Let’s Talk Hot Flushes
Do They Ever Really Stop?
For many women, the end of monthly periods is supposed to mark freedom from hot flushes, but reality often tells a different story.
These sudden waves of heat, sometimes followed by a pounding heartbeat or night sweats, are more than a passing nuisance. They are the visible signs of a profound neurological shift. When oestrogen levels fall, the hypothalamus, the brain’s internal thermostat, becomes hypersensitive, misreading even slight changes in body temperature as a reason to cool down.
The result is a surge of heat that can interrupt sleep, cloud concentration and erode confidence at work or in relationships.
Far from a brief inconvenience, research shows that hot flushes can persist well beyond the final menstrual period. A 2023 review in The Lancet found that for many women, symptoms last seven to ten years and for some they continue for more than a decade. The impact isn’t just physical; chronic sleep disruption and elevated stress hormones such as cortisol have measurable effects on memory, mood and cardiovascular health.
Understanding this biology matters even more when we consider cultural and racial disparities. Black and Asian women, for example, frequently report longer-lasting and more intense symptoms, a pattern confirmed in both UK National Health Service (NHS) data and the U.S. SWAN (Study of Women’s Health Across the Nation) research. Social stressors, from structural racism to unequal access to menopause care, can heighten these challenges, creating a layered health burden that often goes unseen.
This conversation isn’t simply about comfort; it’s about health equity and self-advocacy. By learning how and why hot flushes persist, women can seek effective treatment, challenge outdated assumptions and support one another through every stage of the menopausal journey.
What the Science Shows
Studies from the UK’s National Institute for Health and Care Excellence (NICE) reveal that up to 50% of women still experience hot flushes several years after menopause. In the U.S. SWAN study (Study of Women’s Health Across the Nation), the median duration of vasomotor symptoms was 7.4 years and in some cases, over a decade. The hypothalamus, the brain’s “thermostat”, becomes more sensitive when estrogen levels drop, leading to these sudden heat surges.
The SWAN study and UK research highlight striking disparities:
Black women report hot flushes that are longer-lasting and more intense than those of white women, often persisting for 10 years or more.
Women of South Asian heritage also report higher frequency and greater sleep disruption from night sweats.
Factors include genetics, lifestyle, body mass index and social stressors such as systemic racism and healthcare access, which can heighten cortisol levels and worsen symptoms.
Black British researchers like Dr. Ijeoma Azogu have noted that healthcare systems often under-recognise these differences, leading to under-treatment. Cultural stigma can add another layer, discouraging open conversations and delaying support.
Living With and Beyond, Hot Flushes
Managing ongoing hot flushes often involves a multi-pronged approach:
Lifestyle: Reducing alcohol, caffeine and spicy foods and maintaining a cool sleep environment.
Mind-Body Practices: Mindfulness and paced breathing have been shown to calm the nervous system and reduce symptom severity.
Medical Support: Hormone Replacement Therapy (HRT) or non-hormonal options such as SSRIs or gabapentin can be effective.
Black and Asian women, however, are statistically less likely to be offered or to accept HRT, something that calls for both patient advocacy and culturally competent care.
Hot flushes after menopause are not a sign of weakness or something to simply “put up with.” They are a natural, biologically driven response that deserves understanding and care. For Black women and women of colour, acknowledging the unique challenges and demanding equitable treatment, is essential.
Sadly, hot flushes may not stop on a set schedule, but knowledge and support can make the journey far easier. If you have found strategies that work, whether lifestyle changes, medical treatments or community support, share them with the group. Your experience could guide someone else through a sleepless night or a stressful workday.
Like, comment and share your story or your best tip for managing persistent hot flushes. Your voice could be the comfort and knowledge another woman needs today.
