Hear “hot flash” and most of us think of menopause. But reproductive-aged women have them too. How many healthy premenopausal women have vasomotor symptoms (hot flashes and night sweats), and why?

In women ages 45 to 56 with regular menstrual cycles, about 55% have experienced vasomotor symptoms at some point, shows new research in Menopause. The cross-sectional study examined 1,513 women in the Pacific Northwest. Native American women were most likely to report vasomotor symptoms (66.7%), followed by black women (61.4%), and white women (58.3%).  Asian and Hispanic women in the study were least likely to report ever having vasomotor symptoms (about 8% and 37%, respectively), similar to the patterns during the menopausal transition and early postmenopause.

Why would premenopausal women have hot flashes? As levels of estrogen go down in the body, numbers of hot flashes go up. Estrogen naturally declines as a woman gets older, especially at menopause. But estrogen levels can fluctuate enough to cause hot flashes years before menopause. Some women have hot flashes right after giving birth. Some may get them from intense exercise or from illness.

The relationship between reproductive status, general health, hormone levels, age, and vasomotor symptoms is complex and needs further investigation. But rest assured that it is perfectly normal to have hot flashes in the years before menopause. If you are still having regular cycles, these vasomotor symptoms do not necessarily mean menopause is beginning.

Researchers have made new discoveries about how hot flashes happen:

A group of brain cells called KNDy (“candy”) neurons are probably the control switch for hot flashes. KNDy neurons respond to estrogen. When estrogen gets too low, these brain cells make more of a brain chemical (neurotransmitter) that signals the body that it is too hot. The body then releases heat by opening blood vessels to the skin that cause flushing and sweating as a cooling method.

Hot flash sufferers, take note: these insights will eventually help scientists create new and safer treatments for menopausal hot flashes. And that’s cool news.

A new study about the effect of hypnosis on hot flashes published in the NAMS journal Menopause shows that hypnosis can help cut hot flashes by as much as 74%. One group of women in the study got five weekly sessions of hypnosis where they received hypnotic suggestions for mental images of coolness, a safe place, or relaxation — whatever their preference — and they also got a recording to practice with daily. Their hot flashes were reduced by 74% and their severity was also lessened. 

Another group of women in this study had five sessions with a clinician where they could talk about their symptoms, and they got a CD to listen to daily that had general information about hot flashes. This group reported only a small reduction in hot flashes: 13%.

This study is the best one so far to test the value of hypnosis for hot flashes because it pitted hypnosis against a similar “treatment” thought not to have much effect, similar to the way drugs are tested against dummy placebo pills. We hope to see these results confirmed by other researchers.

Regular, daily practice of calm or slow breathing is key for this alternative technique to ease hot flashes, shows a new paced breathing study in the NAMS journal Menopause. Women in this study practiced breathing rhythmically, either at a normal pace or slowly, for at least 10 to 15 minutes every day. All of them had fewer and less severe hot flashes, but the ones who had the most relief practiced twice a day.

Both of these approaches are like meditation, which is known to calm down the autonomic nervous system. That’s the system that controls body functions such as sweating, heart rate, and dilation of blood vessels, which all ramp up during a hot flash. You can try the approach that worked best in this study—breathing slowly and regularly at six breaths a minute for 15 minutes twice a day. These short sessions shouldn’t be too hard to work into your busy day.

Keeping your body cool can help keep hot flashes at bay. Here are just some of the cool tricks:

• Keep ice water handy to sip.
• Turn down the thermostat.
• Use a ceiling fan or air conditioning.
• Dress cool—wear cotton, linen, or rayon, and avoid wool, other synthetic fabrics, and silk.
• Stick to open-necked shirts.
• Dress in layers so you can take something off if you’re feeling warm.
• At night, take a cool shower before bed, wear cotton nightclothes or loose fitness clothing designed to wick away moisture, and keep an ice pack under your pillow.
• Get a bigger bed if you and your partner are on different “heat planets.”