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Hot Topic: Chilling the Hot Flashes

I hear the term “excessive heat warning” from our local weathercasters and think they are talking about me. My hot flashes are so intense I can raise the temperature in a room a few degrees simply by standing in it. If you have never experienced a hot flash, think of feeling — without warning — of suddenly standing outside on a blistering summer day dressed in woolly layers as if for the frostiest day of the year. A fever-like heat rises from your torso through your head, resulting in a look like you have just spent 15 minutes in a sizzling steam room — but it’s not a spa day.

Some say I have a glow (like the sun?), but a glow would not cause my shirt to become soaked and make me feel like steam might come out of my ears. Could I be contributing to global warming?

After the waterworks stop, then comes the “big chill.” The flash subsides, and you’re left feeling like you got caught in the rain: wet, shivering, and sporting goose bumps.

Because 90% of my hot flashes are completely random, I’ve had hot flashes while out at a work dinner, while talking to one of my kids’ teachers, and while wearing a gown at a black-tie event. I can just see whomever I may be talking to wondering why I’m seemingly calm and collected but simultaneously literally steaming up. Friends even avert their eyes when beads of sweat start sliding down my face, neck, and arms like rain droplets. Tropical rain droplets.

I’ve heard, “OMG you’re sweating like a pig!” too many times to count from my daughter, as I embarrass her regularly. My lame attempt to joke about the situation, “Did you ever think you’d have such a hot and flashy mom?” falls completely flat. By the way, pigs don’t sweat, they roll in the mud to cool down. In moments of desperation, I’ve thought about it.

Hot flashes are caused by a decrease in estrogen. When estrogen levels drop or estrogen receptors are blocked, the body’s temperature control system gets confused, and the result is hot flashes. Menopause causes hot flashes, as do some of the treatments for breast cancer: chemotherapy, hormonal therapy, and ovarian shutdown or removal.

Aside from moving to Alaska, some more practical ways to deal with hot flashes include avoiding triggers such as caffeine, smoking, spicy food, alcohol, heat, obesity, physical inactivity, hot weather, and stress. I wish I could tell you the trigger list included vacuuming, weeding, and washing the dishes.

I have found having a cold drink (non-alcoholic!) nearby, sitting in front of a fan or fanning yourself with whatever you can get your hands on, and holding a bag of frozen peas or anything icy on your neck provides some relief.

Dressing in cotton fabrics can be invaluable: it’s both cooler and provides more camouflage than, say, silk, when perspiration is flowing like a river.

I would guess that roughly 10% of my hot flashes are caused by stress. That’s why meditation, yoga, massage, and other relaxation techniques that help relieve stress are important to integrate into your routine. They have all been shown to reduce the number and/or severity of hot flashes.

Studies have also shown that certain antidepressants may help relieve hot flashes. The more successful agents include selective serotonin reuptake inhibitor (SSRI) antidepressants. One in particular, venlafaxine (brand name: Effexor), has been shown to lower the number and severity of hot flashes for most women. This includes women with severe hot flashes from tamoxifen. In several studies, venlafaxine was most effective for hot flashes when used at a lower dose than is normal for treating depression.

My hot flashes are related to my tamoxifen regimen. Because completing a course of tamoxifen or other hormonal therapy is so significant for preventing breast cancer recurrence, it is crucial to take steps to allay side effects such as hot flashes to increase your chances of sticking with whatever hormonal therapy regimen has been prescribed for you (other drugs used for hormonal therapy can cause hot flashes as well).

Although I use humor to deal with my severe hot flashes, hot flashes need to be taken seriously by your medical providers, support team, family, and, most importantly, you. When hot flashes are severe, frequent, or occur during the night (known as night sweats), they often disrupt a woman’s quality of life, affecting her sleep and sexual, family, social, and work life. Discuss with your health care team what steps you can take to help diminish their duration and effects, and make sure you get the support you need to maintain the highest quality of life possible during treatment and survivorship. You deserve it.

A potential positive of the hot flashes: a 2008 British study suggests that women who experienced hot flashes and night sweats while taking hormonal therapy medicine were less likely to have the breast cancer recur. Knowing that these pesky hot flashes might indicate a reduced risk of the cancer coming back may help some people stick with treatment despite the side effects.

Because of my burning desire to rid my life of cancer, I’ll sizzle through my own personal heat wave of hot flashes, icy drink and fan in hand, hopefully still laughing at when and where I show my “hot and flashy” side. How do you deal with your “hot and flashy” side?

Jean Heflin Kane lives in Devon, Pennsylvania with her husband, four children, and the real star of the family, their fluffy, fun-loving dog Toby. Jean is an attorney who founded and directs a non-profit aimed at supporting sustainability initiatives in K-12 schools. She is actively striving to be a breast cancer "thriver." She blogs at striving2thrive.wordpress.com. She welcomes comments and suggestions on blog topics.

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