Normally hot flashes begin during perimenopause, the years leading up to menopause. This is the time when estrogen levels begin to fluctuate. It is possible for hot flashes during perimenopause to be accompanied by mild to severe heart palpitations, anxiety or irritability.

Hot flashes are often more severe in women who experience premature menopause due to chemotherapy, antiestrogen treatment for breast cancer or surgical removal of the ovaries (oophorectomy). Premature ovarian failure (POF), which can be caused by factors such as genetics, smoking and autoimmune diseases, also results in premature menopause, which in turn, may cause hot flashes.

Other potential causes of hot flashes include:

• Hot weather
• Spicy foods
• Alcohol consumption
• Caffeine
• Stress
• Infertility medications (e.g., ovulation drugs)

The severity of hot flashes will vary from woman to woman, with some experiencing few or none. In most cases, hot flashes will gradually fade or disappear over time, with or without treatment.