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Too Hot To Handle?

It’s not just your imagination — perimenopause symptoms really are worse in the summer. Here’s the best way to cope.

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Marta Montiero
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Hot flashes aren’t exactly bearable at any time of year, but at least in the winter you can throw open the door and — presto! — instant relief. Come summer, though, those 90-degree days can actually turn up the dial on your internal thermostat.

As part of the decade-long Study of Women's Health Across the Nation, nearly 1,000 women recorded their menopausal symptoms each month over 10 years. After examining the data, scientists recently concluded that hot flashes, night sweats and difficulty sleeping were most prevalent in the summer and least prevalent in the winter. Women were 66 percent more likely to experience hot flashes, 50 percent more likely to experience night sweats, and 24 percent more likely to experience difficulty sleeping in June and July than in December and January.

“The reproductive system, including fertility, is impacted by the seasons,” says the study’s lead author Siobán Harlow, director of the Center for Midlife Science and professor of epidemiology at the University of Michigan School of Public Health. “I’ve previously suspected that hot flashes could, to some extent, be sensitive to seasonal rhythms.”

One reason: That boiling summer heat. As your ovaries wind down and stop producing estrogen, it reduces your body’s ability to regulate its own temperature in response to the environment. As a result, even mild changes in temperature can trigger sweating or hot flashes.

“Normally, if you go from a hot to cold room, your body adjusts in milliseconds thanks to a part of the brain called the thermoregulatory zone,” says Heather Hirsch, M.D., clinical program director of the menopause and midlife clinic at Brigham and Women’s Hospital in Boston. “During perimenopause, simply sleeping next to someone who is warm and breathing heavily on you could be all it takes to bring on a hot flash, whereas before you’d sleep right through it.”

And let’s face it: a bit of heavy breathing is nothing compared to a hot day at the beach, an afternoon of yard work in the sun, or even just navigating a parking lot shimmering with heat.

Harlow also notes that it’s probably not just external temperature contributing to increased menopause symptoms during the summer. “There are other factors that could be at play, such as longer periods of daylight, which impact our circadian rhythms.”

Outside of moving to Antarctica or installing a walk-in freezer in your bedroom, how can you cope during the hot summer months? Here are a few expert-approved strategies.

Track your symptoms. Perimenopause is not a “one size fits all” stage of life. “Keeping track of when hot flashes and other symptoms occur can shed light on whether you’re susceptible to certain triggers, whether it’s the weather or spicy food or red wine,” says Hirsch. Understanding these patterns could also help you predict your next period at a time when your menstrual cycle is probably all over the place, she adds. “You might start to feel better right before your period, for instance, and then you know it’s right around the corner.”

Lower the thermostat. Further. Even further. If you can handle the resulting electric bill, lowering the temperature inside, especially in your bedroom, can help induce better sleep and reduce hot flashes at night, says Hirsch. “I always tell my patients to keep the bedroom at 65 degrees, as cold as possible,” she says.

Try different ways to cool down. Staying cool inside when it’s 90 degrees outside takes some creativity. When it comes to bedding and clothing, look for materials labeled “moisture wicking” or “temperature regulating.” Dress in light, breathable layers so it’s easy to adjust when the temperature starts to rise. Stay hydrated by sipping on an icy (nonalcoholic) beverage throughout the day. Leave a bottle of cooling spray on your nightstand for when you wake up in the middle of the night drenched in sweat. “Remember, there will likely be some trial and error in figuring out what works to alleviate your symptoms,” says Hirsch, so if a potential solution turns out to be a dud, move on to another one.

Prepare for outdoor time. Long stretches spent under a blazing sun are taxing on anyone, but perimenopausal women may find it even more challenging. Try to reserve exercise or strenuous activities (like gardening or mowing the lawn) for the early morning or late evening hours instead of the hottest periods of the day. Carry a portable fan if you need a quick blast of cool air or drape a cold pack around your neck. If you come inside and still feel like you’re radiating heat, hop in a cold shower or wipe your body down with a frozen washcloth.

Talk with your doctor. Just because symptoms tend to be worse in the summer doesn’t mean that you’re doomed to suffer until Labor Day. It’s always worth having a conversation with your doctor (find a menopause specialist at if your hot flashes are interrupting your quality of life. “Women should be proactive. Especially around menopause, there’s often this mantra of ‘just keep sticking it out,’ but it’s the wrong message,” says Hirsch. “If nothing else, you can talk about your experience and work through your options. If it’s the summer and you’re having 10 hot flashes per day, and then later on in the fall you’re having five per day, that’s still pretty crappy.”