“Doc, I am having hot flashes, but I am only 30 years old! Does this mean I am menopausal? I haven’t even started my family yet! I was planning to get pregnant in a year or two. What am I going to do?”  Jane asked me last week when I saw her in my office for her Well Woman exam. 

This is not unusual for me to come across. We feel that hot flashes mean menopause but is that entirely true? In order to understand what causes hot flashes, I believe it is important to first understand -what is a hot flash?

A hot flash is the sudden feeling of warmth in the upper body usually most intense over the face, neck and chest. Your skin might redden as if you’re blushing. It may also cause sweating and if you lose too much body heat, you might feel chills afterward.  Hot flashes that happen at night, are called Night Sweats and they may disrupt your sleep.

So, what causes hot flashes?

Our brain, just like our house, has a thermostat system for temperature regulation. It is very sensitive and maintains a fine delicate balance by reacting to various hormones circulating in our blood. Consequently, any changes in the level of these key hormones can disrupt the temperature regulation mechanism and trigger a hot flash.

I told Jane, “Let’s talk more about what else you are feeling. What you are eating? Do you have additional stress in your life? How are your relationships? How much alcohol and coffee are you drinking? Are you exercising?”

And, she says, “But what has that to do with my hot flashes?!”

And my response was, “EVERYTHING!!!”

Our bodies are complex; it’s not one thing that determines how we feel. It’s the net effect of multiple factors. [I BELIEVE WE NEED TO TALK SOMETHING ABOUT THE FEMALE SEX HORMONES THAT CAUSE HOT FLASH VS. THE ADRENAL-THYROID COMPLEX WE ARE TALKING TO GIVE A COMPLETE PICTURE]It is very important to make sure that the adrenal and thyroid glands are working at their best.

Adrenal glands are tiny glands that sit on top of each of our kidneys. Our adrenal glands make many hormones including cortisol. If someone is stressed for a longer duration, that can affect the circadian rhythm and production of cortisol also called the stress hormone. One of the ways of checking it is by checking the levels of cortisol in the saliva using a Four Point Cortisol Test. Testing can be done in the privacy of your own home and involves collecting your saliva four times a day at specific times. This can calculate the level of cortisol in your system and also draw a pattern as to how the levels are changing throughout the day.

Thyroid levels can be checked via a simple blood test.

Another thing to consider is your gut health. If you are constipated or don’t have regular bowel movements, that can be a sign of a not so healthy gut. An unhealthy gut  can affect the way hormones are produced and processed by the body.

Excess body fat, especially in the midsection of the body, also creates insulin resistance and abnormal glucose levels. So, if you carry excess fat especially around your belly, you are more likely to be estrogen dominant (higher level of estrogen compared to progesterone). This can also cause symptoms.

That’s why what you eat and what you excrete makes a difference.

Jane nodded and said, “Is that the reason why you keep asking me to take my vitamin D, C, B complex and fiber?”  I said, “Yes, you got it. Lots of fiber!!!”

Certain foods like spicy foods, caffeine, alcohol, some medications and even smoking can be a trigger for hot flashes. Chronic infections like tuberculosis, trauma, chronic inflammation, exposure to toxins and certain cancers like lymphoma are some of the other causes of hot flashes.

I told her that what you put on your skin makes a difference too. Even your cosmetics.

“My cosmetics!!! Are you telling me that my lipstick is giving me a hot flash?? You’ve got to be kidding me!”

It’s true, there is something called- Xenohormesis: – how various macronutrients, chemicals, chemically modified food ingredients and foreign chemicals can influence the hormonal response. So Jane, YES your lipstick can give you a hot flash too.  If, you want to learn more about the products you are using, visit the site EWG’s Skin Deep. They have listed data on cosmetic ingredients and their safety.

Jane said, “I can see now how what I eat, do, read, exercise, like, dislike, pee, poop, and sweat has an impact on my hormones. Too bad it’s all connected.”

While Jane was on the right track there, I think it’s a good thing that it is all connected because if you change one thing-you can change EVERYTHING.

That brought a smile to her face and mine too.

So, if you are in your 30s and experiencing hot flashes, it doesn’t necessarily mean that you are going into menopause. It means that there is an imbalance in the body, and we need to dig deeper to figure out why is it happening.