While many people associate hot flashes with menopause, they can also happen to people who still get their period.

Menopause is a common culprit for hot flashes, but some people experience them before entering this period of their life.

In this article, we look at what hot flashes are, the causes of hot flashes during a period, whether they indicate early menopause, and what people can do about them.

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A number of conditions may cause hot flashes.

A hot flash is a sudden burst of heat, often in the upper body and face. Doctors do not fully understand what causes them, but they believe changes in hormone levels affect how the body regulates its temperature.

Some symptoms of hot flashes include:

  • sudden heat in the chest, neck, or face
  • pink or red flushing in the skin
  • rapid heartbeat
  • sweating
  • anxiety

Perimenopause

Perimenopause is the name for the time leading up to menopause. The American College of Obstetricians and Gynecologists (ACOG) state that people will still get periods during perimenopause. However, they may become irregular or follow a different pattern from month to month.

People often begin perimenopause at some point during their forties. Perimenopause can last for 10 years, so people who experience hot flashes during a period may be experiencing symptoms of perimenopause.

People undergoing perimenopause often find that their hot flashes occur at night. Other symptoms include:

  • difficulty sleeping
  • headaches
  • mood changes
  • vaginal dryness

Premenstrual dysphoric disorder

According to Johns Hopkins Medicine, premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome. This disorder can cause feelings of depression, anxiety, or hopelessness, as well as physical symptoms, including hot flashes, nausea or vomiting, swelling, skin irritation, and pain.

Typically, the symptoms of PMDD occur a week before a period and usually improve a few days after a period begins.

Doctors are not sure what causes PMDD but believe serotonin may play a role. Serotonin is a chemical that helps to regulate a person’s mood, digestion, and other bodily functions.

Premature ovarian insufficiency

Premature ovarian insufficiency (POI) is a condition that affects a person’s ovaries. During the menstrual cycle, the ovaries release an egg. The ovaries can only release eggs a finite number of times during a person’s life.

POI occurs when a person’s ovaries stop releasing eggs or release them much less frequently. A person can develop POI at any age, and sometimes it causes similar symptoms to menopause, including hot flashes.

Some other reasons a person might experience hot flashes during a period include:

  • Hyperthyroidism: Hyperthyroidism, or an overactive thyroid, is when the thyroid gland produces too much thyroid hormone. This hormone plays a role in many bodily functions, including body temperature. Problems with the thyroid may cause hot flashes.
  • Medication: Some medications, especially those that affect hormone levels, may cause hot flashes.
  • Stress: Stress and anxiety can cause hot flashes, a racing heart, symptoms of panic, and flushing in the face or neck.
  • Tumors: Very rarely, a tumor that secretes hormones can cause hot flashes.

Some people begin experiencing hot flashes years before their periods have stopped. Hot flashes at this stage in a person’s life are usually a sign of perimenopause. ACOG estimate that the average age of menopause is 51, although some people experience it as early as 45.

According to the National Institutes of Health, doctors only diagnose premature menopause in people under 40. Hot flashes in people under 40 may be a sign of early menopause. This happens to around 1% of people. In most cases, there is no apparent cause.

However, sometimes a treatment or underlying condition triggers or accelerates menopause. According to a review of literature in Annals of Medical and Health Sciences Research, these include:

  • autoimmune diseases, such as lupus or Addison’s disease
  • surgical removal of the uterus or ovaries
  • diseases that affect the endocrine system
  • certain cancer treatments
  • some infections, such as mumps or tuberculosis
  • smoking, which may speed up the onset of menopause

Hot flashes are not dangerous in themselves but may signal an underlying condition. Treating the underlying condition will help reduce the hot flashes.

