Hot flushes are one of the most common symptoms associated with the perimenopause with a reported 70% or more of women experiencing them at some stage.

One definition of a hot flush is…

“… a rapid and exaggerated heat dissipation response, consisting of profuse sweating, peripheral vasodilation, and feelings of intense, internal heat.”

Yep, that pretty much sums it up!  Basically, it feels like your whole body is on fire, you sweat, and it comes on quickly! It’s not a fun experience and it can be embarrassing, inconvenient and in some cases, debilitating.

Hot flushes usually last between 1-5 minutes, but they can last much longer.  Some women don’t get them at all, some only experience a few months of them, but some experience them for many years. Some women have just one hot flush a day, and some can more than 10 a day. White Caucasians tend to report most hot flushes, and Chinese and Japanese women report the lowest. Everyone’s experience is different.

But why do we get them? What on earth is going on? And how can we stop them? 

It is understood that during the perimenopause our ‘thermoneutral zone’ becomes smaller. Basically, we start to sweat at lower temperatures than before, and we shiver at higher temperatures than before.  The zone between shivering with cold and sweating is smaller.

There are 2 main players


Hot flushes are understood to be triggered by changes in our oestrogen levels.  Over the course of the menopause, our oestrogen levels fluctuate up and down, and gradually decline. This is why oestrogen replacement (HRT) can reduce hot flushes. 

However, this can’t be the only factor because we don’t all have hot flushes, yet we all have a decline in oestrogen. Plus, we don’t get hot flushes in pre-puberty when our oestrogen levels are low. It can’t just be due to a lack of oestrogen. 

What else is going on?

Studies have shown that stimulation of noradrenalin ie the stress response, can bring on hot flushes. Likewise, suppressing the stress response can reduce them.

Noradrenalin is understood to reduce that thermoneutral zone. Also, oestrogen itself can trigger noradrenalin, so the surges of oestrogen we experience may be a factor too.

 In other words, the stress response is a key factor.

What can we do about this?

Studies have shown that relaxation techniques, can significantly reduce the frequency of hot flushes in women who are experiencing multiple hot flushes in a day.

This is one reason I work with my clients to help them find ways of mitigating stress by finding relaxation techniques that work for them. 

Taking time out in your busy day to practice therapeutic breathing, or other relaxation techniques, is a key part of thriving during perimenopause. 

For more information on consultations and to find out if nutritional therapy could help you, book your totally free Discovery Call by emailing me at [email protected]



1. Freedman RR. Menopausal hot flashes: mechanisms, endocrinology, treatment. J Steroid Biochem Mol Biol. 2014;142:115-120. doi:10.1016/j.jsbmb.2013.08.010

2. J. H. Irvin, A. D. Domar, C. Clark, P. C. Zuttemzeister & R. Friedman (1996) The effects of relaxation response training on menopausal symptoms, Journal of Psychosomatic Obstetrics & Gynecology,17:4, 202-207, DOI: 10.3109/01674829609025684

3. Lindh-Åstrand L, Nedstrand E. Effects of applied relaxation on vasomotor symptoms in postmenopausal women: a randomized controlled trial. Menopause. 2013 Apr;20(4):401-8. doi: 10.1097/gme.0b013e318272ce80. PMID: 23149867.


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