Does Alcohol Cause Hot Flashes?

Why Does Alcohol Make You Feel Hot?

Sensations of feeling warm or hot flashes related to alcohol are associated with several conditions, including vasodilation, hangovers, alcohol withdrawal syndrome, alcohol intolerance, and menopause.

Vasodilation

Alcohol use impacts thermoregulation, or the body’s ability to maintain its internal temperature. The body does this by widening blood vessels when you’re hot (vasodilation) and narrowing them when you’re cold (vasoconstriction). (1) Drinking low to moderate amounts of alcohol can cause hot flashes because it amplifies the effects of nitric oxide, which causes vasodilation. (2) This then increases blood flow in small vessels under the skin to expel heat, causing you to feel hot and flushed–even though the body is cooling itself through vasodilation.

Hangovers & Hot Flashes

Hot flashes often accompany next-day hangovers. This is because a night of binge drinking “robustly activates the sympathetic nervous system,” provoking an acute stress response. (3)(4) When alcohol is cleared from the body, the sympathetic nervous system, which coordinates this stress response, remains in an unbalanced and overactive state. This results in physical symptoms, such as increased body temperature, sweating, trembling, elevated heart rate, and high blood pressure.

Alcohol Withdrawal & Hot Flashes

As with hangovers, withdrawals cause hot flashes because of alcohol’s effects on the brain’s stress response. As a central nervous system (CNS) depressant, alcohol releases inhibitory chemicals (GABA) that dampen the body’s stress response, causing relaxation. (5) However, through long-term exposure, alcohol dependence develops, and the CNS loses the ability to produce its own inhibitory chemicals. (6)

During withdrawal, the CNS rapidly rebounds from its dependence on alcohol. Without inhibitory chemicals to counterbalance excitatory chemicals, the CNS becomes hyperactive. (7) This can lead to hot flashes and other symptoms ranging from uncomfortable to life-threatening.

Alcohol Intolerance

Alcohol intolerance presents as an uncomfortable flushing reaction immediately after an individual starts drinking. Alcohol intolerance occurs due to a genetic metabolic disorder most commonly found in people of East Asian descent. (8) When a person is affected by this condition, their body cannot break down alcohol efficiently.

The body uses an enzyme (ALDH2) to neutralize alcohol so it can be removed from the body. (9) A person with alcohol intolerance has a genetic variant in the ALDH2 gene that renders these enzymes inactive. Their body, therefore, cannot break down a toxin called acetaldehyde into a non-toxic metabolite (acetate). As a result, toxic chemicals accumulate, leading to effects such as flushing, hot flashes, headache, stuffy nose, nausea, and vomiting.

Sulfite Intolerance

Sulfites are used as preservatives and are found naturally in many alcoholic drinks, such as wine, beer, sake, and others. Sulfites act as a preservative by releasing sulfur dioxide gas, which can be an irritant for those with sulfite sensitivity or intolerance. (10) Reactions can present as allergy-like symptoms, including flushing and hives that cause the skin to feel warm.

Menopause

Women going through menopause often experience hot flashes, and some women report that alcohol use can worsen them. In fact, the National Institutes of Health explicitly states that menopausal women experiencing hot flashes should avoid alcohol. (11) Because hot flashes are commonplace during menopause and alcohol itself can also cause them, the connection seems logical. Nevertheless, researchers are conflicted on whether or not alcohol increases or reduces a woman’s risk of having hot flashes. (12)(13) As a result, The North American Menopause Society suggests that because “drinking may trigger hot flashes for some women,” you’ll need to “determine whether it’s a personal trigger for you.” (14)

Alcohol Hot Flashes Could Be a Sign of Oncoming Hypothermia

In certain environments, hot flashes could be an early sign of hypothermia, a life-threatening result of the body losing more heat than it produces. Hypothermia is a medical emergency that can result in organ failure and death. If you or someone you know is experiencing symptoms of hypothermia, (15) call 911 immediately and move yourself or the other person out of the cold. Also, remove wet clothing and try to warm up gradually while waiting for EMTs to arrive.

Heavy drinking can contribute to hypothermia because, as noted, alcohol induces vasodilation and causes the body to expel heat from its core. (16) Despite this, however, the person can continue to feel warm or hot on the inside. This illusory effect can prevent them from realizing their internal body temperature is plummeting due to external factors like exposure to a cold or wet environment (17)—especially when engaging in activities that can induce sweating, such as skiing or shoveling snow.

Furthermore, alcohol delays the onset and reduces the duration of the body’s shivering mechanism, which helps a person stay warm and prevents hypothermia. Unfortunately, alcohol use can also impair judgment and decision-making, further compromising a person’s ability to recognize a potentially life-threatening situation. (18)