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Hot flushes are the most common menopause symptom. They can be very distressing and difficult to cope with.

This blog post looks at how your thoughts can influence the impact a hot flush can have.



It is known that negative expectations prior to menopause are associated with a more difficult menopause experience.
This puts you on the back foot before it’s even started!
There have been a number of studies done on this and we know that there are lots of external triggers for hot flushes but they are also known to be impacted by worrying about them as well your general mood affecting your ability to cope with them.
Stress and anxiety are often common features of menopause and you might also have a lot of worries when it comes to hot flushes.
Some of the main worries women have are:
  • Shame or social embarrassment – this causes thoughts such as “I’m over the hill” or “Everyone is looking at me”.
  • Feeling out of control – this causes thoughts such as “My body is letting me down” or “There is nothing I can do about this”.
  • Catastrophic thinking – this causes thoughts such as “This is awful and will never get any better”.

As you can see, these are some quite powerful thoughts!



When you think in this way, it’s easy to forget that your thoughts are just that. Thoughts. The negative thoughts you have are often outside of your awareness and they can really drive that psychological distress because you accept them as fact.

The way you think about symptoms in some situations tends to affect how you feel and what you do. These reactions can increase the intensity of your physiological symptoms.


Thinking styles

When you’re in an anxious state, you tend to veer towards anticipating the worst possible outcomes of every situation. This fuels that anxiety fire. This type of thinking is called catastrophising. This essentially means that you are overestimating the likelihood of the worst case scenario and also underestimating your ability to cope. Feeling like this can cause physical anxiety symptoms such as rapid breathing and increased heart rate which in turn causes the symptoms to intensify. It’s easy to interpret these symptoms as serious issues as they can actually be. However, during menopause, symptoms such as palpitations are relatively normal. Keeping a diary of them can help you to distinguish if they’re associated with hot flushes or stress.

Obviously when you feel anxious and your breathing increases, you can often feel sweaty too. Can you see how this all adds up to fuelling hot flushes and making them feel worse??


What can you do?

There are behavioural and cognitive techniques that can be used to train you to perceive your symptoms differently and with a more positive approach. This can help you become calmer and more accepting of your situation. Just to note; it’s not about ignoring your symptoms or minimising the fact that you may be struggling with them. The aim is to support you to recognise unhelpful thoughts in order to change the thought, behaviour and ultimately, outcome.
The good news is, there are ways you can manage this with cognitive behavioural therapy strategies. It usually starts with identifying your negative thoughts and having some steps to run through when you recognise them. This will involve questions which aim to disprove your belief of what is happening in that moment. Questions such as:
  • What would I say to a friend in this situation?
  • Have I managed a similar situation in the past?
  • Is there a clear threat right now?


Think about your responses in these situations

We all develop our ways of coping with these situations. In clinical terms, these are called safety behaviours. Despite that sounding like something that’s good as it keeps us safe, it’s not! Safety behaviours can very often be unhelpful and reinforce your belief further which leads to much more negative responses and even avoidance of some situations or places.
Think about your own safety behaviours or responses. You might use some of the following:
  • drinking more alcohol than usual
  • avoiding certain people
  • avoiding places where you might have had a negative experience
  • carrying certain things with you such as a bottle of water or mints (this was mine!)

The aim is to then develop more healthy coping strategies. This means thinking about things you can do to stay calm. This can be used in the moment. However, it is also helpful to get into the habit of practising some regular relaxation stuff as this will help to manage your general stress levels but also make it easier for you to snap into what you need in a moment of worry or stress.


Cognitive behavioural therapy

You may heave heard of CBT in the context of mental health support. It’s now first line treatment for most mental health conditions on the NHS in the UK.
Whilst depression and low mood aren’t associated symptoms of menopause, it stands to reason that you’ll feel low at times if you’re not sleeping well or feeling worried about hot flushes coming on. Many women also feel low due to issues in work or feeling their not themselves anymore. This is common.
Whilst CBT can be effective just for management of hot flushes alone, it is also very effective if you have symptoms of low mood and/or anxiety.
There are no specialist menopause CBT programmes available on the NHS so sadly you will have to access this privately. The good news is, I now offer a CBT group therapy programme specifically for menopause symptoms! It is a 6 week programme with 1 90 minute session each week. The sessions are held remotely online.
If this is something you are interested in, please contact me here for information on costs and when the next round of sessions is starting.
If you’ve had experience of using CBT to manage menopause symptoms, please comment below about your experience of it if you feel comfortable to.

Hi, I'm Kerry. I'm a menopause coach for women who want to take control of their menopause and do it their way.


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