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Menopause

Hot flushes and sweats

Hot flushes and sweats (vasomotor symptoms) are the most common symptoms of the menopause and can affect three out of every four menopausal women*. Characterised by sudden feelings of heat which seem to come from nowhere and spread upwards through the body, the chest, neck and face, hot flushes and sweats are probably caused by changes in hormone levels which affect the body’s temperature control. Women talked about their experiences of hot flushes and sweats, the effect on their life, and what they did to relieve the symptoms.

Hot flushes
Some women we talked with had either not had flushes at all, had noticed just occasional mild feelings of warmth lasting seconds, or had simply not been bothered by them. Others, however, had more intense hot flushes which happened throughout the day and night, lasting several minutes or longer and accompanied by sweating, dizziness, light-headedness and heart palpitations. One woman said she had ‘about twenty’ hot flushes a day; another flushed every ten minutes throughout the day (see ‘What is the menopause?’).
 

Denise has never had a hot flush or night sweat. She feels blessed

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Age at interview: 53
Sex: Female
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Some women I speak to tell me about hot flushes and night sweats. You mentioned you hadn’t really had that.

Not a one, not a hot flush, not a night sweat. Yes, because I know some friends who are drenched etcetera. I have missed that out for whatever reason and as I say to be honest I don’t think the symptoms I’ve had have been particularly bad. They’re fairly general what probably a lot of the population has experienced and maybe some have experienced a lot more or more of the symptoms but I don’t honestly think mine have been too bad. But again, I can’t bench mark. Because I’ve nothing really to refer to but certainly no hot flushes to my great relief because I would normally have a high colour anyway and no night sweats at all.

 

Susie’s hot flushes haven’t been a problem as she’s not working. (Video clip in Cantonese,...

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Age at interview: 51
Sex: Female
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The menopause, at first I felt, well I’m not usually afraid of the heat, I’m afraid of the cold, when I’m hot I feel vexed, but not so much that I would shout at people. So not shout at people so then it was just sometimes getting hot and sweating so sometimes during the day and sometimes at night, it wasn’t something that just happened at night. But actually, it hasn’t been too bad for me, I’ve heard that it’s caused a lot of trouble for some people, all mixed up. It’s been very good for me, maybe because I don’t have to work. If you’re afraid of the heat and you have to stand in front of a cooker, isn’t that very vexing?

 

Maria’s hot flushes are ‘unbelievable’ coming over her ‘as a wash’ anytime of the day. She feels...

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Age at interview: 43
Sex: Female
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I’ve been to the doctor and they say I’m borderline, perimenopausal and, oh, the flushes are unbelievable. Yes, there are times at work where I’ll just be fanning myself. It just comes over me as a wash at anytime of the day and I just sweat. I will be dripping from head to toe and then you feel uncomfortable because you’re wet. I just assume oh, I wonder if people think I smell, I’m sweaty. It’s not nice.

First thing eight o’clock it seems to be the worst. When I’ve got up, had a wash, shower, got myself dressed that’s when it happens. Not before I’ve had the wash, after. So you feel as if you need another wash, but we’ll go to work and literally I’ve always got a magazine or a catalogue or some form of paper and I fanning myself and my whole face and I just get sweaty around my nose and mouth and under my armpits and my back.

I don’t know if anyone’s noticed that I’m sweaty but I just completely and I have to fan myself because I get to the point where I feel that maybe I might faint. You know that sort of dizziness and sometimes it lasts a few minutes, sometimes longer and then you can come out of a flush and go straight into another one or they can just stop and later on. It’s very random.

Women generally experience hot flushes at some stage during the menopause; in some they continued for about a year or more after the last period. However, hot flushes can continue for many years after the menopause. There is no way of predicting whether women will have flushes or not and some women continue to flush until their 80s. One woman was still having hot flushes ten years after her periods stopped; another, who stopped taking hormone replacement therapy (HRT) four years ago, ‘never imagined’ she would be having hot flushes in her late 70s.
 

