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Hot Flashes, Menopause, and Perimenopause:
What You Need to Know
Hot flashes are one of the most common and disruptive symptoms experienced during menopause and perimenopause. Understanding what causes hot flashes, when menopause begins, and how the menopausal transition unfolds can help women make informed decisions about their care.
This page explains the key differences between menopause and perimenopause, why hot flashes occur, and how acupuncture may support women during this natural transition.
What Are Hot Flashes?
Hot flashes are sudden sensations of intense heat that typically affect the face, neck, chest, and upper body. They are the most frequently reported symptom of menopause and perimenopause and can vary in intensity, duration, and frequency.
Hot flashes may be triggered by internal or external factors, including stress, spicy foods, alcohol, warm environments, or emotional excitement. However, many hot flashes occur without an obvious trigger.
What Causes Hot Flashes?
The exact cause of hot flashes is not fully understood, but research points to changes in the brain’s temperature-regulation system. During menopause, declining estrogen levels may alter the function of the hypothalamus - the part of the brain responsible for regulating body temperature.
When the hypothalamus mistakenly senses that the body is overheating, it initiates cooling responses. Blood vessels near the skin’s surface dilate, increasing blood flow and causing flushing and redness. Sweating may follow, sometimes excessively, along with a rapid heartbeat or a brief sensation of internal heat.
Expert Insight
In clinical practice, hot flashes rarely follow a single pattern. Some women experience frequent, intense episodes early in the menopausal transition, while others develop symptoms gradually over time. From a Chinese medicine perspective, these variations reflect individual differences in physiology, lifestyle, stress levels, and overall health - factors that are essential to consider when creating an effective treatment plan.
Learn more about Dr. Grosam’s clinical background and experience →
What Is Menopause?
Menopause is a natural biological process marking the permanent end of menstruation and fertility. It is officially diagnosed after 12 consecutive months without a menstrual period, assuming no other medical cause is present. Menopause can also be induced by surgery or medical treatments affecting the ovaries.
Although menopause is not a disease, it represents a significant hormonal shift that can affect physical, emotional, and overall wellbeing. Common menopause symptoms include hot flashes, night sweats, sleep disturbances, fatigue, and mood changes. At the same time, menopause can mark the beginning of a new and fulfilling phase of life.
When Does Menopause Start?
In the United States, the average age of menopause is 51, according to the National Institute on Aging. However, menopause can occur earlier or later. Some women experience menopause in their early 40s, while others may not reach it until their late 50s or early 60s.
What Is Perimenopause?
Menopause does not happen suddenly. The transition leading up to menopause is known as perimenopause, meaning “around menopause.”
During perimenopause, estrogen levels fluctuate and gradually decline, often triggering early menopause symptoms. These may include irregular menstrual cycles, hot flashes, night sweats, sleep disturbances, and mood changes.
How Long Does Perimenopause Last?
Perimenopause can begin several years before the final menstrual period and may last six years or longer. This phase officially ends one year after the last menstrual period, at which point menopause is reached.
Clinical Perspective
Many women are surprised to learn that perimenopausal symptoms can appear long before periods stop completely. In practice, addressing symptoms early rather than waiting until menopause is “official” often leads to better symptom management and improved quality of life during the transition.
Acupuncture for Hot Flashes and Menopausal Symptoms
Acupuncture is a safe and effective treatment option for many women experiencing hot flashes and other menopausal symptoms. It is commonly used during perimenopause and menopause to support hormonal balance, regulate temperature sensitivity, and improve sleep and overall wellbeing. Acupuncture can be used alone or alongside conventional treatments such as hormone replacement therapy.
Considering Acupuncture for Hot Flashes?
An initial consultation allows time to review your symptoms, health history, and goals to determine whether acupuncture is an appropriate option for you.
Can Acupuncture Be Used with HRT or Medications?
In most cases, yes. Acupuncture is generally safe to use alongside hormone replacement therapy (HRT) and many common medications, including those for blood pressure, cholesterol, heart disease, or digestive conditions. Individual circumstances vary, and treatment decisions are best made after a thorough health assessment.
Acupuncture Treatment Schedule & Frequency
The number and frequency of acupuncture treatments depend on the severity and duration of symptoms.
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Mild symptoms: 3-6 treatments, once per week
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Moderate symptoms: 6-12 treatments, 1-2 times per week
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Severe symptoms: 12-24 or more treatments, 1-2 times per week
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Acute or short-duration symptoms: 3-12 treatments
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Chronic or long-standing symptoms: 12-24 or more treatments
These are general guidelines. Individual responses vary.
How Long Does Acupuncture Take to Work?
Women’s health conditions including: menstrual irregularities, PMS, fertility concerns, and menopausal symptoms, often respond well to acupuncture. Many patients notice changes within the first few weeks of treatment, though results vary depending on lifestyle, stress, sleep, diet, and overall health.
A personalized treatment plan can be developed after an initial consultation and intake.
What If Acupuncture Doesn’t Work for Me?
Acupuncture is low-risk, minimally invasive, and cost-effective. If symptoms do not improve as expected, Chinese herbal medicine may be recommended alongside acupuncture. Outcomes can be influenced by factors such as long-term medication use, chronic illness, surgical menopause, and lifestyle habits.
Diet, exercise, stress management, and sleep quality all play important roles in symptom relief. Patients are often guided toward practical lifestyle changes to support long-term results.
Schedule a Consultation
If hot flashes or menopausal symptoms are affecting your quality of life, acupuncture may be a supportive treatment option. Schedule a consultation to discuss your symptoms and create a personalized care plan.