Are You Setting Off Your Hot Flashes?
If you start taking note of your hot flashes, you may recognize some events, emotions, or activities that actually seem to contribute to, or “trigger,” the onset of a hot flash.
Scientifically speaking, while the physiology of hot flashes is associated with a decrease in estrogen level or an increase in gonadotropin concentrations, the actual physiological mechanism of hot flashes is not known. While they may sometimes seem to occur spontaneously with no prior warning, it has also been reported that there are often “triggers” that precede hot flashes.
What Is a Hot Flash Trigger?
A hot flash trigger is anything that appears to precede a hot flash on a regular basis. Triggers may be termed as external, internal, or learned. Some examples of each include:
• External hot flash triggers: temperature fluctuations, alcohol, hot or spicy foods/beverages, caffeine
• Internal hot flash triggers: anxiety, stress, illness (e.g.: migraines, coughing), emotional situations
• Learned hot flash triggers: entering a certain room, applying makeup, planning a dinner menu, getting ready for church
To find your hot flash triggers, I suggest keeping a record of your hot flashes. Include the activities you were doing when the hot flash started and list the possible triggers associated with that activity. By recording your hot flashes, you might be able to see a pattern, identify the activities associated with the trigger, and determine if you could make any changes that would affect the situation and possibly help with the hot flashes.
5 Common Hot Flash Triggers To Look For
Some of the more common triggers identified by women experiencing hot flashes from menopause or breast cancer treatment are:
• Stress/anxiety: Psychological stress is often identified as a precursor to hot flashes. This stress may come from a host of factors, each as individual as you are from others. Making an attempt to identify the stressors that appear to preempt a hot flash could be helpful to you because the situation may be controllable. It may mean reducing stress by changing a situation, saying “no” to a new demand, or just taking time to relax.
• Emotional situations: There are certain situations in which you may find that extreme emotions may precede a hot flash. In these cases, symptoms of the hot flash may even exacerbate the emotional feelings as you also feel embarrassment and discomfort relating to the hot flash.
• Foods: While certainly not limited to these, the foods most commonly attributed to triggering a hot flash are spicy foods, hot foods and beverages, and caffeine. As you begin to be more aware of when and how your hot flashes occur, you may notice that certain foods you eat or beverages you drink act as a precursor to your hot flashes. With this information, you may choose to alter some of your dietary habits to reduce your hot flashes.
• Drugs/alcohol: Hot flashes have reportedly been associated with alcohol and certain medications like niacin, which is sometimes proscribed for high cholesterol and has the common side effect of hot flashes. Alcohol consumption can also trigger hot flashes for some women. The mechanisms for alcohol-provoked hot flashes are complex, and sensitivity varies. However, it is known that alcohol causes vasodilation (expansion of the blood vessels) in the face and neck that can trigger a hot flash. As she became aware of her triggers, one of my patients, Emily, noticed that whenever she had a glass of wine (or two) this was always followed by a severe hot flash. While she didn’t want to forego her wine with dinner altogether, she adapted her activity to make a change. She reduced the amount of wine she had with dinner, and began using my self-hypnosis program when needed as she enjoyed her dinner.
• Environment/activities: In some cases, environment may prompt a hot flash because it may be crowded, loud, or hot. Or there may be an activity, not normally associated with sweating, that you find almost always precedes a hot flash for you. For example, Emily reported that every morning as she was about to put on her makeup, she would have a hot flash. Emily typically put her makeup on in the dressing area of her bathroom, and shared the space with her husband who was brushing his teeth and shaving at the same time. Above the dressing counter mirror were four high-wattage light bulbs. She described the activity as a “rush time.” After our discussion about this trigger, Emily decided to start putting her makeup on in her bedroom, seated at a small dressing table. She would do this alone and allow herself ample time so that she didn’t feel crowded or rushed. She stated that, “It gives me a special feeling… to have my own space that is quiet and uncrowded. I bought a lighted makeup mirror that doesn’t get hot like the bathroom lights. I even play soft music while I put my makeup on, and if I feel [a hot flash] coming on, I take a moment to relax and imagine my cool place [from hypnotic relaxation therapy]. I’ve still had hot flashes some, but they are not as often and not nearly as severe.”
Gary R. Elkins, Ph.D., ABPP, ABPH, is the Director of the Mind-Body Medicine Research Laboratory at Baylor University. He is a Professor of Psychology and Neuroscience at Baylor University where he is the Director of the Doctoral Program in Clinical Psychology. Dr. Elkins is also a Clinical Professor in the Texas A&M University Health Science Center. He maintains a private practice in clinical psychology with a specialization in clinical health psychology, behavioral medicine, and hypnotherapy. Dr. Elkins has board certification from the American Board of Professional Psychology (ABPP) and from the American Board of Psychological Hypnosis (ABPH). He is a Past-President of the American Society of Clinical Hypnosis and of the American Board of Psychological Hypnosis. He is the 2014 President of Division 30 (the Society of Psychological Hypnosis) of the American Psychological Association. With over 35 years of experience he conducts an ongoing program of research into the use of hypnotic relaxation therapy and mind-body interventions for hot flashes, menopausal symptoms and improving sleep. Dr. Elkins is the author of the groundbreaking publication Hypnotic Relaxation Therapy: Principles and Applications that provides a resource for training health care providers.