Menopause, along with the 7-14 years leading up to it, known as perimenopause, impact all women as they grow older.

During this time, various symptoms may arise, including trouble sleeping, discomfort during sex, hormonal fluctuations, and night sweats. Hot flashes can occur alongside these symptoms, adding their own challenges. “Approximately 80% of women will experience hot flashes during menopause or the transition period,” states Rebecca Thurston, PhD, a psychiatry professor and menopause specialist at the University of Pittsburgh.

Let’s explore what hot flashes are, what causes them, and how they can be managed.

What are hot flashes?

Hot flashes refer to sudden and intense sensations of warmth, primarily affecting the neck, chest, and face, according to Dr. Ruta Nonacs, a reproductive psychiatrist at Massachusetts General Hospital and a Harvard Medical School instructor. She notes that these episodes often include “facial flushing” and “heavy sweating,” which is why night-time occurrences are termed night sweats.

Hot flashes can also bring about feelings of anxiety, flushed and blotchy skin, an increased heart rate, and some women may experience chills as the heat subsides. Thurston explains that these episodes can occur at any time of day or night but usually last just a minute or two.

What causes hot flashes?

The primary cause of hot flashes is hormonal changes associated with menopause, according to Thurston. A sharp decline in reproductive hormones like estrogen and progesterone affects the brain’s thermoregulatory centers, leading the body to try to cool itself down through sweating and heat waves.

Aside from menopause-related hormonal changes, other medical conditions such as urinary tract infections, migraines, neurological disorders (like multiple sclerosis and Parkinson’s disease), and inflammatory diseases (such as rheumatoid arthritis and lupus) can also trigger hot flashes.

“Certain medications that influence hormone levels may provoke hot flashes as well,” Nonacs adds, mentioning breast cancer hormone inhibitors and some infertility treatments as examples.

How to alleviate hot flashes

There are several ways to manage hot flashes, including medical treatments.

Nonacs mentions that the medication gabapentin — initially intended for other uses — “can be effective for hot flashes.” The same goes for numerous antidepressants and non-hormonal medications. Furthermore, in 2023, the U.S. Food and Drug Administration approved an oral treatment called Veozah (fezolinetant), which is specifically authorized for moderating severe hot flashes. “Low-dose estrogen replacement therapy can also be suggested if symptoms are severe or if other treatments are not effective or well-tolerated,” Nonacs adds.

Regarding lifestyle adjustments, “there are some straightforward and beneficial strategies,” says Dr. Mary Jane Minkin, an OB-GYN and clinical professor at Yale School of Medicine. Suggestions include wearing layered clothing, reducing stress, keeping a healthy weight, steering clear of common triggers like alcohol and spicy foods, and ensuring a cool sleeping environment at night.

She also mentions that herbal supplements such as Remifemin, Relizan, and Thermella may provide relief.