Why do I have chest pain when I have a hot flash?

Q:

I recently started having hot flashes—but whenever one hits, I feel an odd sense of anxiety and a painful tightening in my chest that starts at my breastbone and spreads outward. I’m starting to worry. What’s going on?

A:

What you’re experiencing is called an aura, and it is quite common. Nearly 1 in 3 women experience these episodes just before or during a hot flash. The reason: Your sympathetic nervous system releases the neurotransmitter norepinephrine in response to the thermal stress created by a hot flash. And while norepinephrine helps regulate body temperature, it also speeds heart rate and constricts blood vessels, producing anxiety, chest tightness or a racing heartbeat.

Though hot-flash auras aren’t considered harmful, I recommend seeing your doctor to confirm there are no cardiovascular issues contributing to your symptoms. If she concurs that what you’re experiencing is a hot flash response, there are easy, effective ways to quell it:

My go-to remedy: taking six to eight slow, deep breaths, inhaling for five seconds and exhaling for another five seconds, when you feel a hot flash coming on. This practice, called “paced breathing,” can calm the sympathetic nervous system and lower norepinephrine levels to ease tightness and tension. And in a study published in the journal Menopause, performing paced breathing for 15 minutes twice daily reduced hot flashes by as much as 75 percent.

Also smart: Once a day, take a red clover supplement that delivers 80 mg of isoflavones—compounds shown to reduce hot flashes and anxiety. A brand we like: Promensil Menopause Double Strength ($10 for 30 tablets, Amazon.com).

But if these measures don’t give you the relief you need within two to four weeks, consider visiting your gynecologist. She can advise you on other treatments that can help ease your hot flashes and the auras that accompany them.