Hot flushes, demystified
What is actually happening, the triggers worth tracking, and natural ways to ease them.
One moment you are perfectly fine. The next, a wave of heat rolls up through your chest, floods your face, and suddenly you are the only person in the room who is absolutely sweltering. Sound familiar? Hot flushes (also called hot flashes) are one of the most commonly reported symptoms of menopause, affecting up to 80 per cent of women during the transition. And yet they are still so often suffered in silence, brushed off as just part of the deal.
They are not something you just have to put up with. Understanding what is actually happening in your body is the first step toward managing them with more confidence. Let's break it all down.
So what is actually happening?
At the heart of a hot flush is your hypothalamus, the part of your brain that acts as your body's internal thermostat. Under normal hormonal conditions, it keeps your body temperature within a fairly narrow comfort zone. But when oestrogen levels decline during menopause, the hypothalamus becomes hypersensitive to even tiny changes in body temperature. Your brain essentially interprets a very small rise in core temperature as a major overheating emergency, and it launches an exaggerated cooling response.[1]
That response involves rapidly dilating the blood vessels near the surface of your skin (which is why you feel flushed and red), triggering sweat production, and increasing your heart rate. Your body is working incredibly hard to cool you down, even when, to everyone else in the room, the temperature is perfectly comfortable.
Newer research has started mapping the specific molecular pathways involved in this response, including the kisspeptin and GnRH signalling pathways in the brain, inflammatory markers, and even blood glucose levels. This is exciting because it means we are getting ever closer to understanding not just what happens, but why some women experience them more severely than others.[2]
The average hot flush lasts between one and five minutes, though they can feel much longer in the moment. Frequency varies enormously, from a handful per week to more than 20 per day in some cases.
Triggers worth tracking
Not all hot flushes are random. Many women find that certain situations reliably set them off. Keeping a simple diary for a week or two can be genuinely eye-opening and give you real power over your experience. Common triggers include:
Spicy foods and chilli, which can cause a rapid rise in skin temperature.[3]
Caffeine, particularly coffee, which affects vascular tone and can lower the threshold at which a flush is triggered.[3]
Alcohol, especially wine and spirits.[3]
Hot drinks and hot environments, including hot showers or crowded, stuffy rooms.
High blood sugar and sugary foods, particularly in women in the early years of menopause.[2]
Stress and anxiety, which activate the sympathetic nervous system and can nudge your internal thermostat even lower.
Tight or synthetic clothing, which traps heat against your body.
Identifying your personal triggers is one of the most practical things you can do. It does not mean eliminating everything you enjoy, it means understanding your patterns and making informed choices.
Natural ways to ease hot flushes
Eat more whole, plant-rich foods
Research shows that a diet rich in fruits, vegetables, and whole grains is associated with reduced severity and frequency of vasomotor symptoms. Phytoestrogens, plant compounds that have a mild oestrogen-like effect in the body, are found in foods like flaxseeds, edamame, tofu, tempeh, chickpeas, and lentils. Regular consumption has been associated with modest reductions in flush frequency in several studies.[2]
Move your body regularly
Exercise training has been shown to improve thermoregulatory control, meaning it raises the threshold at which your hypothalamus triggers that exaggerated cooling response. Even moderate-intensity movement on most days can make a meaningful difference. We have a whole blog on getting started with gentle movement, which is worth a read.[1]
Try mind-body practices
Stress is a significant flush trigger, and practices that calm the nervous system can help lower both the frequency and intensity of hot flushes. Yoga, mindfulness meditation, slow deep breathing, and cognitive behavioural therapy (CBT) have all shown promising results in clinical settings. Even five minutes of slow, deliberate breathing (in for four counts, out for eight) can interrupt the stress response that often precedes a flush.
Consider herbal support with guidance
Some herbal remedies have been researched for their potential to ease vasomotor symptoms. Black cohosh has shown some evidence for reducing flush frequency. Red clover, which is rich in phytoestrogens, has also been studied. A double-blind study found that licorice root reduced both the frequency and severity of hot flushes. If you are considering herbal supplementation, please discuss it with a qualified practitioner first, as some herbs interact with medications or are not appropriate for everyone.[4]
Dress in breathable layers
Practical but genuinely effective: natural fibres like cotton, bamboo, and linen allow your skin to breathe. Layering means you can adjust quickly when a flush arrives without drawing too much attention to yourself or feeling completely uncomfortable for the duration.
Hot flushes are real, they are physiological, and they can be disruptive. But they are also manageable for most women with the right information and support. You deserve to feel informed and empowered about your own body, and that starts with understanding what is happening inside it.
If you would like some support please reach out and book a free 30-minute discovery call
REFERENCES
[1] The Lancet (2017). New pathways in the treatment for menopausal hot flushes. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30886-3/fulltext
[2] PMC (2024). Menopause Hot Flashes and Molecular Mechanisms Modulated by Food-Derived Nutrients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10935406/
[3] Cleveland Clinic. Hot Flashes: Triggers, How Long They Last and Treatments. https://my.clevelandclinic.org/health/symptoms/15223-hot-flashes
[4] GoodRx. How to Stop Hot Flashes: Natural Remedies and Treatments. https://www.goodrx.com/conditions/menopause/natural-remedies-for-hot-flashes
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