Hot Flashes? Night Sweats? You’re Experiencing VMS
If you’re like most women, you probably first learned about hot flashes while watching a menopausal character on TV. Or maybe your mother clued you in while she was going through “the change.” Either way, your menopause knowledge is likely relegated to what you’ve heard through pop culture or secondhand anecdotes from other women—not necessarily science.
“Health curriculum covers puberty but mentions nothing about menopause, so we don’t learn about it in school,” says Andrea Donsky, a certified nutritionist and researcher who’s known to her 265,000+ social media followers as the Menopause Educator. “And we don’t really talk to our healthcare providers about it until we’re, like, ‘Wait, what’s going on with my body and mind?’”
The good news: It’s never too late to learn about menopause and vasomotor symptoms (VMS), the medical term for hot flashes, night sweats, and other temperature dysfunction conditions. Whether you have yet to experience your first hot flash or you’re already well into the menopausal transition, there’s plenty of info to take away—and pass along to other women—about these symptoms, why they happen, and how to prevent or ammeliorate them. Here are the answers to some of the most commonly asked VMS-related questions.
What causes VMS?
Hot flashes and night sweats can leave you feeling as though you’re burning up. And that’s exactly what your body thinks is happening when it experiences VMS, says Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology, and reproductive sciences in New Haven, Connecticut.
It all comes down to the area of the brain called the hypothalamus. “Think of it as your body’s thermostat,” she says. “It’s sensitive to a chemical called neurokinin. Before menopause, neurokinins are kept in check by estrogen. What happens with menopause is our estrogen levels go down, the neurokinin is left to its own devices, and we start getting hot.”
As you approach menopause, your estrogen levels decrease until hitting an all-time low, which is when menstrual periods stop altogether. But the road to menopause is anything but smooth. Estrogen levels fall less like a ski slope and more like a downturn in the stock market—with lots of ups and downs. That’s why VMS and other symptoms of menopause tend to come and go over a long period of time. According to the North American Menopause Society, hot flashes may last for 10 years or more for some women.
What does VMS feel like?
More than 80% of women experience hot flashes, which last acutely for an average of one to five minutes, according to a review published in the Journal of Mid-Life Health. Just as with cramps associated with premenstrual syndrome and nausea in pregnancy, VMS varies greatly from one woman to another.
“The best way to describe it is that it feels like a heat wave that overtakes the body,” says Felice Gersh, M.D., author of Menopause: 50 Things You Need to Know. “Like everything in life, there’s a spectrum. Some women feel the heat rising from the chest into the face, whereas for others it’s a total body experience.”
In other cases, women report feeling uncomfortably warm for a few minutes. Still others become flushed and sweat profusely. “There are very sophisticated mechanisms in the body to get rid of the heat,” says Dr. Minkin, “including relaxing the blood vessels so the blood can rush out [which leads to the red flushing] and sweating.”
Thanks to the steps your body took to cool itself down, once the hot flash passes, you may experience a chill, which can be equally uncomfortable.
Can I predict a hot flash before it starts?
Research indicates that several factors can influence when menopause might start, and there is also a genetic component to menopause-related VMS that may be inheritable, Donsky says. If you’re interested in knowing what your menopause experience might be like, and you’re able to ask your mother, do.
“Genetics play a role in when you’re likely to go into menopause, and there’s evidence that genetics play a role in how menopause is experienced as well,” says Dr. Minikin, referencing a study published in Menopause, the Journal of the North American Menopause Society. “Just speaking from personal experience, I had a lot of the same symptoms—including terrible hot flashes—that my mother did,” she shares. “And I hear that a lot from other women as well.”
Are hot flashes harmful?
Hot flashes are more than just an annoyance. They can be embarrassing, for sure—particularly when they come on during a meeting, rehearsal dinner, or some other event you can’t easily escape. But they can also really take a toll on your overall physical and mental well-being, especially when they happen at night and interrupt your sleep.
“When they occur during the day, we call them ‘hot flashes,’ but at night they’re ‘night sweats,’” Dr. Minkin says. “It’s the same phenomenon, and night sweats can be particularly troublesome.”
While some women may simply need to sleep near a fan, others will wake up several times a night, sweating through their pajamas and sheets. “After changing the sheets, they’ll be awake for an hour or two, finally fall back asleep, then another hot flash will happen and wake them up again,” says Dr. Minkin. “It’s no wonder these women are exhausted.”
Research tells us that, beyond causing fatigue, inadequate sleep increases your risk for heart disease, immunodeficiency, chronic pain, depression, and more. VMS may also affect your health in other ways. Researchers are currently studying the effects of VMS on cardiovascular disease and insulin resistance, though it’s too early to identify an exact connection.
I have VMS—what can I do about it?
There’s no surefire way to avoid VMS altogether, but there are steps you can take to reduce hot flashes and make them as tolerable as possible. “Something as simple as dressing in layers so you can remove articles of clothing when you get hot, and carrying a personal fan with you can help,” says Dr. Gersh. “Also, open the windows, drink cold beverages instead of hot, and invest in a set of cooling sheets.”
Dr. Minkin suggests having a spare nightgown next to your bed to keep disruptions from night sweats to a minimum. “That way you can quickly change and get back in bed [before you fully wake up],” she says.
Tracking your VMS triggers and avoiding them can help, too. “Everyone has different triggers,” Donsky says. “For me, stress, caffeine (particularly chocolate and coffee), alcohol, and processed sugar are major.” Other common triggers include spicy food and tight clothing.
Smoking, and possibly obesity, are also linked to more severe VMS. “We have very good data that shows that smokers tend to get worse hot flashes than non-smokers,” Dr. Minkin says. “What’s less known is that [women who are overweight or obese] tend to have more of a problem with hot flashes, probably because their bodies aren’t as effective at dissipating the heat that’s generated. So it’s a good idea to get help with smoking cessation and nutritional guidance when necessary.”
Is VMS treatable?
If you don’t have any luck alleviating VMS through lifestyle changes, don’t hesitate to talk to your healthcare provider. “There are options for treating hot flashes,” Donsky says. “There’s no need to give up hope.” Treatments range from over-the-counter supplements to hormonal and non-hormonal prescription medications. The key is finding a provider who’s well-versed in menopause.
“The North America Menopause Society’s website is an easy one to remember: It’s menopause.org, and there are listings of menopause practitioners there,” Dr. Minkin says. “If you feel like your questions are going unanswered, find a certified menopause practitioner—they’re much more likely to know about something that can help you.”
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