If the hot flashes are related to early menopause or an endocrine condition such as POI, doctors will focus on relieving the symptoms and making the hot flashes easier to manage. The National Institute on Aging (NIA) suggest that making the following lifestyle changes might help:

  • Avoiding triggers: Sometimes, people experiencing menopause notice that caffeine, alcohol, and spicy foods can make their hot flashes worse or trigger them.
  • Reducing stress: Stress can worsen hot flashes. In some people, it even causes hot flashes unrelated to perimenopause. Mindfulness, cognitive behavioral therapy, and deep breathing exercises may help. Early research suggests that yoga and tai chi may also reduce menopause symptoms.
  • Maintaining a healthy weight: People with a higher body mass index tend to experience more frequent or severe hot flashes during menopause.
  • Stopping smoking: Smoking can make hot flashes worse during menopause, so cutting down or stopping entirely may help.
  • Reviewing any medications: If a person takes drugs that could cause hot flashes, such as cholesterol or blood pressure medications, they could discuss other options with their doctor.

If lifestyle changes do not work, a doctor may recommend hormone replacement therapy or a non-hormonal medication to improve hot flashes, such as paroxetine (Paxil).

If a person enters menopause and still wants to have a baby, they may need fertility treatments, such as in vitro fertilization or the use of a gestational surrogate.

Several herbal remedies and management strategies may work to reduce the discomfort of hormonal hot flashes. However, what works for one person might not work for another.

Most research into these remedies has focused on their effect on people with menopause. They may not work for someone who is not experiencing menopause or perimenopause. If a person believes that menopause is not the cause of their hot flashes, they should speak to their doctor.

Some herbal supplements can cause side effects or drug interactions. Always consult a doctor before trying a herbal remedy to ensure it is safe.

Acupuncture

A randomized study showed that acupuncture reduced hot flash frequency by 36.7% after 6 months. After 1 year, participants still saw a 29.4% improvement. This suggests that acupuncture could provide long-lasting benefits for some people.

St. John’s wort

A 2010 double-blind study found that after 8 weeks, people who used St. John’s wort had fewer menopause-induced hot flashes than those who took a placebo. St. John’s wort can interact with some drugs.

Licorice

Licorice root or extract may also ease hot flashes caused by menopause. Like St. John’s wort, it takes time to work. A 2012 study found that at 8 weeks, licorice relieved hot flashes better than a placebo. However, licorice is not safe for everyone.

Evening primrose oil

A small 2018 study comparing black cohosh to evening primrose oil (EPO) found that EPO reduced the severity of hot flashes and improved quality of life. Researchers believe EPO helps the body create prostaglandins, which may suppress hormonal hot flashes.

EPO is likely safe and does not usually cause side effects, but people who experience seizures or who are pregnant should avoid it.

Black cohosh

The same 2018 study found that unlike EPO, black cohosh could reduce the frequency of hot flashes during menopause, as well as their severity. However, researchers are not sure how black cohosh works in the body, and no research exists to show that black cohosh is safe to take long-term.

It is worth noting that despite some evidence that herbal medicines can help with hot flashes, the North American Menopause Society indicate that others require further research. At the moment, it is not clear which herbal remedies, if any, are most effective for hot flashes.

Other tips

There are a few other ways a person can manage hot flashes and make themselves more comfortable. The NIA suggest:

  • dressing in layers, which a person can remove if they get hot
  • wearing and sleeping in natural fabrics, like cotton
  • carrying a portable fan

People over 40 who get hot flashes during a period could be perimenopausal. Menopause is not a medical condition, so it does not usually require treatment.

However, some medications and strategies can ease the symptoms. A person beginning the menopause may want to discuss their options with a doctor.

Someone below the age of 40 should consult a doctor if they notice regular hot flashes during their period. A person should also see a doctor if they have other symptoms, such as:

  • sudden changes in appetite, weight, or mood
  • heavy menstrual bleeding
  • pelvic pain or fever

Hot flashes can be alarming, but they are not dangerous in themselves. Sometimes, hot flashes are a sign of early menopause or perimenopause. This may have implications for a person’s fertility.

If a person experiences hot flashes during a period when they are in their twenties or thirties, or notice other symptoms that might indicate an underlying problem, they should speak to their doctor.