Hot Flashes and Breast Cancer

A hot flash is a sudden, intense, hot feeling on your face and upper body, which usually causes sweating. Hot flashes feel different for everyone; some people also experience a rapid heartbeat, nausea, dizziness, headache, weakness, or anxiety. The skin on your face and neck may feel flushed, and, depending on your complexion, may redden like you’re blushing. As the flash ends, you may feel chills. 

Some people also experience a sense of unease right before a hot flash, giving them a hint that one is on the way. That feeling of unease is called an “aura.”

Hot flashes that happen at night are referred to as night sweats and can disrupt your sleep.

Hot flashes can make everyday activities difficult and are the number one reason women seek medical care during menopause.

Hot flashes are most commonly caused by the drop in estrogen brought on by menopause — be it natural, surgical, or induced by hormonal therapy or chemotherapy. Hormonal therapies, like tamoxifen, cause hot flashes by lowering estrogen levels.  

This drop in estrogen throws off the hypothalamus — the part of your brain that regulates body temperature. The hypothalamus thinks your body needs cooling down even when it doesn’t, and triggers the hot flash and actually lowers your body temperature.

Read more about what causes hot flashes. 

A hot flash can last anywhere from a few seconds to a few minutes, or sometimes as long as an hour, and varies from person to person. Once it’s over, it can take another half hour for you to feel like yourself again.

The frequency also varies: some people who experience hot flashes get them daily, while others just get them once in a while. For some, they may occur for a year or two; others may get them for up to 10 years. The average duration of hot flashes is seven years. ¹

About 75% of U.S. women have hot flashes as they approach menopause and for the first year or two after their periods stop. Between 20% and 50% continue to have them for many more years. Although the majority of these people have mild to moderate hot flashes, about 10% to 15% of them experience such severe hot flashes that they seek medical attention. As time goes on, the intensity usually decreases, but for a very small number of women, they may never go away. 

Whether you have a history of breast cancer or not, there is considerable variation in time of onset, duration, frequency, and the nature of hot flashes, as well as how they can affect your life.

For some women, hot flashes gradually fade away without treatment. But for other women, hot flashes linger for a number of years, and are extremely bothersome.

New research shows non-hormonal treatments can ease hot flashes, which is good news for people with a history of breast cancer.

Read about the latest research.

While there's no cure for hot flashes, there are lifestyle changes and medicines that can offer relief. 

Studies have shown that, over time, reducing the fat in your diet may help provide some hot flash relief. Losing excess weight can also help, but losing too much weight or being too thin can worsen hot flashes.

A 2023 study looked at low-fat, plant-based diets that included soybeans, which contain phytoestrogens (plant-based compounds similar in structure to estrogen), and its effect on hot flashes. The group of women on the plant-based diet experienced an 88% reduction in hot flashes, compared to 34% for those who did not change their diet. Talk to your oncologist before changing your diet to see if this type of diet is a good idea for you.

Some fabrics, such as cotton, linen, and rayon, are known for being airier, which can help you stay cool and provide some hot flash relief. Cotton in particular wicks or soaks up sweat and dries quickly. Dress in layers so if you do start to get warmer, you can easily peel off a layer or two to cool down. Just as it’s a good idea to lean toward cotton and the other fabrics mentioned above, you also should avoid thick, heavy fabrics and synthetics.

It may seem like a no-brainer, but keep ice water and maybe even a small cooler full of cold water with you. If you can, lower the room temperature by turning down the thermostat, turning on the air-conditioner, or using a fan.

If you get night sweats, try taking a cool shower before bed and sleeping in cotton pajamas or a nightgown — those are easier to change than sheets. You may also put cotton sheets on your bed. If the hot flashes are interfering with your ability to get enough sleep, talk with your doctor about ways to manage sleep disruptions, including lifestyle changes and medicine.

There are several hot flash medications that can ease hot flashes, including the relatively new drug Veozah (chemical name: fezolinetant), a hormone-free drug approved in 2023 specifically for hot flashes. 

Other drugs that may help — like hormone-replacement therapy, progestin-containing medicines, and Duavee (chemical name: conjugated estrogen/bazedoxifene) — are generally not recommended for people who have a history of hormone receptor-positive breast cancer or who are at high risk for breast cancer. Medicines used to treat some other conditions, such as high blood pressure or depression, may also offer some relief.

Several natural remedies for hot flashes, such as meditation, massage, yoga, and acupuncture, can be helpful. It may take some trial-and-error to find one that’s right for you. Unfortunately, no over-the-counter dietary supplement or herbal therapy has been proven to offer hot flash relief. 

The best relief from a hot flash is avoiding one in the first place. Known hot flash triggers include stress, smoking, alcohol, caffeine, and spicy food. Hot tubs, saunas, hot showers, hot rooms, and hot weather, as well as hot food and drinks, can also cause hot flashes. 

 

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