How does the autonomic nervous system contribute to hot flashes?

During menopause, declining estrogen levels interfere with the brain’s ability to regulate body temperature. Specifically, the hypothalamus—the body's temperature control center—becomes overly sensitive to these hormonal changes.1

This sensitivity triggers sudden activation of the autonomic nervous system, which stimulates the dilation of blood vessels that supply the skin. This process, known as vasodilation, leads to a rapid increase in skin temperature and perspiration, resulting in the characteristic sensation of warmth, flushing, and sweating associated with a hot flash.231