Meet the Baltimore Nurse TikToker Who Wants to Make Hot Flashes Sexy

Delayna Watkins knows what it’s like to have a hot flash interrupt your life.

The Baltimore area nurse remembers being in the middle of a presentation to hospital executives in Maryland when suddenly she couldn’t think straight. “There was an intense moment of panic. I could tell the hot flash was coming,” says Watkins, 53, who also works as a health consultant. “All these thoughts were going through my head: ‘Am I sweating? Can they see the drips?’ ”

That was five years ago, but “just talking about it takes me back emotionally,” says Watkins, who now runs a menopause support group and creates TikTok videos to bring attention to menopause symptoms. “It created this level of anxiety. It makes you feel like you have no control.”

Like most women, Watkins suffered for years from hot flashes (also known as vasomotor symptoms or VMS). For a period of six months during perimenopause they were at their worst, and she would have three or four each day.

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One of the most common menopause symptoms, hot flashes usually last between two and five minutes and are often more intense in the two years leading up to menopause itself (defined as 12 months with no period), says Dr. Makeba Williams, an OB-GYN and associate professor at Washington University in St. Louis who is a certified menopause practitioner.

But despite their prevalence, “we are still learning a lot about why these occur,” she says. The good news? “We’re in a promising space right now with treatments—for so long we’ve had a very narrow set of options.”

It’s thought that the decline in estrogen during menopause affects the hypothalamus, the area of the brain that regulates temperature. “So where your body might have been able to tolerate fluctuations in temperature, when you have less estrogen circulating, that range narrows,” Williams says.

As a result, any number of triggers can quickly cause the upper body to feel like it’s burning from the inside: walking into a warm room, eating something spicy or, as in Watkins’s case for her presentation, stress.

When a hot flash takes over (the sensation “is as if regardless of how much water you consume, it won’t put out the flame,” Watkins says), little can be done to stop it. “That’s what makes women feel defeated and powerless,” says Watkins. “It’s something going on internally that they feel they have no control over.” For a time, Watkins would refuse invitations to outdoor events in summer, “or I’d say, ‘I’ll come, but I’ll be there later in the day.’ Otherwise it would be too much, and I’d feel as though I was going to pass out,” she says. “It became crippling at a point.”

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Dr. Williams says she often meets women in her practice who have similar experiences: “I recently had a professor say to me, ‘I can no longer teach higher-level courses, because when I’m in front of a room, I’m likely to get a hot flash. It is distracting, and I cannot think of the next word.’” But Williams says most women can find relief by talking to a certified menopause provider. “I hate to see patients delaying effective care,” she says.

The “gold standard” for treating severe VMS, Williams says, is hormone replacement therapy (HRT)—estrogen combined with progesterone (unless a woman has had a hysterectomy—then only estrogen is needed). “Estrogen makes the biggest difference in terms of relief for hot flashes and night sweats,” she says.

For women who aren’t candidates for HRT (i.e., women who have suffered a heart attack or stroke or who have a personal history of breast cancer), a number of nonhormonal options including antidepressants like Paxil are effective. And in May the FDA approved a new nonhormonal drug, fezolinetant. “Our options have opened up,” Williams says.

Watkins decided against prescription drugs but says keeping a journal of her symptoms and her triggers helped get her own VMS under control. She also began a practice of meditation. “Quieting things and staying still helped bring down the intensity of the hot flashes,” she says.

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Those are all techniques Watkins teaches to her clients in her business the Women’s Wellness Lounge and in her free weekly support group Black Women in Menopause, an online Facebook community of more than 2,000 women in the “menosquad.”

African American women are 60 percent more likely to experience VMS, Dr. Williams says. And while, on average, women experience hot flashes for about seven years, for African-American women they last an average of 10 years. And yet, Williams says, “African-American women are half as likely to be treated for hot flashes and night sweats.”

Watkins wants to reach out to that population, which she says has been overlooked.  “These women are not being heard,” says Watkins, who uses her TikTok account to put a fun—and sexy—spin on menopause. In one, she cools herself — seductively — using a "cute" pink fan: “It’s not about the hot flash itself — it's about doing something cute. It's about changing the narrative of it being something negative.”

Her mission, she says “is to have the conversation so we can share experiences and not be afraid. Women need to know this is all part of the feminine cycle. It’s part of our trajectory.”