Can Anxiety Trigger Menopause Hot Flashes?
Stress and hormonal shifts can create a frustrating feedback loop. Here’s how to break it.
If you’re in perimenopause or menopause, you might already know this dance: stress levels spike, and suddenly your face flushes, your heart races, and you’re peeling off layers of clothing. But is it anxiety causing a hot flash—or is a hot flash triggering anxiety?
For many women, it’s not an easy answer. Stress and hot flashes often feed off each other, creating a cycle that feels impossible to escape. Here’s what’s really happening in your body, and how to stop the spiral.
About the Experts:
Shelly Latte-Naor, M.D., is an integrative medicine physician and Menopause Society Certified Practitioner.
Christine Greves, M.D., is a board-certified OB-GYN at Orlando Health Women’s Institute Center for Obstetrics and Gynecology.
Anxiety Hot Flashes vs Menopause Hot Flashes
Anxiety hot flashes and menopause hot flashes feel similar and are both brought on by blood vessel dilation. But they have different root causes.
- Menopause hot flashes are driven by hormone fluctuations, specifically dropping estrogen levels, which confuse your body’s internal thermostat.
- Anxiety hot flashes happen when your body’s stress response triggers similar symptoms to menopause hot flashes: rapid heartbeat, sweating, and feeling flushed. 1
Menopause hot flashes
More than three out of four women will experience hot flashes and/or night sweats during the menopause transition. Sometimes, they persist years after you’ve had your last period. 2
While you feel menopause hot flashes in your body, they start in the brain: As estrogen levels fall, your hypothalamus (your body’s temperature control center) becomes overly sensitive to small changes in temperature.
That’s why even slight shifts in estrogen can trigger the body’s cool-down response: your heart rate increases, sending blood flow to the skin, causing flushing and sweating that dissipates heat. These vasomotor episodes can last anywhere from a few minutes to up to an hour. 3
Anxiety hot flashes
Anxiety or panic can cause a racing heartbeat, sweating, and a sensation of warmth that may feel similar to menopause hot flashes, says Menopause Society certified practitioner Shelly Latte-Naor, M.D.
Anxiety hot flashes excite the sympathetic nervous system, which controls your fight-or-flight response. Anxiety also churns out stress hormones like cortisol, which make you highly alert and potentially reactive. 4
In addition to sweating or chills, anxiety or a panic attack can cause hot flash symptoms like warmth, difficulty breathing, weakness and dizziness, tingly or numb hands, chest pain, stomach pain, and nausea. 5
| Menopause Hot Flashes | Anxiety Hot Flashes | |
| Symptoms | Feeling of intense heat, sweating, racing heartbeat | Feeling of intense heat, sweating, racing heartbeat |
| Source | Hypothalamus | Sympathetic nervous system |
| Hormone | Estrogen | Cortisol, adrenaline |
Does Anxiety Cause Menopause Hot Flashes?
Anxiety can worsen menopause hot flashes, making them more frequent and intense. And research shows that women who experience physical symptoms of anxiety—like muscle tension, nausea, or a racing heart—are at higher risk for hot flashes. 6
Experiencing physical symptoms is called “somatic” anxiety, and in one study of menopausal women, every point higher a woman scored on a somatic anxiety scale increased the risk of hot flashes threefold. 7 Interestingly, “cognitive anxiety” symptoms, like rumination or worrying, were only minimally linked with menopause hot flashes.
Anxiety increases during menopause
Compared to premenopausal years, research finds that women have a 56 to 61 percent higher risk of developing high anxiety in perimenopause or postmenopause. 8
Blame both hormonal and life changes. As Latte-Naor explains, estrogen is more of a “stimulating” hormone, while progesterone has calming properties. During perimenopause, fluctuating and declining levels of both can leave you imbalanced and drive up anxiety.
“It makes sense physiologically that during a time of hormonal upheaval, we may experience mood changes, including anxiety,” she says. Add midlife stressors like work pressure, family obligations, and aging parents, and it’s no surprise that anxiety feels like it’s at an all-time high during perimenopause and menopause.
Hot flashes cause anxiety
Menopause hot flashes can cause anxiety, especially if they happen in public or interfere with daily life. The sudden onset of profuse sweating, red cheeks, and feeling faint can make you feel completely out of control and embarrassed when it happens while driving, in a meeting, or out to dinner.
“When hot flashes happen in public, it’s stressful. Many women don’t want their symptoms to be that visible,” adds Latte-Naor. This fear can raise your baseline anxiety and make you hyper-aware of your body’s signals.
One 2020 study suggests that the more hot flashes bother a woman, the more anxious she gets. One factor that seemed to reduce anxiety in the study was having self-compassion, which may protect against feeling embarrassed or humiliated during a hot flash. 9
Does Stress Cause Hot Flashes?
Evidence suggests stress may trigger hot flashes or make them worse. A classic study from 1990 put 20 menopausal women in stressful and non-stressful situations, and found that women had more hot flashes when they were stressed. 10
“Women are under so many stressors in midlife,” says Latte-Naor. Add menopause stress to the hormonal fluctuations that affect mood, and this effect is only more pronounced. Chronic stress causes anxiety and depression, 11 and anxiety is linked with worse and more frequent menopause hot flashes. 12
How to Stop the Anxiety Hot Flash Cycle
The best way to manage hot flashes and anxiety is to treat both together with lifestyle changes, therapy, or medication. While it might be impossible to completely stop anxiety or hot flashes, reflecting on your triggers and behavior patterns might reduce overall discomfort.
But be sure to talk to your doctor: Anxiety and hot flashes can be associated with conditions outside of menopause, such as thyroid disorders, which become more common in women as they age, 13 says board-certified OB-GYN Christine Greves, M.D. “When you hit your menopausal stage, it’s important not to assume every symptom is menopause-related,” she says.
