What does a hot flush feel like? Perimenopause hot flushes explained
By Softer Mind · Updated 15 October 2026 · 7 min read · Based on NHS guidance and published research
It can come out of nowhere. Heat rushes through your chest, neck and face. You go red, you start to sweat, and your heart speeds up. A few minutes later it fades, and you may be left feeling chilly and damp.
If you've been asking "what does a hot flush feel like?", or wondering whether what you're having counts as one, that description will sound familiar. Hot flushes are the most common symptom of the menopause, and they often begin in perimenopause, while you're still having periods. The British Menopause Society says hot flushes and night sweats affect 70 to 80% of women.
They're common, and they're real. But because a few other health problems can cause flushing too, it's worth knowing which signs need a check.
See your GP if your hot flushes come with:
- weight loss you can't explain
- a fever, or you feel hot, cold or shivery
- a racing or uneven heartbeat even when you're resting, especially if you also feel shaky, anxious or more sensitive to heat than usual
Call 999 if you have chest pain that comes on suddenly and doesn't go away, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, light-headed or short of breath.
These signs come from the NHS advice on night sweats, the NHS page on an overactive thyroid and the NHS advice on chest pain.
What does a hot flush feel like?
The NHS describes hot flushes as your face, neck and chest suddenly feeling very hot or cold. A flush can make you sweat a lot, cause palpitations or anxiety, or make you feel dizzy.
Women describe it in lots of different ways:
- a wave of heat that starts in your chest and climbs to your face
- going red in the face, neck or chest
- sweat on your face, neck, chest or back
- a pounding or racing heart
- a sudden feeling of anxiety or unease
- feeling cold and shivery once it passes
That last one surprises a lot of people. Women's Health Concern, the patient arm of the British Menopause Society, says flushes can come with sweating and palpitations, or sometimes shivering. It also says they can cause embarrassment, anxiety and broken sleep.
When researchers have measured flushes, the heat isn't just in your head. Skin temperature rises in the fingers, face, arms, chest, back and legs, and in most flushes there is measurable sweating. Heart rate goes up a little, by about 7 to 15 beats a minute (Freedman, 2014).
How long does a hot flush last?
A single flush usually lasts about 1 to 5 minutes, though some can last as long as an hour (Freedman, 2014). The NHS says they can last for several minutes and happen during the day or at night. At night they're called night sweats.
As for how many months or years you'll have them, there's no set answer. The British Menopause Society says menopause symptoms last on average for more than 7 years. It estimates that more than a third of women have symptoms that carry on for years beyond that.
Do perimenopause hot flushes start before your periods stop?
Yes, they can. Perimenopause hot flushes (perimenopause hot flashes) are common. The British Menopause Society explains that in early perimenopause, your cycle starts to change, and some women begin to get menopause symptoms alongside those changes. In late perimenopause, when periods may be months apart, many women find their symptoms get worse.
So if you're still having periods, perhaps a bit irregular, and you've started getting sudden waves of heat, perimenopause is a very likely reason. Our guide to perimenopause symptoms explains the other signs to look out for.
What's happening in your body during a hot flush?
Your brain has its own thermostat, in an area called the hypothalamus. Normally, your body is happy across a small range of core temperatures. It only starts to sweat when you get too hot, and only shivers when you get too cold.
Women's Health Concern explains that changing oestrogen levels affect this thermostat. It's as if it now has a narrower range of temperatures it can put up with. So your body tries to cool down with a flush, in response to small changes that you wouldn't have noticed before.
The research backs this up. In women having flushes, that comfortable range is much narrower, and a small rise in core temperature can set off the whole cooling response. Blood rushes to the skin and you sweat. Falling oestrogen is needed for this to happen, but it isn't the whole story (Freedman, 2014).
Women's Health Concern adds that flushes tend to be more frequent when oestrogen falls quickly, for example after surgery to remove the ovaries or with some breast cancer treatments. It also says stress narrows the range further.
