Can Stress Cause Hot Flashes?

If you're menopausal, it can seem like your hot flashes pick the worst possible moments to kick in. You're racing to an appointment, refereeing a family squabble or pitching a new client when the flushing and sweating begin. That may not be a coincidence: Experts say stress can trigger hot flashes.

Stress, on its own, doesn't cause hot flashes, says Stephanie S. Faubion, MD, MBA, medical director of the North American Menopause Society. "You're not going to trigger a hot flash in a 20-year-old if she's stressed," she says. But for a woman who's already in the menopause transition, it's a possibility. "Stress worsens hot flashes. And it may be a trigger for some women with hot flashes," adds Dr. Faubion.

Stress can also affect how long you get hot flashes. For an April 2015 study in JAMA Internal Medicine, researchers measured the number of years women reported having frequent hot flashes and night sweats (hot flashes that happen while you sleep). Women who reported more frequent feelings of stress tended to get hot flashes for more total years, including before and after their last menstrual periods.

Read more: How to Tone Up After Menopause

Scientists haven't identified the exact bodily processes involved in hot flashes. It's likely that the midlife decline in hormone production in a woman's ovaries plays a key role, according to the National Institute on Aging.

With an estimated 75 percent of menopausal women having hot flashes or night sweats, it's likely that stress is just one possible trigger, says the Office on Women's Health (OWH). Other triggers can include:

• Smoking
• Alcohol
• Caffeine
• Spicy food
• Hot environments

It may not be possible for you to avoid stress, but finding ways to manage it can help. Dr. Faubion notes a connection between hot flashes and stress resilience, or how well you cope with the stresses in your life. "People who have higher resilience tend to be less stressed and tend to have less hot flashes," she says.

Because the sudden, surprising discomfort of hot flashes can be stressful in itself, learning to cope with them when they occur may create a kind of virtuous cycle. "They're not going to get you as stressed out," says Dr. Faubion. "And you may get triggered a little bit less, too, so it's possible that you wouldn't go into a full-blown hot flash."

Read more: 25 of the Best Stress-Relief Techniques

When it comes to which stress-relieving approaches might lessen the impact of hot flashes, the North American Menopause Society says only two therapies are backed by high-quality research: cognitive behavioral therapy and clinical hypnosis.

Cognitive behavioral therapy (CBT) is a psychological approach that helps you become aware of and modify unhelpful ways of thinking or behaving, says the American Psychological Association. In a CBT study published in July 2012 in Menopause: The Journal of the North American Menopause Society, menopausal women were trained in relaxation and paced breathing, the physiology of hot flashes, stress as a trigger and the role of negative beliefs about their symptoms. After receiving CBT, women reported that that their hot flashes and night sweats weren't any less frequent, but they did find them less problematic.

Clinical hypnosis involves achieving a deeply relaxed state and using mental imagery and suggestion to focus on desired changes. The evidence for its effectiveness with hot flashes is more limited, but in one clinical trial, published in March 2013 in Menopause, postmenopausal women who underwent clinical hypnosis saw a reduction in both the frequency and severity of their hot flashes.

Finally, Dr. Faubion says it's important to put all this in context with other issues women may face during the menopausal years. "They've got a lot of stuff going on," she says. "Parents are aging, kids are leaving the nest, job changes, marriage dissolution — all kinds of stressors."

It may be a perfect storm of triggers, many of which you can't control, but acknowledging them and finding ways to cope with the stress may be one step toward relief.