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Understanding Hot Flushes in Perimenopause: A Practical Guide

Understanding Hot Flushes in Perimenopause: A Practical Guide

As you move through the stages of perimenopause, many women (not all)  experience hot flushes, which can be a surprising and often bewildering symptom. They can arise unexpectedly and can feel overwhelming, but by understanding why they occur and how to manage them, you can find relief.

The Science Behind Hot Flushes: What’s Actually Going On?


  1. Hormonal Fluctuations

The main culprit behind hot flushes is the fluctuation of oestrogen levels in your body. As these hormone levels ebb and flow, your body's thermostat (the hypothalamus) becomes more sensitive and can overreact, causing the sensation of heat that spreads over the body.

  1. The Hypothalamus at Work

Your hypothalamus is responsible for regulating body temperature but it  can sometimes trigger an unnecessary heat dump, which results in a hot flush. It's a bit like your body mistakenly thinking it needs to cool down when it doesn't.

  1. Vascular Responses

Your blood vessels can expand rapidly in response to the signals from the hypothalamus, which increases blood flow and leads to the reddening of the skin that is characteristic of a hot flush.

  1. Neurotransmitter Surprises

Lower oestrogen levels can affect the brain's neurotransmitters, which can occasionally disrupt temperature regulation, leading to a hot flush.

  1. Lifestyle Factors

Certain lifestyle choices and environmental triggers, like hot drinks, spicy food, and stress, can also prompt hot flushes. Identifying and managing these triggers can help reduce their frequency and severity.

As we navigate through the various causes of hot flushes, it's important not to overlook one crucial aspect that often remains in the shadows: the health of your gut!

The Gut-Perimenopause Connection: A Deeper Understanding

This inner ecosystem plays a substantial role in our overall wellbeing and specifically in the changes that occur during perimenopause. Just as a garden requires balanced soil to flourish, our bodies need a healthy gut to function optimally. 

It's within this complex environment that certain bacteria have a profound impact on how our body manages hormones, reacts to stress, and ultimately, how it copes with the waves of heat known as hot flushes. Let's delve deeper into the gut's role and discover how enhancing its health can be a key strategy in managing these often uncomfortable hot flushes along with many other unwanted symptoms of menopause.


  1. Oestrogen and the Microbiome: A Delicate Dance

The gut microbiota and oestrogen have a bidirectional relationship. Your gut houses a unique collection of bacteria known as the estrobolome, which is responsible for metabolising oestrogen. When the gut microbiome is balanced, it can efficiently modulate the oestrogen levels in your body, possibly easing the severity and frequency of hot flushes. A diverse and thriving estrobolome can mean more stable oestrogen levels, softening the hormonal rollercoaster of perimenopause.


  1. Reducing Inflammation: The Gut’s Role in Immune Regulation

Inflammation is a well-known aggravator of menopausal symptoms. A healthy gut acts as a lookout, managing your body's inflammatory response. By maintaining a rich and diverse microbiome, you support the integrity of your gut lining, which helps to prevent endotoxins from escaping into the bloodstream and sparking inflammatory reactions that could worsen hot flushes and other menopausal discomforts.


  1. The Gut-Brain Axis: Neurotransmitters and Mood Balancing

Your gut is a neurochemical powerhouse, producing a substantial portion of serotonin, a neurotransmitter that contributes to feelings of well-being and happiness. An optimally functioning gut microbiome supports the production of serotonin and other neurotransmitters that can affect not only mood but also the body's ability to regulate temperature. A healthy gut-brain connection means better overall balance and potentially fewer hot flushes.


  1. Stress and Cortisol: How Gut Health Can Buffer Stress Responses

Chronic stress is a common trigger for hot flushes, and the gut-brain axis is integral in the stress response. A robust gut microbiome can modulate the body's response to stress, potentially lowering the release of cortisol, a stress hormone that can trigger or exacerbate hot flushes. By focusing on good gut health, you could be indirectly soothing your body's stress response systems, leading to fewer perimenopausal symptoms.

Strategies for Boosting Gut Health


Probiotic and Prebiotic Foods

Incorporate foods such yoghurt, kefir, and sauerkraut, which are rich in probiotics, the "good" bacteria. Additionally, feed those beneficial microbes with prebiotics found in foods such as garlic, onions, bananas, and oats. When introducing fermented foods watch out for increased wind or bloating and take it slowly as your microbiome adapts to this new food source. If you have an adverse reaction to fermented foods read our post on histamine here.


Fibre-Rich Diet:

A diet high in fibre supports a healthy gut microbiome. Aim for a variety of fruits, vegetables, legumes, and whole grains to encourage the growth of beneficial gut bacteria.


Limit Inflammatory Foods

Reducing the intake of processed foods, sugars, and unhealthy fats can decrease gut inflammation and improve the overall gut environment.



Water is essential for maintaining mucosal lining in the gut, which houses a significant portion of your gut flora. Staying well-hydrated is a simple yet effective strategy for gut health.


Mindful Eating

Eating slowly and mindfully can improve digestion and absorption, reducing the burden on your gut and allowing it to function more efficiently.


Take a Daily Probiotic

Taking a daily probiotic  means you ensure you feed your gut with an optimal dose of good bacteria everyday - a highly concentrated supplement focused on supporting the gut health of women specifically during perimenopause like The Better Gut would be of most benefit.

By focusing on these gut-centric strategies, you’re not just addressing hot flushes; you're potentially enhancing your overall health and wellbeing as you navigate through the perimenopause. 

It's important to remember that hot flushes are a natural part of perimenopause, but they don't have to take over your life. With a clear understanding of the physiological changes happening in your body and armed with strategies to manage them, you can lessen their impact and maintain your quality of life. 

Also remember that seeking support from experts and sharing experiences with others going through similar changes can be incredibly beneficial.