What causes hot flashes?

Full answer

Hot flashes (vasomotor symptoms) are caused by hypothalamic temperature dysregulation triggered by declining and fluctuating estrogen levels in perimenopause and menopause. Severity correlates more with the rate of estrogen decline than with the absolute level — which is why early perimenopause can produce more severe symptoms than postmenopause. Workup is primarily clinical, supported by estradiol, FSH, and TSH (hyperthyroidism can mimic). Treatment options span lifestyle (cooling, layering, trigger avoidance), bioidentical hormone optimization (estradiol +/- progesterone), and non-hormonal options when BHRT is contraindicated. Severity and duration vary widely; persistent severe symptoms warrant provider review.

Educational. Not a substitute for individualized provider review.