Anne had occasional hot flushes and palpitations during the menopause. When her periods stopped...

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Age at interview: 58
Sex: Female
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I would have hot flushes for periods of a couple of months and then they’d stop and I wouldn’t have any at all. And then I’d have a period of hot flushes where I would have them every ten minutes and that would be quite uncomfortable but I’ve always just tried to ignore them. So if I had one and I was talking to someone I’d try very hard not to draw attention to it and I found that helps actually a lot. And occasionally I had periods where I’d get palpitations but nothing very serious and not very often. And then a year ago my periods stopped altogether and since then I really only have hot flushes.

So it wasn’t really until my period stopped altogether that I got hot flushes consistently. In that I’d have them sort of, at the moment I’m having them not as frequently as I have done but most of the time so day and night. Whereas before I’d go through, have a couple of months where they’re quite intense and then they would stop.

What were they like? What are they like now? How often do you get them? How long do they last?


Well, they don’t last very long at all. I mean literally I suppose it would maybe be a minute to a couple of minutes at the most. And I just feel very warm and I perspire and I can feel perspiration on my face and on the back of my neck and then it’s over. And if I have been with friends and afterwards I’ve said to them, “Did you notice because I was really aware of having one?” And they didn’t notice at all.

Women described their hot flushes vividly. They talked about a ‘creeping sensation’ which rises from the feet through the whole body; an ‘explosion’ in the chest and neck which goes ‘right up to your brow’; ‘a thermometer going up and down’. One woman compared the warmth she feels to ‘going under a sun bed’, another felt as if someone had opened a ‘little trap door’ in her stomach and put a hot coal in.
 

Sharon’s hot flushes start from her toes, travelling as a tremendous heat through her body

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Age at interview: 51
Sex: Female
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What happened with me the very first signs I had was around about a year ago when I started to experience hot flushes. And they became so bad at one stage that I would be stripping off in front of people just literally ripping my clothes off to the extent that I had to go somewhere private just to cool right the way down.

If I could bottle it, I’d make a fortune. Right okay, basically what happens and I can’t describe them, it’s all of a sudden you are totally overcome by a traumatic, tremendous heat inside. Not outside, because you can feel cold outside. But a tremendous heat and it literally starts from your toes and it works right the way throughout your body and you know it’s travelling. Have you ever tasted Southern Comfort? Have you tasted a little Southern Comfort and as it gets down to your throat and then all of a sudden it sort of just hits your chest. And as it hits your chest, it sort of, I don’t know what it does, but it warms up your body. Well you can imagine that happening, not drinking but that is a flush to me and I always used to think “Oh I wish I could have them when I’m working outside, when I’m cold”. “And switch them on” but you can’t, they’ll come anytime.

How often do you get them?

Oh gosh, I don’t know, I mean my husband could probably pin point it more if I’m with him all day long, ten, fifteen, twenty times a day.

While hot flushes can happen without warning throughout the day, women spoke of certain triggers which appeared to bring them on. These included the wearing of woollen clothing and polo necks, temperature changes, feeling stressed, drinking alcohol or coffee, and eating spicy food (see ‘Non-HRT and lifestyle options’). Even taking a hot shower, making love, and doing housework had affected some women.
 

Cynthia resents having had to give up alcohol because it triggers hot flushes

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Age at interview: 54
Sex: Female
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And at its worst how many were you getting in a day?

On the hour every hour and if I drank alcohol they were even fiercer. I did learn I could not drink. I had to stop completely. One millimetre of Southern Comfort particularly watered down with a tin of Seven Up would still be enough for me to be hot flushing. I noticed if I had, oh, what are those round things that you get at Christmas with meat in them? Pastry. Ah, mince pies. Now you see that’s a menopause thing. That happens to me all the time. What’s the name of that? I’m playing like ‘Give us a Clue’. Mince pie with a little bit of brandy in that would be enough. I would be hotter for about twenty minutes after I’d feel it sort of radiate from inside. So I was teetotal and I’m still teetotal. I still resent the fact. It’s not worth it and curry can set me off as well yeah, some Chinese food.

