A hot flash is a sudden, intense sensation of heat that spreads across the body, typically beginning in the face, neck, and chest. This wave of warmth, known medically as a vasomotor symptom, is often accompanied by flushing and sweating, lasting anywhere from one to five minutes. While hot flashes are overwhelmingly associated with the natural decline of reproductive hormones during menopause, many women worry they could signify a more serious underlying condition, such as ovarian cancer. Evaluating this potential connection requires understanding how ovarian cancer and its treatments affect the body’s temperature regulation system.
Hot Flashes and the Link to Ovarian Cancer
Hot flashes are generally not considered a characteristic or initial symptom of the most common form of ovarian malignancy, epithelial ovarian cancer. The presence of hot flashes alone is highly unlikely to indicate this diagnosis, as their onset is usually related to benign hormonal shifts like perimenopause. However, hot flashes can occur as a secondary or atypical symptom through two primary pathways. These involve either direct hormonal disruption caused by the tumor or profound endocrine changes induced by cancer treatment. When connected to ovarian cancer, hot flashes are rarely the first or most prominent warning sign.
How Ovarian Tumors Affect Hormones and Body Temperature
A small minority of ovarian tumors are hormonally active, producing substances that interfere with the endocrine system and affect temperature regulation. For example, a rare sex-cord stromal tumor, such as a granulosa cell tumor, often secretes high levels of estrogen. This excess estrogen, known as hyperestrogenism, is more likely to cause symptoms like abnormal uterine bleeding or breast tenderness than the typical hot flashes associated with low estrogen. However, any large tumor mass can cause systemic disruption.
The tumor’s direct influence on body temperature may also manifest through a paraneoplastic syndrome. These rare disorders are triggered by the body’s immune response or by substances the tumor releases into the bloodstream, not by the cancer’s physical presence. While not always a classic hot flash, these syndromes can cause flushing, fever, and drenching night sweats, related to a disruption of the hypothalamus, the brain’s thermostat. The tumor-secreted chemicals or immune reaction confuse the central nervous system, leading to the sudden, inappropriate dilation of blood vessels that characterizes a warming episode.
Chemotherapy and Surgical Effects on Vasomotor Symptoms
The most frequent and direct cause of severe hot flashes in the context of ovarian cancer is the necessary treatment, particularly surgery and chemotherapy. Removal of one or both ovaries, known as an oophorectomy, causes an abrupt drop in reproductive hormone levels. When both ovaries are removed in a premenopausal woman, this procedure induces sudden surgical menopause. This often results in hot flashes that are more intense, frequent, and physically disruptive than those experienced during natural menopause.
Certain chemotherapy agents are cytotoxic and can damage ovarian tissue, leading to premature ovarian insufficiency or chemical menopause. This damage impairs the ovaries’ ability to produce hormones, causing an estrogen decline and subsequent onset of vasomotor symptoms. More than half of women treated for epithelial ovarian cancer report experiencing vasomotor symptoms, such as hot flashes and night sweats, even years after treatment concludes. This treatment-induced hormonal change is the most common reason for a woman with a history of ovarian cancer to experience intense hot flashes.
Other Key Symptoms and Common Causes of Hot Flashes
While hot flashes can be a consequence of ovarian cancer treatment, they are not the main warning signs that prompt a diagnosis. The most important symptoms that should be persistent and frequent enough to warrant medical attention are:
- Bloating
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary urgency or frequency
When these symptoms are new and occur more than twelve times a month for a period of weeks, they represent a potential red flag that requires immediate consultation with a healthcare provider.
For the vast majority of women, hot flashes are caused by much more common, non-cancer-related factors. The most frequent cause is the natural transition into menopause, which typically occurs around the age of 51. Other common, benign causes include:
- Certain prescription medications, such as some antidepressants, which can disrupt the body’s thermoregulatory center.
- Hyperthyroidism, a condition where the thyroid gland produces too much hormone, which can mimic hot flashes by causing heat intolerance and sweating.
- High stress.
- Excessive consumption of alcohol or spicy foods.
- Certain infections.
If hot flashes are persistent, severe, or accompanied by any of the hallmark ovarian cancer symptoms, medical evaluation is the appropriate next step.