Our bodies have built in a temperature control regulated by the hypothalamus, a small gland near the brain stem, which acts as a conduit between the thalamus and the pituitary gland. The hypothalamus helps to regulate temperature with a number of hormonal “messengers.” For women, one of these messengers is the hormone estrogen, which begins to decrease in supply a few years before menopause begins. This reduction in supply can temporarily confuse the hypothalamus, causing a significant rise in body temperature and very uncomfortable hot flashes.

Hot flashes is only one of the symptoms associated with the underlying cause. They do cause sudden increase in body temperature, but it is really the hypothalamus' response to the sudden confusion that makes people extremely uncomfortable. The body can be said to go into hyperdrive to get rid of what it perceives as excess heat. This means the heart rate increases, and profuse sweating occurs. It’s not uncommon for women to sweat so much their clothing gets soaked through in a matter of minutes during hot flashes.

Hot flashes may be somewhat comparable to panic attacks. The rapid heartbeat can certainly induce panic, and it may also cause extreme headaches, nausea and dizziness. A woman’s first hot flash can be frightening, especially since it usually occurs before menopause begins and isn’t expected. You can tell several differences between a hot flash and a panic attack. First, breathing may increase slightly, but there is not the hyperventilation typical with panic attacks. Second, panic attacks rarely cause flushing on the face, or such profuse sweating.

It's important to stay calm during a hot flash. Increased respiration can only add to the temporary chaos in the body, and panic as to the cause of a hot flash may actually sustain the hot flash longer. As you experience more of these, and about 85% of women do during the few years before and after menopause, remember you’re certainly not alone.

As you get used to hot flashes occurring, you may note certain things trigger them, and these can be quite different for each person. A few groups tend to get more of them than others. Smokers tend to get them with greater regularity than do nonsmokers. Stress, consuming alcohol, caffeine or spicy foods, sitting in hot tubs, being in warm rooms, or walking around in hot weather may all be potential triggers.

Some women can tell a hot flash is on its way by sudden chills, or just an indefinable feeling called an “aura” that a hot flash will occur. If you get hot flashes frequently, it’s a good idea to chart what you were doing before the hot flash occurred. You might detect patterns between behavior or conditions and the flashes, and thus be able to reduce them.

Most women do note that these flashes diminish a few years after menopause begins. In the interim, wearing cotton clothing, using air conditioning, and having some cold washcloths on hand to get through hot flashes is a good idea. Medications like estrogen replacement therapy have in the past been used to help reduce hot flashes, but these are now contraindicated because they strongly increase risk for cancer. Some women find taking estrogen for a few months when menopause begins is helpful in countering the worst hot flash time period.