Hot flushes during the day at work can be uncomfortable and made a few women feel self-conscious and embarrassed (see ‘Work’). Those who were badly affected felt ‘exposed’ because their hot flushes were highly visible and embarrassing. One woman felt her face lit up ‘like a Belisha beacon’; another developed a ‘red rash’ on her chest. Sweating sometimes left women ‘totally soaked’.
 

Sandra gets embarrassed when she has a hot flush in front of clients

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Age at interview: 47
Sex: Female
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I do feel very embarrassed because I know I can feel when one’s coming on and the first time I experienced that was when I was sitting opposite one of my clients and I knew it was coming and I could feel the sweat on the top of my forehead and it just like down under my eyes as well and I thought if I keep talking I’ll work my way through this but I was thinking surely they must be able to see that I’ve gone red or I’ve got sweat on the top of my forehead and my face and I felt very uncomfortable with that. And I couldn’t start stripping off taking my cardigan or my coat off or anything like that and I found that very difficult.

Night sweats
Hot flushes at night, or ‘night sweats’, can also be troublesome. Women talked about tossing and turning and feeling hot ‘like a furnace’, waking up ‘soaking wet’, and experiencing ‘awful drenching sweats for about two years’. One woman’s night sweats felt like ‘a serious infection’ that made her temperature ‘go haywire’. Others talked about searching for ‘cool parts’ in the bed or getting up to change night clothes or bedding.
 

On a bad night Christina wakes up drenched, and has to get up and wash before trying to get back...

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Age at interview: 52
Sex: Female
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The night sweats are terrible. It doesn’t matter whether I go to bed with nothing on and I sleep on my own, and I will still wake up absolutely drenched. And I can have a sheet over me and that will be wringing wet in the morning as well so it’s like having to go to sleep with towels. And I don’t have a plastic cover on my mattress because that tends to aggravate the situation so it’s just me having towels underneath me so you wake up with marks all over your back and everything else. But, even just going with no sheet you still have the sweats.

So this is even in winter you are sleeping with a sheet.

Yeah. Windows open and everything else so just trying to calm that down.

And how many times would you be woken up at night?


On a bad night at least three or four times and then having to go and get washed and try and dry off and everything else and change everything and then try and get back to sleep again.

So you actually change your clothing and your bedding do you?

Yeah, if I’m wearing like a cotton nightie. That all has to come off. The towels that are on top of the sheets have to come off and be changed again. And then I go to the other side of the bed and try and make sure that you’re sleeping on a dry patch. I mean I’m quite lucky because I am on my own and I don’t have to disturb anybody.

But not all women get night sweats. Some never have them, or can cope if they do. Others can be even more upset by night sweats than by daytime flushes because they disrupt sleep leading to daytime tiredness, irritability, poor memory and concentration (see ‘Sleep’). To stay cool some women avoided touching their partner, or woke them up with their restlessness (see ‘Relationships, sex and contraception’).
 

Donna’s night sweats are ‘like being in a tropical climate’. She has them two to three times a...

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Age at interview: 47
Sex: Female
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I very rarely have them in the day, I usually have them at night, just before going to sleep and it’s just extraordinary rush of energy, and breaking out in a complete sweat, can sweat right through your night clothes, even into the sheets. I don’t actually mind it in a way. I guess if I hadn’t known about it I might have found that quite disturbing, but actually my sister’s been going through that prior to me so I was quite aware in a way. But in some ways it’s quite nice because I’ve always been a person who’s cold in bed at night, now I feel like I’ve got my own hot water bottle to keep me warm at night.

Did you have to change the bedding and your clothes at night when it happened?

Sometimes. Yeah, sometimes.

And how did that affect your partner?

He’s just kind of curious actually. Yeah, he’s asking questions, he’s asked me like, “What does that feel like?” I said I thought it was a bit like having a panic attack, something that happens, that you don’t really have any control over.

