Managing Hot Flashes in Summer: OB/GYN Expert Discusses How to Navigate Menopause Symptoms When the Heat Rises

Most women who have had a hot flash know the feeling.

Warmth blooms suddenly in the upper body, intensifying as it goes over the face, neck and chest. The skin reddens as if you’re blushing. Sweat beads up. You awake in the middle of the night feeling as if you’re burning up. The feeling can sometimes be fleeting; other times, it seems to last forever.

Hot summer weather, travel stress and vacations can make hot flashes even more miserable.

Although other medical conditions can cause them, hot flashes are mostly a symptom of menopause, a time in a woman’s life when menstrual periods become irregular and eventually stop. However, many women can feel they are suffering alone in their menopausal symptoms. OU Health obstetrician-gynecologist Dr. Pamela Miles, M.D., says that’s not true.

“The majority of women do get hot flashes, and that's the main reason most of them will take hormone therapy,” said Dr. Miles. “Summertime can raise some extra risks, and they can be a trigger. Having more social gatherings involving alcohol can be a trigger. The stress of travel can be a trigger. Summertime can bring more activities that may trigger hot flashes.”

The good news, she said, is women don’t have to live in menopausal misery, thanks to different options available at OU Health Physicians – Women's Health Clinic.

What Is a Hot Flash?

During a hot flash, women can experience a variety of symptoms, such as:

• A sudden feeling of warmth spreading through your chest, neck and face
• A flushed appearance with red, blotchy skin
• Rapid heartbeat
• Perspiration, mostly on your upper body
• A chilled feeling as the hot flash lets up
• Feelings of anxiety

The frequency and intensity of hot flashes can last a minute or two or as long as 5 minutes. Sometimes the hot sensation is mild, but some can be so intense that they disrupt sleep or disrupt daily activities.

How To Treat Menopausal Symptoms

Though menopause can have uncomfortable symptoms, it requires no medical treatment. Most treatments are optional and focus on relieving or preventing discomfort and managing chronic conditions that may occur with aging. Treatments may include:

• Hormone therapy. The most common and effective treatment for relieving menopausal hot flashes is estrogen therapy. A doctor may recommend estrogen in the lowest dose and the shortest time frame needed to provide symptom relief, depending on your family and health history.
• Progestin therapy. Women who still have a uterus will need progestin in addition to estrogen. Though estrogen got a bad rap due to cardiovascular and breast cancer risks if taken long-term, Dr. Miles said estrogen has the added benefit of helping prevent bone loss. However, talk to your doctor about the benefits and risks of hormone therapy and whether it's a safe choice for you.
• Vaginal estrogen. Vaginal dryness is also a symptom of menopause, and estrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. By releasing just a small amount of estrogen, which is absorbed by the vaginal tissues only, vaginal dryness, discomfort with intercourse and some urinary symptoms can be alleviated.
• Low-dose antidepressants. Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, have been shown to decrease menopausal hot flashes and could be a choice for women who can't take estrogen for health reasons or for women who need an antidepressant for a mood disorder. A low dose product is available that is FDA approved just for hot flashes.
• Fezolinetant (Veozah). By blocking a pathway in the brain that regulates body temperature, this medicine is a hormone-free option for treating menopause hot flashes that is also FDA approved.
• Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures. Your doctor might also recommend vitamin D supplements to help strengthen bones.

Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each.

“It’s also best to look at overall wellness,” said Dr. Miles. “The symptoms people are familiar with such as hot flashes, mood changes and irregular cycles tie into overall wellness, such as keeping your bones healthy by staying active. So we encourage exercise, nutrition and continuing social activities because hormonal therapy is not for everybody.”

OU Health also has specialists in urogynecology who can help treat bladder and incontinence issues. Breast screening and bone density screens are also available at the Women’s Specialty Clinic.

Make a Plan for Summer Triggers

While most women who report having hot flashes experience them daily, hot flash symptoms can persist for more than seven years. If that wasn’t enough, hot flashes can become even more pronounced during the warm months of summer, especially if travel is involved.

“Travel can cause stress because of delayed flights and things, so people need to have good plans for their travel. Most importantly, don't forget your medicine and keep them with you, not in your luggage,” Dr. Miles said. “If something happens, you don't want to be without any hormone therapy you may take for any length of time, as well as all your other medications.”

Warm weather locations like islands or beaches can exacerbate hot flashes as well. The added social activities, alcohol, spicy foods and too much sun can act as triggers, she added.

“People can use a lot of things besides a basic fan to cool off,” Dr. Miles said. “Cooling neck wraps that you can keep in the fridge, the little portable fans you can plug into your phone or portable neck fans can work.”

With hot flashes come fluctuating temperature changes. When a hot flash is over, some women experience chills due to the sweat moistening and cooling the skin. Keeping a light sweater or wrap while traveling can help.

“Most importantly, don’t feel like menopause is embarrassing. Most women don’t want to turn cherry red, sweat and have to change their outfits, and we can help with that,” said Dr. Miles. “The bottom line is to start treatments early when you can get the most benefits. So many regimens exist, and I have a printout for patients to look at and consider, like multiple regimens of estrogen and progesterone that may have some side benefits. Ultimately, we are here to help you find the best therapy for you.”

Learn more about menopause care at OU Health or visit OU Health - Women’s Health Clinic.