What can trigger a hot flush?
Women's Health Concern lists these common triggers:
- coffee and other hot drinks
- some spicy foods
- alcohol
- stress
- changes in temperature, such as walking into a warm room
- rushing, for example dashing to work
The British Menopause Society adds smoking. Everyone is different, so it helps to keep a short diary. Note when each flush happens and what was going on just before. After a week or two, you may spot your own pattern.
What else can cause hot flushes and sweating?
Hot flushes in your 40s and 50s are very often hormonal. But they're not always. Other causes include:
- an overactive thyroid, which can make you sweat more, feel the heat, lose weight and have a fast heartbeat (NHS)
- anxiety
- some medicines, including some antidepressants, steroids and painkillers
- low blood sugar
- alcohol or drug use
The NHS lists most of these as common causes of night sweats. It also says to see a GP if night sweats come with a very high temperature, a cough or diarrhoea, or you're losing weight for no reason. If you think a medicine might be playing a part, talk to your GP or pharmacist. Don't stop or change it on your own.
What can help with hot flushes?
Practical things to try
The NHS suggests:
- wearing light clothing
- keeping your bedroom cool at night
- having a cool shower, using a fan or having a cold drink
- cutting back on triggers such as spicy food, caffeine, hot drinks, smoking and alcohol
- finding ways to lower your stress
- exercising regularly and keeping to a healthy weight
Women's Health Concern suggests light layers in natural fabrics like cotton, so you can take one off quickly. At night, cotton sheets, a lighter duvet, a towel in the bed and a cooling pillow can all make things easier.
If flushes mostly bother you at night, read why hot flushes are worse at night and our guide to menopause night sweats.
What to do when a flush starts
Women's Health Concern suggests paced breathing: slow, even breathing from your stomach. When you feel a flush coming, relax your shoulders, breathe slowly from your stomach and focus on your breath. Let the flush wash over you, knowing it will pass.
It also helps to notice what you say to yourself. Thoughts like "everyone's looking at me" or "I can't cope" can make you feel worse. Try calmer ones, such as "this will pass soon" or "I notice my flushes more than other people do". The factsheet also suggests staying where you are, if you can, rather than leaving the room.
What your GP can offer
If hot flushes are getting in the way of your life or your sleep, it's worth talking to your GP or practice nurse. Things to discuss include:
- HRT. The British Menopause Society says HRT is the most effective treatment for menopause symptoms.
- CBT. The NHS says you may be offered cognitive behavioural therapy for hot flushes and night sweats. The British Menopause Society says CBT is an option if you don't want HRT or can't take it. Women's Health Concern says it can be used on its own or alongside HRT.
- Non-hormonal medicines. The NHS says a doctor may suggest clonidine or an antidepressant.
The NHS notes that herbal remedies such as red clover and black cohosh are sometimes sold for menopause symptoms, but there's very little evidence about how well they work or how safe they are. Talk to a doctor or pharmacist before trying them.
When to see a GP about hot flushes
See your GP if:
- hot flushes or night sweats are affecting your daily life, work or sleep
- you think you have menopause or perimenopause symptoms and want to know your options
- your flushes come with weight loss, a fever or a racing heart at rest (see the box at the top)
- you're not sure if they're hot flushes at all
Writing down when your flushes happen, and anything else you've noticed, makes the appointment easier.
Where relaxation fits in
When the heat rises, it can help to have something calm to turn your attention to. Some women like to practise slow breathing and a calming routine for those moments, and for winding down at night. Our hypnosis for menopause hot flushes, Cool and Calm, is a recording to help you relax and feel calmer. It uses cool, calming imagery and a simple cue you can practise: a slow breath out and the word "cool". It's a relaxation recording, not a treatment, and it doesn't replace advice from your GP.
You may also find these pages useful: menopause cold flushes, perimenopause body odour and perimenopause heart palpitations.
This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.
