“Does anyone else get hot flashes from taking prednisone? I feel like I’m in a sauna,” said one member of MyLupusTeam. Another shared, “When I double up on my prednisone due to a flare-up, I drip sweat like I’m swimming.”

If you’re wondering whether prednisone causes hot flashes, excessive sweating, or flushing, you’re not alone. Hot flashes are common for people with systemic lupus erythematosus (SLE), and steroid medications like prednisone can make these symptoms worse. Some side effects of prednisone that might be related to hot flashes include:

• Chills
• Fever
• Skin flushing
• Skin rashes or hives
• Sweating

In addition to the effects of prednisone, people with lupus may get hot flashes because of menopause, other health conditions, or lupus itself. Here’s how hot flashes impact daily life for those with lupus, along with tips from MyLupusTeam members on how to cope.

How Prednisone Affects the Body

Prednisone is a corticosteroid medication used to reduce inflammation caused by allergies, autoimmune disorders, asthma, and other inflammatory conditions. Because it has some significant side effects, prednisone requires a prescription. Prednisone interacts with several different medications, and shouldn’t be stopped without a doctor’s supervision. If you’ve been taking prednisone for a long time and need to stop taking it, your doctor will usually recommend gradually lowering your dose to avoid withdrawal symptoms.

Hot flashes are most noticeable in the face and neck and usually disappear after about three days. In one study, 40 percent of people experienced facial flush after receiving corticosteroid injections.

In addition to side effects related to hot flashes, prednisone can affect your mood, digestive system, and sleep patterns. Prednisone can also increase your risk of osteoporosis (weak, brittle bones) and lead to unwanted weight gain due to water retention. Because of this, if you are on cortisone therapy it’s important to reduce your salt intake and add calcium and vitamin D supplements to your treatment plan. Prednisone can also raise blood pressure and blood sugar levels, so people with diabetes or arterial hypertension should use it with caution. Despite these risks, prednisone remains a highly effective anti-inflammatory medication. Health care professionals should closely monitor people taking prednisone to make sure the benefits of taking it outweigh the risks.

Prednisone and Anxiety

Prednisone may also worsen anxiety for some people, leading to panic attacks and hot flashes. One MyLupusTeam member described their experience with panic attacks: “The first time, I swear I thought I was dying. I just take deep breaths to help with the panic attacks. The hot flash went away by itself, but it scared me.” People with lupus can also experience neuropsychiatric symptoms like anxiety, making it hard to tell whether the anxiety is a result of lupus or a side effect of prednisone.

Symptoms of panic attacks may be similar to those of other serious conditions, like a heart attack. If you experience chest pain or high blood pressure while taking prednisone, it’s important to seek medical advice immediately.

Other Causes of Hot Flashes

Hot flashes can be a symptom of lupus even without prednisone. One MyLupusTeam member shared, “I’m not on any medication for lupus yet … I sweat all the time. I don’t even have a life anymore because I sweat when I walk around my house with few clothes on. The sweat gives me heat rashes.”

Lupus can cause excessive sweating, hot flashes, and low-grade fevers, which may or may not be a sign of an upcoming flare-up or infection.

In addition, people with lupus may be more likely to develop other health conditions that can trigger hot flashes. For example, about 7 percent of people with lupus also have thyroid problems. Thyroid issues can affect the body’s temperature regulation and heat tolerance. Certain foods and drinks — like alcohol, caffeine, and spicy foods — can trigger or worsen hot flashes. Reducing or eliminating these foods and drinks from your diet may help.

Other Medication Side Effects

One member of MyLupusTeam suspected that hydroxychloroquine (Plaquenil) might be causing their hot flashes. They asked, “Does anybody experience hot flashes as a side effect of Plaquenil? I’ve been taking it since July, but I only started dealing with hot flashes in the last couple of months … I’m not sure if it’s a lupus thing, a medication side effect, or if I’m going through menopause really early. My mom started menopause at 40, but I’m only 26, so it’s not very likely.”

Hot flashes aren’t a common side effect of hydroxychloroquine, but everyone’s body reacts to the medication differently. One MyLupusTeam member shared, “I take hydroxychloroquine and have excessive sweating and hot flashes. I am constantly asking others if it is warm in the room.”

Menopause and Hormonal Shifts

Hot flashes are often linked to menopause, but for people with lupus, it can be hard to tell whether symptoms are from menopause or lupus. Early menopause is more common in people with lupus, often due to medications or health conditions. However, menopause typically happens between ages 45 and 60, whether or not you have lupus. Your health care provider can help you determine if menopause is the cause of your hot flashes.

In some cases, hormone replacement therapy (HRT) may help manage symptoms. However, HRT isn’t suitable for everyone with lupus. HRT can cause lupus flares or increase the risk of blood clots. People with active lupus, a history of blood clots, or a higher risk of blood clots (such as having high antiphospholipid antibodies) shouldn’t take HRT.

The type of HRT — whether estrogen or progestogen (a hormone that mimics progesterone) — must also be considered alongside your health history. For some people, non-oral estrogen may be a safer option, as it’s less likely to lead to coagulation (clotting) in the blood vessels.

While HRT can help with hot flashes and night sweats, it also carries an increased risk of blood clots, stroke, and, with long-term use, breast cancer.

Depending on your health history and how well-controlled your lupus is, you may need to explore other treatment options or strategies for managing hot flashes. Talk to your doctor about whether HRT is right for you, and if so, which type may be best.

Managing Hot Flashes During the Day

In addition to hormone therapy, doctors sometimes prescribe certain antidepressants to help reduce hot flashes and manage their effects. One MyLupusTeam member said, “I get severe hot flashes, and I am constantly embarrassed about my appearance when I am out with friends. I was diagnosed with lupus when I was 15 years old, and it has taken a huge toll on my life. I am only 20 now.”

While you may not be able to eliminate hot flashes, there are steps you can take to feel more comfortable and reduce their impact on your quality of life. Try dressing in layers so you can easily remove or add clothing when needed. You can also try carrying a portable fan to help you cool off.

Maintaining a healthy weight is also important, as extra body weight can make you more likely to get hot flashes. If you experience hyperhidrosis (excessive sweating), apply antiperspirant to your dry skin before bed. You can even apply it to the bottoms of your feet to reduce sweating through your socks and shoes. Finally, try experimenting with mind-over-matter approaches, such as mindfulness meditation or hypnotherapy. These techniques may help you feel more in control of your hot flash symptoms.

Trying To Sleep With Hot Flashes

“I never sleep well anymore. The covers are on and off, over and over, but I’m always hot when I get up. Warm weather makes it worse for me,” said one MyLupusTeam member.

Another shared, “I’m always hot, especially at night. I chew crushed ice, and it seems to cool me off. I find it very difficult to sleep at night.”

Some strategies to help with hot flashes and night sweats include sipping on cold water before bed and lowering the thermostat in your bedroom. One member shared, “I take cool baths and sleep on white sheets to help me stay cool.”

Cooling pillows, which are made of breathable materials, and bed fans, which blow air directly under your sheets, may also help you sleep better.

If prednisone is part of your treatment, talk to your doctor to see if taking it first thing in the morning could help reduce its impact on your sleep. They may also have other strategies to help manage your hot flashes.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 232,000 people with lupus come together to ask questions, give advice, and share their stories.

Are hot flashes one of your symptoms of lupus or side effects of your lupus treatments? Have high doses of prednisone triggered hot flashes for you? Post your thoughts in the comments below, or start a conversation by posting on your Activities page.