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Am I Having a Hot Flash or a Panic Attack?

woman standing on bed holding her head in her hands

Here’s how to tell and what you can do.

They call it a flash for a reason: It tends to come and go relatively quickly.— Dr. Kourtney Sims, Phenology Chief Medical Advisor

Our bodies are often trying to tell us something. Why did you eat that? Um, that exercise is not compatible with your current knee situation. Hey lady, if you don’t go to bed soon, we’re going to have a problem tomorrow! Sometimes what we feel is discernible and others it’s hard to decipher what our internal guides are getting at. And when there are multiple things going on, the conversation can get downright muddy.

In that sense, it’s quite possible that a hot flash could be mistaken for a panic attack. They’re both uncomfortable, sometimes the source of embarrassment and definitely unwelcome. But they are very different.

What is a hot flash and how long will they last?

“When you’re having a hot flash, think of it as a synergistic overdrive to your thermoregulatory systems as a result of less estrogen,” says board-certified OB/GYN Kourtney Sims, MD, Phenology's Chief Medical Advisor, aka Dr. Kourtney.

Simply put, it’s like a temperature tantrum, and your body is upset. The decrease of estrogen through perimenopause and menopause is a gradual thing, and as the body adjusts to it, hot flashes may ensue.

The good news is that the hormone fluctuations get smaller and smaller in amplitude and eventually level out, so you don’t feel the symptoms. But until that time, hot flash season is in full effect.

And it can look differently on everybody. “There’s no right or wrong way to have a hot flash,” says Dr. Kourtney. Generally, they will last a matter of minutes (it’s hard to give a specific duration of time, she says, but it could be anywhere from two to 15 minutes) but that doesn’t mean that they can’t be longer and occur sequentially.

“How long they last depends on what stage of the transition you’re in. Other characteristics, like how much extra weight you are carrying, can also influence the severity and frequency of your hot flashes,” explains Dr. Kourtney.

Abstract paint marbled in shades of orange, blue and black.

What's the difference between a hot flash and a panic attack?

A hot flash is temperature-related, and while it may or may not cause sweating, it will feel like you were walking down the street and suddenly stepped into an oven, although everything and everyone around you looks unaffected.

In contrast, a panic attack “is a sympathetic response driven by either a traumatic experience or anxiety,” Dr. Kourtney says. Typically, it’s associated with heart palpitations as opposed to sweating, although sweating can be included in the mix, and a panic attack can last longer than a hot flash.

“They call it a flash for a reason: It tends to come and go relatively quickly,” says Dr. Kourtney. The major way most people can tell the difference is the increased heart rate, shortness of breath, or feeling like something is sitting on your chest that comes with a panic attack, she adds.

None of that is associated with a hot flash. Everything that comes after a flash like nervousness or sweating might feel like panic, but it’s all related to your body’s increase in temperature.

How to help hot flashes

Up to 80% of all women, will experience hot flashes or night sweats during the menopause transition, and these symptoms often top the list for the most bothersome. "There’s no one solution that will stop them completely, but a layered, holistic approach to perimenopause management can help provide relief," says Dr. Kourtney.

1. Consider your clothing & accessories

Try to wear loose, dark clothing so that if you do sweat, you’ll be more comfortable. There are even cooling necklaces and bracelets (such as Hot Girl Pearls) that are specially designed to refresh you.

2. Get a rescue spray for in-the-moment cooldowns

Cool, refresh and rejuvenate flushed skin fast with a spray formulated for fast-acting hot flash relief. Phenology Cool Mist contains Coolact®, a cooling agent that freshens your skin for up to two hours§, and a low-molecular weight hyaluronic acid to lock in moisture for more replenished, luminous skin.* The bottle is small enough to throw in your purse and the spray is unscented, so it's discreet relief you can use anywhere, at any time.

3. Try focusing on your breath

Another tactic that can be helpful whether in the throes of a panic attack or a hot flash is pranayama breathing, says Dr. Kourtney, who is also a registered yoga teacher. “You can use the power of breath to tap into your parasympathetic system so that you calm down your heart rate, breathing rate, and thermoregulatory systems,” says Dr. Sims. “That tends to work a whole lot better than just vigorously fanning yourself.”

4. Think holistically and make lifestyle changes.

Instead of being solely reactionary, she also recommends a proactive approach for handling hot flashes. Drink two or three cups of green tea, rich in phytoestrogen, daily. Eating a rainbow diet of fruits and vegetables also full of phytoestrogen plus flavonoids and polyphenols can mitigate the situation.

“So, even though I might not have a lot of estrogen hanging around, guess what? I can get some from plants to help ease my body's transition as I back away from my own innate production,” says Dr. Kourtney. You can also try the phytoestrogen genistein, which can cut severity and intensity of hot flashes by more than 50% after 12 weeks. Genistein is a major ingredient in the Phenology Morning+Evening Gummies, formulated to help with hot flashes as well as fatigue and mood swings.

And of course, staying on top of regular exercise and getting enough sleep can minimize the severity and frequency of hot flashes. Curious about what other lifestyle changes you may be able to make to help with your symptoms? Talk one-on-one with a Registered Dietitian specially trained in menopause-related topics in the Phenology app. You can ask the Phenology coaches your questions in nutrition, exercise, hydration and how you can help manage your symptoms.

Holly Carter
Formerly the Style Features Director at O, The Oprah Magazine, as well as the Beauty Director at People StyleWatch magazine, Holly is now a consultant and content creator for brands, including Burt’s Bees, Smashbox and Josie Maran Cosmetics.

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