Heat intolerance
Sensitivity to heat; Intolerance to heat
Heat intolerance is a feeling of being overheated when the temperature around you rises. It can often cause heavy sweating.
Heat intolerance usually comes on slowly and lasts for a long time, but it may also occur quickly and be due to a serious illness.
You're a woman nearing middle age. It's that time in your life when your periods are starting to stop and your body is going through changes. You may be starting to have hot flashes that you've heard about before. Could menopause be around the corner? So, what is menopause? Menopause typically happens to women somewhere around the ages of 45 to 55. During menopause, your ovaries stop making eggs and produce less estrogen and progesterone, hormones that play a vital role in pregnancy and how your body uses calcium and maintains healthy cholesterol levels, among other things. Changes in these hormones cause menopause symptoms. You will often begin having fewer periods, and eventually they stop. Menopause is complete when you have not had a period for over a year. Women who are post-menopausal can no longer get pregnant without a donor egg. Symptoms can vary from woman to woman. And these symptoms may last 5 or more years. Also, some women have worse symptoms than others. The first thing you may notice is that your periods start to change. They might occur more often or less often. Some women get their period every 3 weeks during menopause. These changes may last several years before periods completely stop. Other common symptoms include your heart pounding or racing, hot flashes, night sweats, skin flushing, and problems sleeping. You may have a decreased interest in sex, develop forgetfulness, have headaches, and suffer from mood swings, and have vaginal dryness and painful sexual intercourse. Treatment for menopause depends on many things, including how bad your symptoms are, your overall health, and your preference. It may include lifestyle changes or hormone therapy. Hormone therapy may help if you have severe hot flashes, night sweats, mood problems, or vaginal dryness. Hormone therapy is treatment with estrogen and, sometimes, progesterone. Talk to your doctor about the benefits and risks of hormone therapy. Hormone therapy may increase your risk of developing breast cancer, heart attacks, strokes, and blood clots. Topical hormone therapy has some of the benefits and fewer of the risks. Your doctor can tell you about other options besides taking hormones, including antidepressants, a blood pressure medicine called clonidine, and Gabapentin, a seizure drug that can help reduce hot flashes. Lifestyle changes may help in reducing your menopause symptoms, though it's not been proven. You might consider trying to avoid caffeine, alcohol, and certain spicy foods. Or to try eating soy foods and other legumes, because they contain phytoestrogens. You'll want to remember to get plenty of calcium and vitamin D in your food or supplements, and plenty of exercise especially during this time. Consider Kegel exercises every day to strengthen the muscles of the vagina and pelvis. Practice slow, deep breathing if you feel a hot flash coming on. Yoga, tai chi, or meditation may also helpful. After menopause, you may be at risk for bone loss, higher cholesterol, and heart disease, so make sure you work with your doctor to manage or even prevent these problems.
Causes
Heat intolerance may be caused by different factors:
Some types of medicines may make you less tolerant to heat. Not all medicines will affect everyone the same. If you have questions about any medicines you take, contact your health care provider. The types of medicines that may increase your risk of heat intolerance include:
- Antihistamines
- Amphetamines or other stimulants, including those found in drugs that suppress your appetite
- Antibiotics
- Antidepressants
- Antipsychotic medicines
- Blood pressure medicines
- Cholesterol medicines (statins)
- Decongestants
- Diabetes medicines
- Overactive bladder medicines
- Pain relievers (non-steroidal anti-inflammatories, also called NSAIDs)
- Parkinson disease medicines
Certain health conditions may make you less tolerant to heat. This can be due to the condition itself or any medicine you may take to manage it:
- Cystic fibrosis
- Diabetes
- Cardiovascular disease
- Graves disease
- Mental health conditions
- Multiple sclerosis
- Obesity
- Too much thyroid hormone (thyrotoxicosis)
Other issues and conditions can make you more likely to have heat intolerance. These include:
- Alcohol use
- Bacterial or viral infection
- Having had heat exhaustion or heat stroke before
- Illegal drug use (opioids, cocaine, methamphetamines)
- Lack of physical fitness
- Menopause
- Pregnancy
Age can also be a factor. Young children and older adults are less able to adjust to temperature extremes. Older adults are also more likely to be taking medicine that increases the risk for heat intolerance.
Home Care
Exposure to extreme heat and sun can cause heat emergencies or illnesses. You can prevent heat illnesses by:
- Drinking plenty of fluids
- Keeping inside room temperatures at a comfortable level
- Limiting how much time you spend outdoors in hot, humid weather
When to Contact a Medical Professional
Contact your provider if you have unexplained heat intolerance.
What to Expect at Your Office Visit
Your provider will take a medical history and perform a physical examination.
Your provider may ask you questions like these:
- When do your symptoms occur?
- Have you had heat intolerance before?
- Is it worse when you exercise?
- Do you have vision changes?
- Are you dizzy or fainting?
- Do you have sweating or flushing?
- Do you have numbness or weakness?
- Is your heart beating fast, or do you have a rapid pulse?
- Are there any medicines or drugs that may be involved?
Tests that may be performed include:
References
Hollenberg A, Wiersinga WM. Hyperthyroid disorders. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 12.
Pearce EN, Hollenberg AN. Thyroid. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 207.
Sawka MN, O'Connor FG. Disorders due to heat and cold. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 95.
Version Info
Last reviewed on: 3/11/2024
Reviewed by: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
