium.

So if you're low in magnesium, your nervous system is going to be extra stressed, and that's going to trigger your hot flushes and night sweats. So the first thing to do is, if any of these situations apply to you, is to deal with them first.

What you can do to help yourself

So for your anxiety, we would look at lovely calming herbs, maybe like AvenaCalm or Passiflora, or even a really good vitamin B complex can help to reduce the anxiety.

You can look at cutting out or cutting down the tea, and the coffee, and your high salt and sugar foods.

You can look at drinking more water. Get plenty, plenty of water, and I can't really stress this enough. And, again, it's amazing how many women come back to us and say that all they've done is added in some more plain water, and their symptoms have started to ease off. So this is a really easy one that you can do for yourself.
And, also, you need to eat little and often, or if you can't eat little and often too much, then just make sure that you're getting a good, healthy snack that's going to keep your blood sugar level stable, and your nervous system will really thank you for that.

And, also, look about taking a magnesium supplement. Usually to start with about 200 milligrams a day is fine, but you can increase it a little bit if you feel that you absolutely need to.

What else can help?

So that is the first steps to going about trying to help your hot flushes and your night sweats, but there are other things you can do. And I'm a great one for looking at the situation in its entirety and trying to break things down to see why certain things are happening.

Keep a hot flush diary

And I think it's a really good idea to have a hot flush diary. So what you would do, maybe over a week or two, is have a little diary, every time you get a hot flush, put in the time, put what's happening. What situation are you actually in at the moment? What were you doing an hour before the hot flush? Or what were you eating maybe 15 minutes ago?

And if you're getting woken up by night sweats, then try and jot down the time that you're being woken up. And you might actually find after a week or two that there is actually a set pattern to some of the hot flushes or night sweats that you're getting. Then you can look at the situation that was happening before it and try to deal with that.

My hot flush story

And I know some of you have heard this story before, but one of the interesting things that I found was to do with my hot flushes.

I have to travel quite a lot between my home and Edinburgh. And to get to Edinburgh, I have to drive through Glasgow. And Glasgow, the motorway through the town center is an absolute nightmare, because at some points there's five lanes of traffic, and there's cars coming from the left crossing in front of you. There's cars coming from the right in front of you. There's cars coming up behind, there’s cars seesawing all over the place, and it's a very, very stressful 15 - 20 minutes to drive through the town center.

And I actually realised that I was getting a hot flush at the same point in the journey every time I went that way. And it was a point about three miles outside the city center, and I'm thinking, "Why am I always getting a hot flush?" It was just as I was passing this big cinema complex, and I thought, "This is really strange."

But when I looked back to 15 minutes, half an hour beforehand, I could see I was driving through a large amount of traffic, I was very anxious about the traffic, I was clinging on to dear life onto the steering wheel, and I was holding my breath because I was concentrating so much on just making through...I could get through it in one piece.
And I realised that that situation was putting my nervous system into overdrive. So what I do now is I always make sure to remind myself to breathe as I'm going through the top of the city, and I also try and have a good swig of water before I actually reach that point, so I'm hydrated and that my nervous system is that little bit calmer. And I found that that has just absolutely worked a treat for me.

Another hot flush scenario – supermarket shopping!

So, you know, maybe take a little bit of time and see what's going on with the hot flushes. And another sort of make-believe scenario, if you like, just to let you see the sorts of things that you can do. We get an awful lot of women who hate shopping now.

Going into a supermarket is a nightmare, because, inevitably, they get hot flushes or they get sweats while they're shopping, and they really hate it. So you imagine this situation. Maybe you've been working all day. You're a little bit stressed. You're feeling tired. All you want to do is get home, and now you've got to go and do the shopping. You won't have had anything to eat for a while. You probably haven't had anything to drink for a while either.
And then if you're anything like me, you get to the shop and find you've forgotten your shopping list. And can you remember all the things that you've got to buy? So you know the system at this point is already just on the brink. And then, of course, just the trolley race, and trying to get round where you want to go to, and people are blocking the aisles and banging into you. And you have to wait for ages in the supermarket queue. And at that point, your nervous system just goes, "I really can't cope with this anymore." And there you go, hot flush or a real sweat. And that just makes you feel even worse.

