Is Cardio Good for Hot Flashes During Perimenopause?
Hot flashes and cardio exercise have a complicated relationship. Here's what the evidence says about whether cardio helps or worsens hot flashes in perimenopause.
Hot Flashes and Exercise: A Nuanced Picture
If you've ever had a hot flash during a run or a spin class, you might wonder whether cardio is making things worse. The relationship between cardiovascular exercise and hot flashes is genuinely nuanced. In the short term, vigorous cardio can trigger a flash by raising core body temperature. But the longer-term picture is different. Regular cardio exercise, over weeks and months, is associated with a reduction in the frequency and severity of hot flashes for many women. The short-term discomfort is often worth the longer-term benefit.
Why Cardio Helps Over Time
Hot flashes are triggered by the brain's thermoregulatory system becoming more sensitive to small changes in core body temperature. Regular aerobic exercise trains the body to regulate temperature more efficiently. It expands the thermoneutral zone, the temperature range in which the body feels comfortable without needing to cool down urgently. Research has found that fit women tend to have a wider thermoneutral zone, meaning smaller temperature shifts are less likely to trigger the hypothalamus into initiating a hot flash. Cardio also reduces cortisol and supports better sleep, both of which influence how reactive the thermoregulatory system becomes.
The Best Types of Cardio for Hot Flashes
Lower to moderate intensity cardio tends to be more comfortable and sustainable for women dealing with hot flashes. Walking, cycling at a moderate pace, swimming, and elliptical training all raise heart rate and body temperature in a more controlled way than high-intensity interval training. Swimming is particularly worth highlighting: the cool water counteracts the rise in core temperature, making flash-triggering much less likely during the session itself. If you enjoy higher-intensity cardio, consider doing it in a cool environment and having cold water available.
Managing Hot Flashes During Your Workout
There are practical steps you can take to make cardio more comfortable when hot flashes are frequent. Wear moisture-wicking, light layers that can be removed. Train in a well-ventilated or air-conditioned space. Have a cold water bottle and a small fan nearby. Some women find that cooling their wrists or neck with cold water during a session can reduce flash intensity. Starting your workout gently and building up gradually rather than going hard immediately gives the body more time to adjust.
How Often and How Long
Aim for at least 150 minutes of moderate-intensity cardio per week, spread across several sessions. This is consistent with general health guidelines and the amount studied in research on hot flashes. Three to five sessions of 30 minutes each is a practical way to reach this. You don't need to push into discomfort every session. Steady, enjoyable cardio that you'll actually stick with is far more effective than intense sessions you dread. Track your workouts in PeriPlan alongside your hot flash frequency to see patterns over time.
Cardio as Part of a Broader Strategy
Cardio is a genuinely useful tool for managing hot flashes, but it works best alongside other approaches. Avoiding known triggers like caffeine, alcohol, and spicy food reduces flash frequency. Stress management matters too, since cortisol can intensify flashes. HRT remains the most effective treatment for hot flashes and is worth discussing with your GP if flashes are significantly affecting your quality of life. Cardio supports all of these approaches and is worth prioritising regardless of what else you're doing.
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