Hot flashes are sudden, intense feelings of warmth that spread across the face, neck, and chest. They are often accompanied by sweating and flushed skin. These episodes, also known as vasomotor symptoms, can vary in intensity and duration, sometimes followed by a chilly feeling as the body attempts to cool down. While widely recognized as a common symptom of menopause, hot flashes can stem from various other medical conditions, medications, and lifestyle factors.
Medication-Related Causes
Certain medications can induce hot flashes as an unintended side effect, primarily by influencing the body’s hormonal balance or its thermoregulation system. Cancer treatments are a notable category. Aromatase inhibitors, such as anastrozole, and selective estrogen receptor modulators like tamoxifen, used for breast cancer, lower or block estrogen, a common trigger for hot flashes. Leuprolide, used in prostate cancer therapy, can cause hot flashes by reducing testosterone levels.
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like escitalopram, and serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, can also lead to hot flashes. These medications affect neurotransmitter levels in the brain, which play a role in regulating body temperature. Opioids, steroids, some osteoporosis drugs, and triptans (used for migraine treatment) are additional examples. Niacin supplements can also cause warmth and flushing.
Underlying Health Conditions
Beyond medication, several underlying health conditions can manifest as hot flashes, often due to their impact on the body’s hormonal or nervous systems. Endocrine disorders frequently contribute to these episodes. An overactive thyroid gland (hyperthyroidism) can disrupt metabolism and lead to hot flashes. Low testosterone levels (hypogonadism) can cause hot flashes in males. Hormonal shifts during pregnancy and premenstrual syndrome (PMS) can also trigger hot flashes, as can diabetes.
Cancers and their treatments are significant non-menopausal causes. Hot flashes can be a symptom of the cancer itself, as seen in certain types like leukemia, lymphoma, and medullary thyroid cancer. A rare condition called carcinoid syndrome, where tumors release excessive hormones, commonly leads to flushing. Cancer treatments like chemotherapy, radiation therapy, and hormone therapies can induce hot flashes by lowering sex hormone levels, sometimes creating a medically-induced menopausal state.
Infections also present as a cause, with both viral infections, including the common cold and flu, and bacterial infections potentially triggering hot flashes. This often occurs as the body’s immune response elevates core temperature to fight off pathogens. Neurological disorders that affect the brain’s ability to regulate temperature can also result in hot flashes. Conditions such as autonomic dysreflexia, autonomic neuropathy, and stroke can disrupt the hypothalamus, the brain region responsible for temperature control, leading to a dysregulated thermal response.
Anxiety and stress are also recognized triggers for hot flashes. When the body experiences stress, it activates the sympathetic nervous system and releases stress hormones like cortisol and adrenaline. This physiological “fight-or-flight” response can increase heart rate and body temperature, leading to the sensation of a hot flash.
Lifestyle and Environmental Triggers
Everyday lifestyle choices and environmental conditions can also provoke hot flashes by influencing the body’s internal thermostat. Certain dietary components are known to act as triggers. Spicy foods, for instance, contain capsaicin, which can cause blood vessels to widen and induce a sensation of heat. Beverages containing caffeine and alcohol consumption can also lead to hot flashes by affecting blood flow and thermoregulation. Foods high in sugar can cause rapid fluctuations in blood sugar levels, which may trigger hot flashes.
Environmental factors play a role by directly influencing core body temperature. Being in hot weather, staying in warm rooms, wearing heavy or restrictive clothing, and taking hot baths or showers can all raise the body’s temperature. In response, the body initiates a cooling process, resulting in a hot flash. Smoking is another lifestyle factor that increases the risk of experiencing hot flashes. Obesity is also linked to a higher frequency and intensity of hot flashes.