Can you describe it?

It’s really, I find it really hard to describe but I guess it would be like being in a tropical climate, a kind of clamminess and sweating, and it’s not, I don’t find it particularly unpleasant, actually.

How long does it last?

Well it comes and goes, it’s like waves of heat so they might last a few minutes at a time, and then it kind of recedes and then it,

How many times a night?

For me, two or three.

Coping with hot flushes and night sweats
While HRT and complementary therapies may help some women experiencing hot flushes and night sweats (see ‘Hormone replacement therapy (HRT)’, ‘Complementary therapies’), others ‘learn to live with it’ or use common sense in managing these symptoms (see ‘Non-HRT and lifestyle options’). Choosing lighter clothing, sitting near a window, turning down the heating, and sipping cool drinks can all help relieve hot flushes during the day. One woman talked about ‘spending lots of time in supermarket chiller aisles’; another sprayed her face with rosewater; while a third fanned herself with a magazine. One woman felt it was better just to ignore hot flushes, rather than draw attention to herself by ‘waving her hands and flapping paper’.
 

Beverley coped with hot flushes by using a fan, wearing short sleeved t-shirts and sitting near a...

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Age at interview: 50
Sex: Female
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The sweats got really bad. And it was funny because you could feel it from the tip of your toe and you could feel it rising and then I’d glow and I’d be fanning myself for dear life. I was a typical Caribbean person in terms of I always felt the cold. However, once I was into my menopause I was never cold, in fact I was always hot and this went on for quite a few years.

I adjusted the type of clothes I wore and didn’t layer as much. I could literally wear a short sleeved t-shirt or a jumper or blouse with a cardigan on top in the summer, in the winter, sorry, and I’d be fine. Obviously, my jacket if I was outside. Because I didn’t really feel the cold as much as I had done before. So it’s basically changing your lifestyle but you do it and then it becomes part of your normal day to day. And as I said I’d walk around with a fan. I also had a fan in my office that was on my desk so I could put it on and if I didn’t, if I was sitting somewhere where there wasn’t a fan then I’d try and sit somewhere where I had access to a window. So I could open it.

And as I said, I’m 50 now. The sweats have calmed down but every now and then I do get them but not as much and I’m starting to feel the cold again so I’m wondering if I’ve come to the end of that cycle and my body is now coming back to something like what it was premenopausal.

Women did various things to relieve night sweats. These included sleeping naked, wearing a cotton nightie or t-shirt to bed, and buying separate quilts. One woman bought a ‘Chillow Pillow’ (a cooling pad which ‘relieves discomfort from overheating in any part of the body’) to keep the back of her neck cool.
 

Cynthia managed her severe night sweats using a ‘little hot flush kit’ she kept beside her bed

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Age at interview: 54
Sex: Female
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In the early days, I had to get up physically on the hour every hour. It woke me without fail and I had to get out of bed, go into the other room, had a big fan, stand in front of it until I cooled down and then I went back to bed. You do get used to doing that and you do sleep in between. As I got better at managing them I think, I identified that I couldn’t drink anything and I couldn’t eat curry or Chinese food I got so that I had my little hot flush kit beside the bed. I had a towel and gel pack, sports injury gel pack that had been frozen inside of a pillow case. And I’ve got dozens, dozens and dozens, and I’ve still got them in a little basket of those little hand fans like you’d have on holiday.

And I had that beside the bed so when I woke with a hot flush starting, I’d grab the towel and slip that underneath me, the gel pack behind my neck and the little fan resting on my chest and I’d just lie there like a sack of potatoes until it passed. And then I’d chuck it all off and go back to sleep until the next one. And I did sleep. I did get used to being tired but I did sleep in between each hot flush. But they were on the hour.

Hot flushes and sweats are not dangerous but can be debilitating and reduce many women’s quality of life. In most cases they ease with time.

*Cancer Research UK 2013.

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Last reviewed July 2018.

Last updated July 2018.


 

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