Hot flashes at work are one of the most socially distressing aspects of perimenopause — and they are entirely medical, not a sign of weakness, loss of control, or anything to be ashamed of. The embarrassment is understandable but the experience itself is a recognised medical symptom that happens to occur at inconvenient moments.

What is happening: the hypothalamus — the brain region that regulates body temperature — misfires when oestrogen levels drop or fluctuate. It sends a false signal that the body is overheating, triggering a sudden rush of blood to the skin surface, flushing, and sweating. This can last 30 seconds to several minutes and happens without warning.

For immediate management at work: a small battery-powered fan that fits in a bag is genuinely useful. Loose, breathable fabrics — cotton, linen — in layers you can remove help. Sitting near a window or vent when possible. Avoiding common triggers on workdays: spicy food at lunch, caffeine in the afternoon, and alcohol the night before all increase flash frequency.

Longer-term solutions: HRT is the most effective treatment for hot flashes, reducing frequency and severity by 50–90% depending on dosage. Non-hormonal prescription options include antidepressants or other prescription medications. All of these require a prescription and a conversation with a gynaecologist.

You should not have to quietly suffer through your working day. This is a medical symptom with medical solutions.