Nine ways to predict when your hot flashes will end

One in four women will have hot flashes every day. On affected days, she will usually have four or five hot flashes, but it could be as many as twenty or more. A typical hot flash lasts for a couple of minutes, but it can go on longer.

What does a hot flash feel like?

We’re all different, so women have different experiences of hot flashes, but it will be some combination of:

• A sudden feeling of heat in the chest, neck and face
• The skin in these areas becoming red, sometimes blotchy
• Profuse sweating, often enough to run in trickles or soak the bedsheets
• A rapid heartbeat
• Feelings of anxiety
• Chills at the end

What triggers a hot flash?

Hot flashes can come out of the blue or may be brought on by all sorts of things. There are many potential triggers, and you’ll soon figure out yours. Common triggers include:

• A hot environment
• Hot appliances, such as hair dryers
• Hot drinks
• Caffeine
• Strenuous exercise or physical work
• Stress
• Strong emotions
• Spicy foods
• Alcohol – often red wine
• Tight or warm clothing and bedding
• Smoking

When do they start, and how can I figure out when my hot flashes will end?

Given the disruption they cause and their sheer unpleasantness, it’s no wonder that women are anxious to know when their hot flashes and night sweats will end. It’s also a key factor in deciding whether to ‘grin and bear it’ or seek some help. It’s easier to put up with something if you know there is light at the end of the tunnel in a few months, but a very different proposition if you’re looking at having to put up with something for years.

Because every woman is different, her experience of the menopause transition will be individual to her. However, studies of large numbers of women offer good indicators of what to expect. They provide patterns that help us predict how long the hot flashes and night sweats will last.

Hot flashes and night sweats can start before perimenopause when the only other symptoms are subtle changes in the flow and timing of menstrual periods. However, they most often occur just before the final menstrual period, when some periods are missed altogether. From there, they continue for a variable time into postmenopause.

1. The younger you are when hot flashes start, the longer they will go on for

When the first hot flashes and night sweats occur is a good indicator of how long they will last. The earlier they start, the longer they will go on. If you have your first hot flashes between the ages of forty-two and forty-four, you can expect to have them for three years up to your final period and then another eight years after, for a total of eleven years. However, if your first hot flash doesn’t come along until you are fifty-five, you will have them for about half that time, just six years.

Of course, there’s no such thing as ‘just’ six years. If you are just starting with hot flashes and night sweats, the prospect of having to endure them for ‘just’ six years, let alone eleven is deeply troubling.

2. The earlier in the menopause transition your hot flashes start, the longer they will last

Not only does the age when your hot flashes start determine how long they will last, but also the stage of the menopause transition you’re in at that time. If your hot flashes start before you officially enter perimenopause, you can expect them to last for an average of fourteen years.

How do you know if you have entered perimenopause? Well, towards the end of a woman’s reproductive life, her periods start to lose their regularity, developing changes in flow and length of cycle. Once the variation in cycle length from one period to another is seven days or more, she has entered perimenopause. That’s the official definition doctors and scientists use to ensure they are are all talking about the same thing when designing or interpreting studies.

The further into your menopause transition you are when the hot flashes and night sweats start, the less time you’ll have to endure them. If your first hot flash doesn’t happen until after your final period, then you have less than six years, on average, to deal with them.

A note here about averages: you may not even have known that there are different types of averages, but the one we are talking about here is the median. If we say that the median duration of hot flashes is six years, we mean that half of the women will have stopped having hot flashes by six years. Put another way; you have a 50:50 chance of having your last hot flash within six years. Of course, that means that for the other 50%, their hot flashes will continue for longer. A few women will continue to have hot flashes and night sweats for the rest of their lives.

By comparing the age at which you started with hot flashes and the stage you had reached in the menopause transition at the time, you should now be able to estimate when your hot flashes will end. But are there other factors that affect this prediction?

3. Smokers have more severe hot flashes and night sweats, and they last longer

Smoking doubles the risk of having hot flashes and night sweats, and smokers report more severe symptoms than non-smokers. Although smoking may delay the onset of hot flashes, once started, they go on longer in smokers. Cigarette smoke is particularly toxic to the ovaries. All the eggs a woman will ever have form in the ovaries before birth. Chemicals from cigarette smoke from a mother’s smoking at this vulnerable stage can damage the eggs and much later lead to early menopause. If you smoke, it takes ten smoke-free years before your risk of hot flashes falls to that of a lifelong non-smoker. Even passive smoking increases the risk of hot flashes.

4. Heavier women have worse symptoms, but they often end sooner

One positive consequence of a higher BMI is that hot flashes and night sweats tend to stop faster after the final menstrual period than in lighter women. This is thought to be because fat tissue can produce oestrogens – a reason why overweight men often develop man-boobs.

5. Your ancestry can play a significant role in how long you will suffer from hot flashes and night sweats

6. The longer you spent in school means the sooner your hot flashes will end

A college education is associated with many health advantages. Typically, a woman who has been to college can get a higher paying job and is likely to meet a partner who also has a higher paying job, so they have a more comfortable life with a better diet and better healthcare. It even affects how long you are likely to suffer from hot flashes. Going to college knocks two and a half years off the length of time you can expect to have these symptoms. It brings the average down from ten years without a college education to seven and a half.

7. Worse symptoms mean longer-lasting symptoms

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The infographic below combines all the information we have discussed. You can use it to make a very rough estimate of how much longer your symptoms will continue and when your hot flashes will end. Remember that all the figures are averages, and you are not an average woman – there is no such thing! It’s also not clear how these figures combine. For example, if you are stressed and have severe symptoms, that won’t necessarily add another six years, but it may add more than three.

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