Do Coffee and Alcohol Make Hot Flashes Worse?What Studies Found

Every hot flash handout lists coffee and alcohol as triggers. Fewer of them say how thin the research is. Here is what the main studies measured.

Coffee

At the Mayo Clinic women’s health clinic, 1,806 women with menopause concerns filled out a detailed symptom questionnaire.¹ Women who used caffeine rated their hot flashes and night sweats as more bothersome than women who didn’t: 2.30 versus 2.15 on the scale’s average.¹ The link held after accounting for smoking and menopause stage, and it showed up in women past menopause.¹

That’s a small difference, from one survey at one specialty clinic, and it can’t show that caffeine caused the hot flashes.¹ It didn’t test cutting caffeine.

Alcohol: two studies, opposite answers

Study	Who	What it found
US, 2005	Women aged 45 to 54, comparing those who’d had hot flashes with those who hadn’t2	Drinking at least one day a month went with fewer, milder hot flashes2
Korea, 2022	4,164 women aged 42 to 52 still having periods; 2,396 followed over time3	More drinking went with more bothersome hot flashes, rising with the daily amount3

At 40 grams a day or more (about three standard US drinks), the Korean study found the odds of bothersome hot flashes were 3.5 times those of women who’d never drunk.³ Neither study looked at what happens in the hour after a glass of wine.

What the experts concluded

The Menopause Society’s 2023 review of non-hormone options put avoiding triggers on its “not recommended” list, because the evidence was limited or inconsistent.⁴ Treatments with good evidence include cognitive behavioral therapy, clinical hypnosis, some antidepressants, gabapentin and fezolinetant, and hormone therapy remains the most effective.⁴ See what helps hot flashes without hormones.

That doesn’t mean your own triggers aren’t there. It means the averages from studies can’t tell you about you.

Test it on yourself

1. Log for 2 weeks: the time of each hot flash, how bad it was, and what you had in the hour before, including coffee, tea, cola and alcohol.
2. Change one thing for 2 weeks, such as switching to decaf, and compare.
3. Look at timing, not just totals. Note whether flashes cluster in the hour after a drink.

For alcohol and nights, see how alcohol affects sleep. For the basics, see what causes hot flashes and how long they last.

Try: “My hot flashes seem worse on mornings I have two coffees. I’ve logged it for two weeks. Is it worth cutting back, or should we talk about treatment?”

My Body Changed. Now What? covers this in Chapter 5, “The Heat,” in a section called “Fans, Layers and the Coffee Question.” Its Try It play means one change at a time: a week of counting first, then a daily symptom diary with a line for anything you suspect set off a flash, so a trigger has to show up in your own notes before you give anything up. See the book.