How Long Will I Have Hot Flashes and What Causes Them?

You’re going about your life — putting together a work presentation or taking a walk around the block. All of the sudden you feel really hot. Then the sweating starts.

Oh no, is this another hot flash?

Hot flashes and night sweats are considered vasomotor symptoms, and they are some of the most common symptoms of menopause, affecting about 75% of people assigned female at birth.

While hot flashes can be disruptive and embarrassing, there are things you can do to lessen their effects.

Internal medicine and women’s health specialist Andrea Sikon, MD, explains why hot flashes continue and what may trigger one.

When do hot flashes start?

This can vary from person to person. Typically, you may start experiencing hot flashes in your early 40s as your levels of estrogen and progesterone start to decrease. This triggers the start of perimenopause, the transitional period before menopause.

“You can experience hot flashes in perimenopause, before you go through menopause,” says Dr. Sikon.

Most individuals describe a hot flash as a sudden, intense period of heat that’s accompanied by sweating and discomfort. Sometimes, it’s followed by chills.

When they happen during the day, they’re called hot flashes and when they happen during the night, they’re called night sweats. And night sweats can disrupt your sleep, leaving you feeling fatigued, irritable and more forgetful.

How long do hot flashes last?

You may not experience vasomotor symptoms (hot flashes and night sweats) during menopause. But for those who do, the severity and length of time of each hot flash can vary from person to person. One hot flash may be just a few minutes, while others may last for more than 5 minutes.

And when it comes to how many years you may have hot flashes, that varies as well.

“On average, they can last for four to seven years,” says Dr. Sikon.

Why hot flashes continue to happen

It can be hard to predict when you may have a hot flash.

And unfortunately, there are a handful of things that can trigger a hot flash. But once you learn what triggers your hot flashes, you can work on avoiding or limiting them.

Common hot flash triggers include:

• Alcohol. From beer to wine to that fancy cocktail, alcohol causes your blood vessels to expand, which can lead to a hot flash.
• Caffeine. That cup of joe or can of soda is loaded with caffeine which causes your blood vessels to narrow and raises your heart rate.
• Heat. Sounds like a no-brainer, but any kind of heat can make your internal temperature rise. So skip that hot shower and opt for a cooler one.
• Hot weather. The sun is shining, but you’re a sweaty mess. Hot weather, especially when it’s humid out, can bring on a hot flashes.
• Smoking. Lighting up can cause your heart rate to increase thanks to nicotine which makes your blood vessels tighten up.
• Spicy foods. If you’re a fan of ingredients like jalapenos and cayenne powder, you might find yourself breaking out in a sweat thanks to capsaicin, which causes your body to heat up.
• Stress. You can feel your heart rate quicken and your body getting sweaty when you’re stressed out or anxious. Next time you’re feeling the pressure, try deep breathing.
• Tight clothing. Think about what you’re wearing and opt for pieces made with breathable fabric like cotton and ones that aren’t too tight. Fabrics like spandex and polyester keep your body heat trapped which can lead to a higher body temperature.

In addition to these common triggers, certain medications like tamoxifen, which is used for breast cancer, or raloxifene, an osteoporosis medication that can also be used for breast cancer prevention, and certain antidepressants can cause hot flashes as well.

Do hot flashes ever stop?

Once you enter menopause, which is the cessation of your menstrual cycle, you stay in it forever, says Dr. Sikon.

Most individuals will experience hot flashes for about four to seven years before their symptoms stop. Some experience them for longer.

But can your hot flashes stop and then come back?

“It’s not typical,” says Dr. Sikon. “They can be episodic where you may not have one for months but then they come on again. This is especially true in perimenopause, when your periods may be starting and stopping. But once you’ve completely stopped having periods and are in menopause, it’s highly unlikely that hot flashes would be gone for years and then come back.”

In addition to learning what your triggers are, there are treatment options available. Talk to your doctor if your hot flashes are affecting your daily life.

Your doctor will discuss whether hormone therapy, prescription medication or alternative therapies are right for you. Make sure you talk to a provider who has experience in treating them, as there is a lot of misinformation on hormone therapy and a lack of training for many. Many options exist to help with the symptoms.

“Hot flashes are natural,” notes Dr. Sikon. “It’s easy to be dismissive of them but for some people, hot flashes can be very intense. Identifying your triggers and seeking medical treatment can help.”