What hot flashes and night sweats feel like
A hot flash is a sudden wave of heat, usually across the face, neck and chest. Your skin may flush, your heart may race and you may break into a sweat, then feel chilled as it passes. Most last a few minutes, and they can come several times a day or only now and then.
Night sweats are hot flashes that happen during sleep. They can soak your sheets, wake you repeatedly and leave you exhausted the next day, which is why they so often travel with sleep problems and irritability.
Common causes
Perimenopause and menopause
Falling and fluctuating estrogen affects the brain’s temperature control center, narrowing the range in which your body feels comfortable. Small changes in core temperature can then set off a flash. Hot flashes often start in perimenopause and can continue for several years after the final period, sometimes longer.
Other hormonal and metabolic causes
- Low testosterone, or hormone-lowering treatment, in men
- An overactive thyroid
- Episodes of low blood sugar
- Surgical removal of the ovaries or certain cancer treatments
Triggers and other contributors
- Alcohol, caffeine and spicy food
- Warm rooms and heavy bedding
- Stress and anxiety
- Smoking and excess body weight
- Medications, including some antidepressants
- Infections or other illnesses that cause fever
Medications that can cause hot flashes
Several medicine classes can cause flushing or sweating: some antidepressants, medicines that lower estrogen or testosterone, such as certain breast and prostate cancer treatments, some diabetes medicines when they cause low blood sugar, niacin, opioids and some blood pressure medicines. If a new medicine lines up with new flashes, talk to the prescribing doctor before making any change.
Hot flashes in your 30s and night sweats in men
Hot flashes in your 30s or early 40s
Perimenopause can begin in the late 30s for some women, but hot flashes before 40 deserve a closer look. Primary ovarian insufficiency, when the ovaries stop working normally before 40, can cause hot flashes with irregular or missed periods, and it matters for bone and heart health. An overactive thyroid, medications and anxiety can cause flushing at any age.
Night sweats in men
Hot flushes and night sweats are recognized signs of low testosterone, most often after treatments that lower testosterone, such as therapy for prostate cancer. In men, night sweats also come from sleep apnea, an overactive thyroid, medications, alcohol, infections and, rarely, more serious illness. Low testosterone is confirmed only with consistent symptoms and low levels on at least two separate early-morning blood tests.
What we evaluate
We review when the flashes started, how often they happen, what seems to trigger them, how they affect sleep, and your cycle, menopause and medical history. Because thyroid problems and other conditions can mimic menopause, testing may include:
- Estrogen, progesterone and, when relevant, testosterone
- A complete thyroid panel
- Blood sugar control
- Inflammation markers
- Lipids and blood pressure, since cardiovascular risk rises after menopause
How hot flashes and night sweats are treated
Treatment follows the cause. When hot flashes come from perimenopause or menopause, the Menopause Society considers hormone therapy the most effective treatment, though it isn’t right for everyone, and non-hormonal prescription options also exist. Our page on menopause doctor care and treatment options covers these choices, their risks and how they are monitored.
Identifying triggers, keeping the bedroom cool, adjusting alcohol and caffeine, managing stress and reaching a healthier weight can also reduce symptoms. The four-month Hormonal Wellness program is designed for concerns such as hot flashes, night sweats and disrupted sleep. Compare it on our wellness programs page.
When to see a doctor urgently
Call 911 if a flushing episode comes with chest pain, a racing or irregular heartbeat that does not settle, fainting or trouble breathing.
See your primary care doctor promptly if night sweats come with fever, unexplained weight loss or swollen lymph nodes, if you have any vaginal bleeding a year or more after your last period, or if you are a man with new hot flashes. These can signal conditions that need a different kind of evaluation.
Getting evaluated in Little Rock, Searcy or Miami
Hot flashes and night sweats are evaluated in person at our offices in Little Rock’s Regions Center, Searcy and downtown Miami on Biscayne Boulevard, by appointment. Request a free 15-minute discovery call to discuss your symptoms, or browse our symptom guide for related concerns such as mood changes.
Questions
Common questions about hot flashes
What causes hot flashes besides menopause?
Hot flashes can also be caused by an overactive thyroid, low testosterone or hormone-lowering treatment in men, certain medications such as some antidepressants, infections, anxiety and, rarely, other medical conditions. Alcohol, caffeine, spicy food and warm environments can trigger them too. Hot flashes that are unexplained, or that occur in men, are worth a medical evaluation.
Can men get hot flashes?
Yes, though it is less common. In men, hot flashes are most often linked to low testosterone, particularly after treatments that lower testosterone, such as therapy for prostate cancer. An overactive thyroid, certain medications, anxiety and infections can also cause them. New hot flashes or night sweats in a man should be checked by a physician.
Can you have hot flashes in your 30s?
Yes, though it is less common. Some women enter perimenopause in their late 30s, and hot flashes can also follow pregnancy, certain medications, an overactive thyroid or anxiety. Hot flashes with irregular or missed periods before 40 can signal primary ovarian insufficiency, which affects bone and heart health, so they deserve a medical evaluation rather than waiting to see.
Can thyroid problems cause hot flashes?
An overactive thyroid can. Excess thyroid hormone speeds up metabolism, which can cause heat intolerance, sweating, a racing heart, anxiety, weight loss and trouble sleeping, symptoms that are easy to confuse with perimenopause. Because the two can overlap in midlife, thyroid function is usually checked when hot flashes are new, unusual for your age or come with palpitations or weight loss.
Why do I only get hot flashes at night?
Hot flashes can happen at any time, but night sweats are often noticed more because they wake you. Warm bedrooms, heavy bedding, alcohol or spicy food in the evening and stress can make nighttime episodes more likely. Night sweats also have causes beyond menopause, such as sleep apnea, medications, low blood sugar and infections, so those with fever or weight loss need prompt evaluation.
Can anxiety cause hot flashes?
Yes. Anxiety and panic trigger the body’s stress response, which can cause sudden warmth, flushing, sweating and a racing heart. Anxiety can also make menopausal hot flashes feel more frequent or intense, and hot flashes can in turn feel like anxiety. When episodes come with chest pain, fainting or a heartbeat that does not settle, seek urgent care first.