Plan ahead before you go

So in any kind of scenario like this, plan ahead. If you need to go shopping after work, then make sure maybe half an hour before you finish work have a good drink of water. Have a nice snack. Do maybe five or six really deep breaths, so that by the time you get to the supermarket, you're fed, you're watered, and your nervous system is in a much calmer state. And very often that will help you to get through it just that little bit easier.

Some homework for you

So what I'd like you to do this week for your homework is do the diary and then just have a look and see if there's any situations where you're getting hot flushes, where you can maybe control the situation a little bit better, and then you can tell me if it's worked and if you find that your hot flushes or sweats have reduced.

Something to be aware of

Now, just one tiny little point here. If you are getting profuse sweating, you're really sweating during the night, or you're sweating terribly during the day and it's just not letting up, or the sweating has been going on for years and years. Very often, this can indicate other underlying health issues such as low thyroid function or low vitamin D. And if you're in this situation, I would just advise that you get this checked out by the doctor first and then carry on with your little diary.

So I hope this has helped, and do let me know how you get on. And I will look forward to seeing you next week on A.Vogel Talks Menopause.

Some extra advice...

Getting night sweats between 1-3 am? This could be a bit of liver stress (very common in the menopause) – check out my blog on how to support your liver for a better menopause.

Waking up at other times during the night? Could be low blood sugars so see my blog on blood sugar control.


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  • Pamela Stewart 's photo avatar
    Pamela Stewart — 02.10.2017 20:21
    Hi Eileen I was reading the information ,with regards to the menopause support,and it said not to take it if you are using hormonal contraception . I have been taking it for the last 3 weeks now, without realising , what are the effects , and will it not work ? I would be grateful if you could advise me. Thank you.


    • eileen's photo avatar
      eileen — 03.10.2017 13:17
      Hi Pamela Contraceptives change the balance of hormones in the body and this stops conception, if you add in plant oestrogens such as fermented soya or Black Cohosh it is possible that this could, in theory, affect this balance resulting in the contraceptive being less effective. Although this is unlikely we always err on the side of caution!


  • Caroline wyatt's photo avatar
    Caroline wyatt — 26.09.2017 08:54
    Thank you for all the advise it makes a lot of sense as to what is happening to our bodies . I was wondering why do I feel weird if I have not eaten for a while and start shaking and when I eat I feel ok again I had a diabetes check I while back and it was ok but I am off work at the moment with a fractured fibula so can't get around so well and have put on a lot of weight .


    • eileen's photo avatar
      eileen — 03.10.2017 13:17
      Hi Caroline Sorry for the delay in answering you. Our blood sugar control can be affected in the menopause so when it gets a bit low or dips quickly the nervous system starts to panic and this can then cause dizziness or shaking or weakness or even nausea. Eating something will rebalance your blood sugars levels so that is why you feel better then. This is really common in the menopause and can be a completely different situation to diabetes so they are not necessarily related. This could be made worse if you try and cut calories to try and lose weight. If you cut calories and get this blood sugar see-saw the bosy sees this as a starvation threat so will slow down your metabolism even further resulting in no weight loss and possible weight gain. The secret here is to eat something every 3 hrs or so but make sure any snacks are not sugar/carb/caffeine based as these can make blood sugars fluctuate even more! A small handful of nuts or a plain yogurt and a few berries or a piece of lean meat can often be helpful. Remember the water too as dehydration can make this worse!


    • Pamela Stewart's photo avatar
      Pamela Stewart — 03.10.2017 14:49
      Hello Eileen , thanks for you reply , so what do you suggest that i do ? As I haven't had a monthly cycle in about 8 -9 years so this should be safe for me to continue taking the menopause support ! Without worrying ? Thank you .


    • eileen's photo avatar
      eileen — 04.10.2017 10:43
      Hi Pamela It's fine to keep taking the Menopause Support for as long as you need to, there is no specific time limit.


  • Julie Etheridge 's photo avatar
    Julie Etheridge — 19.09.2017 20:21
    I was surprised to see that your Sage supplement contains hydrogenated oil. My understanding is that this type of ingredients is absorbed by the body and cannot be excreted and is toxic to the body. Why is this found in a natural herbal product?


    • eileen's photo avatar
      eileen — 20.09.2017 13:45
      Hi Julie The cottonseed oil is only used to get the tablet out of the mould (to stop it sticking), but it's now being replaced by magnesium stearate. If you wish you could try the sage tincture Menosan instead as this is just the fresh herb and medicinal alcohol.


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