Start a hot flash diary
Record hot flashes and their triggers, says Greves. If anxiety seems to have triggered your hot flash symptoms, write down any physical sensations of anxiety you felt before the hot flash came on, such as dizziness, nausea, or a racing heart. This can help you distinguish between hormonal hot flashes and those caused by anxiety, which may inform your treatment when shared with your doctor. In addition, if you realize that a racing heart precedes a hot flash, you can manage these symptoms with measures like breathwork exercises.
Make some lifestyle changes
Physical activity, reducing alcohol intake, eating a balanced diet, and improving sleep can all increase your ability to cope with stressors. Regular moderate-intensity exercise (aerobic and resistance training) has been found to reduce hot flashes, according to a research review of 23 studies. 14
Supplements and medication
- Black cohosh may help reduce hot flashes for some women. 15
- Soy has been found to decrease the severity and frequency of hot flashes. 16
- SSRI antidepressants like paroxetine (Brisdelle) are FDA-approved to treat hot flashes; others like citalopram (Celexa) and escitalopram (Lexapro) may also be helpful to address both hot flashes and mood problems. 17
Psychological therapies
- Hypnosis: Research shows it can reduce the frequency and severity of hot flashes. 18
- Cognitive behavioral therapy: CBT can help you reframe your thoughts to reduce stress and improve coping mechanisms when it comes to hot flashes, says Latte-Noor.
HRT for Anxiety and Hot Flashes
Hormone replacement therapy is the gold standard, first-line treatment for vasomotor symptoms like hot flashes, according to The Menopause Society. 19 Emerging research suggests that hormone therapy may also help stabilize mood and improve sleep problems that contribute to anxiety. 20
The Bottom Line
Anxiety can trigger or worsen menopause hot flashes, and hot flashes can increase anxiety, creating a vicious cycle. Lifestyle changes, stress management, and medications like hormonal therapy or SSRIs can help. It’s also important to connect with a healthcare practitioner to rule out other health conditions that may be causing anxiety or hot flashes.20
Substance Abuse and Mental Health Services Administration. (2016) Panic Disorder and Agoraphobia Criteria Changes from DSM-IV to DSM-5
↑Khoudary SRE, Greendale G, Crawford SL, et al. (2019) The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN)
↑Freedman RR. (2013) Menopausal Hot Flashes: Mechanisms, Endocrinology, Treatment.
↑Zhou Q, Wang B, Hua Q, et al. (2021) Investigation of the relationship between hot flashes, sweating and sleep quality in perimenopausal and postmenopausal women: the mediating effect of anxiety and depression
↑National Institute of Mental Health. (2022) Panic Disorder: When Fear Overwhelms
↑Gelenberg AJ. (2000) Psychiatric and Somatic Markers of Anxiety: Identification and Pharmacologic Treatment
↑Freeman EW and Sammel MD. (2016) Anxiety as a Risk factor for Menopausal Hot Flashes: Evidence From the Penn Ovarian Aging Cohort
↑Bromberger JT, Kravitz HM, Chang Y, et al. (2013) Does Risk for Anxiety Increase During the Menopausal Transition? Study of Women’s Health Across the Nation (SWAN)
↑Jones KM, Brown L, Houston EE, et al. (2021.) The role of self-compassion in the relationship between hot flushes and night sweats and anxiety
↑Swartzman LC, Edelberg R, Kemmann E, et al. (1990) Impact of stress on objectively recorded menopausal hot flushes and on flush report bias
↑Ross RA, Foster SL, Ionescu DF. (2017) The Role of Chronic Stress in Anxious Depression
↑Freeman EW and Sammel MD (2005) The role of anxiety and hormonal changes in menopausal hot flashes
↑Frank-Raue K and Raue F. (2023) Thyroid Dysfunction in Peri-and Postmenopausal Women—Cumulative Risks
↑Witkowski S, Evard R, Rickson JJ, et al. (2024) Physical Activity and Exercise for Hot Flashes: Trigger or Treatment?
↑Castelo-Branco C, Gambacciani M, Cano A, et al. (2021) Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms – an update on the evidence
↑Taku K, Melby MK, Fronenberg F, et al. (2012) Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials
↑Casper R, et al. (2023) Patient education: Non-estrogen treatments for menopausal symptoms (Beyond the Basics)
↑Muñiz V, Padilla VJ, Alldredge C, et al. (2025) Clinical Hypnosis and Cognitive Behavioral Therapy for Hot Flashes: A Scoping Review
↑The Menopause Society. (n.d.) Hormone Therapy
↑Liu Q, Huang Z, Xu P. (2024) Effects of Hormone Replacement Therapy on Mood and Sleep Quality in Menopausal Women
↑
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The Edge upholds the highest standards of health journalism. We source research from peer-reviewed medical journals, top government agencies, leading academic institutions, and respected advocacy groups. We also go beyond the research, interviewing top experts in their fields to bring you the most informed insights. Every article is rigorously reviewed by medical experts to ensure accuracy. Contact us at support@honehealth.com if you see an error.
About the author
Jessica Migala is a freelance writer specializing in health, nutrition, fitness, and beauty. She has written for O, The Oprah Magazine; Real Simple; Woman’s Day; Women’s Health; Health; Family Circle; and more.
About the reviewer
Dr. Shelly Chvotzkin, D.O., F.A.C.O.O.G., is a physician board certified in obstetrics and gynecology. She is a member of the American College of Osteopathic Obstetricians and Gynecologists (ACOG), the American Osteopathic Association (AOA), the American Society for Colposcopy and Cervical Pathology (ASCCP) and the Menopause Society (formerly known as the North American Menopause Society or NAMS).
