Why Am I Always Hot? Understanding Hot Flashes, Night Sweats, and the Vasomotor Symptoms of Perimenopause

If you've ever found yourself suddenly overheating in the middle of a meeting or waking up drenched in sweat with your heart racing, you're not alone—and you're not imagining things. These intense and often unpredictable moments are classic symptoms of vasomotor instability, a hallmark of perimenopause.

Most women are familiar with the term "hot flash," but many don't realize this is just one part of a broader picture. Vasomotor symptoms can also include night sweats, sudden feelings of anxiety, flushing, and even heart palpitations. These symptoms can be disruptive, confusing, and downright exhausting.

I am familiar with hot flashes, night sweats, and heart palpitations. And getting them under control is key to moving through perimenopause with confidence. So… what's really happening in your body—and more importantly, what can you do about it?

What Are Vasomotor Symptoms?

Hot flashes are sudden heat waves typically felt in the face, neck, and chest. They can come on quickly and last anywhere from a few seconds to several minutes. Often, they're followed by sweating or chills. While hot flashes can happen during the day, they also frequently occur at night, leading to disrupted sleep—a symptom commonly referred to as night sweats.

But vasomotor symptoms go beyond just feeling warm. Some women experience a racing heart or a sudden surge of anxiety, especially during the night. These palpitations and anxious feelings often have no obvious trigger, but they can leave you feeling shaken and sleep-deprived.

Why Do These Symptoms Happen?

The root cause lies in the shifting hormone levels of perimenopause—particularly estrogen. As estrogen fluctuates and declines, it impacts the brain's temperature regulation center, the hypothalamus. This part of your brain acts like a thermostat, helping the body maintain a steady internal temperature.

When estrogen drops, the hypothalamus can misread your body's temperature and overreact, prompting a series of responses to cool you down. Blood vessels near the skin dilate, leading to that hot, flushed feeling. Sweat glands kick in. Your heart rate may spike. Your nervous system goes on high alert.

This cascade of responses produces the hot flash, which is completely driven by your body's internal chemistry, not your environment or emotional state.

Common Triggers That Can Worsen Symptoms

While hormone shifts are the root cause, plenty of lifestyle and environmental factors can make symptoms more frequent or intense. Common triggers include:

• Alcohol (especially wine)

• Spicy or sugary foods

• Caffeine

• Stress

• Overheating—like hot showers or heavy blankets. 

• Poor sleep and blood sugar dips are also major contributors.

Identifying your triggers can help reduce the frequency and intensity of hot flashes. Keeping a brief symptom journal can also be helpful, especially if your symptoms seem to spike after certain meals, drinks, or stressors.

What About Heart Palpitations?

Heart palpitations are a lesser-known but very real vasomotor symptom. These sudden fluttering or pounding heartbeats often occur alongside hot flashes or night sweats, but they can also happen independently. While they're usually harmless, they can feel frightening, especially if they wake you from sleep or appear without warning.

Palpitations are often linked to hormone fluctuations, blood sugar imbalances, dehydration, or elevated cortisol. If they happen frequently or feel concerning, it's always wise to consult with your healthcare provider to rule out other causes.

Practical Ways to Reduce Hot Flashes and Vasomotor Symptoms

There's no one-size-fits-all solution, but several foundational strategies can help support your body and reduce the intensity of these symptoms over time.

Balance your blood sugar.

Eating meals rich in protein, fiber, and healthy fats helps stabilize your blood sugar levels throughout the day. This not only supports hormone balance but also minimizes the blood sugar crashes that can trigger hot flashes and night sweats. Aim to avoid long stretches without food and limit refined sugars and highly processed carbohydrates that cause rapid spikes and drops in blood glucose.

Manage your stress.

High cortisol, your body's primary stress hormone, can increase the frequency and intensity of hot flashes. Incorporating calming rituals into your day—like deep breathing, journaling, or stepping outside for a short walk—can help regulate cortisol and calm your nervous system. Even just five minutes of intentional relaxation can make a difference.

Support your sleep.

Poor sleep and hot flashes often go hand in hand. Aim to go screen-free 30 minutes before bed to improve sleep quality and keep your bedroom cool, dark, and quiet. A consistent bedtime routine can signal your body that it's time to unwind. If night sweats are a major issue, moisture-wicking bedding or sleepwear made from natural fibers like cotton or bamboo can provide added comfort.

Foods That May Help with Hot Flashes & Hormonal Shifts

• Soy-based foods (tofu, tempeh, edamame, miso, soy milk)

  → Contain phytoestrogens—plant compounds that mimic estrogen and may help reduce the frequency and intensity of hot flashes.

• Avocados, spinach, almonds, sunflower seeds

  → High in vitamin E, which helps stabilize estrogen levels and has been shown to reduce hot flash intensity.

• Ground flaxseeds

  → Rich in lignans, another type of phytoestrogen that may support hormone balance and reduce hot flash severity.

• Oats, leafy greens, bananas, and dark chocolate

  → Great sources of magnesium, which helps calm the nervous system, improve sleep, and reduce anxiety-related symptoms.

• Cold-water fish (like salmon, sardines, mackerel)

  → High in omega-3 fatty acids, which support brain and heart health and may help regulate mood and reduce inflammation.

Supplements That May Help

• Magnesium Glycinate

  → Helps relax the nervous system, supports deeper sleep, and may reduce mood swings and anxiety.

• Black cohosh

  → A widely studied herbal remedy shown to reduce hot flashes and night sweats for some women.

• Maca root

  → A hormone-balancing adaptogen that may improve energy, libido, and mood during perimenopause.

• Ashwagandha

  → Supports stress reduction and helps regulate cortisol, which may ease vasomotor symptoms like night sweats and hot flashes.

• Rhodiola

  → Another adaptogen that helps the body adapt to stress and may improve fatigue and mental clarity.

• Evening primrose oil

  → Contains gamma-linolenic acid (GLA), an omega-6 fatty acid that may help reduce breast tenderness and support hormonal balance.

Before starting any new supplement regimen, it is important to consult with your healthcare provider, especially if you have any pre-existing health conditions, are taking medication, or are pregnant or breastfeeding. Your doctor can help ensure that the supplements you choose are safe and appropriate for your individual needs. This guide is intended for informational purposes only and is not a substitute for medical advice.

Hot flashes, night sweats, and even heart palpitations are a normal—if frustrating—part of perimenopause. But that doesn't mean you have to live in discomfort.

Understanding why these symptoms happen gives you the power to take action. With small, sustainable changes to your meals, stress levels, and sleep habits, you can help calm the chaos of fluctuating hormones and begin to feel more in control of your body again.