Every woman will go through menopause in her midlife, along with the 7-14 years of transition known as perimenopause. During this period, the ovaries start to gradually decline in function, which leads to lower levels of hormones such as estrogen and progesterone. This hormonal change can trigger a range of undesired symptoms related to menopause and perimenopause.

Symptoms can include night sweats, weight fluctuations, changes in menstruation, mood swings, and lessened cognitive abilities like memory difficulties and concentration problems.

Hot flashes are another prevalent symptom of menopause, with “about 70% of women experiencing them at some point during this transition,” explains Rebecca Thurston, PhD, who researches menopause and is a professor of psychiatry at the University of Pittsburgh.

What are hot flashes?

Hot flashes are sudden episodes of extreme heat often paired with sweating and redness, as described by Thurston. “These episodes usually last a few minutes and can occur at any time during the day or night.”

For many women, hot flashes “feel like a sudden surge of heat that begins in the chest and spreads to the neck and face,” notes Dr. Ruta Nonacs, a reproductive psychiatrist at Massachusetts General Hospital and a Harvard Medical School instructor. This sensation can be “quite dramatic,” often disrupting sleep for many women.

Thurston indicates that hot flashes are the body’s way of attempting to cool down from sharp declines in certain reproductive hormones that affect the hypothalamus, which regulates body temperature.

While these hormonal decreases are a natural part of menopause and perimenopause, other factors can sometimes trigger hot flashes. Conditions like migraines, urinary tract infections, neurological disorders (e.g., Parkinson’s disease and multiple sclerosis), hyperthyroidism, autoimmune diseases, and even certain cancers like lymphoma can all lead to hot flashes, explains Dr. Mary Jane Minkin, an OB-GYN and clinical professor at Yale School of Medicine.

Additionally, excessive consumption of caffeine or spicy foods, along with specific heart and blood pressure medications, may cause hot flashes for some individuals.

Do all women experience hot flashes?

Hot flashes can occur in any individual, including men, when triggered by medical conditions or medications. In men, these flashes can arise from treatments for erectile dysfunction or prostate cancer.

However, not every woman undergoing menopause or perimenopause experiences hot flashes. Approximately 70% of perimenopausal women and nearly 80% of women in menopause do, says Dr. Jewel Kling, associate director of women’s health at the Mayo Clinic in Arizona. Of this group, about 30% face frequent and “severe” hot flashes, she notes.

Interestingly, around 20% of women experience no hot flashes at all, and the reasons for their luck remain unclear, remarks Minkin.

Outside of menopause, “some women may experience hot flashes during specific phases of their menstrual cycle,” adds Thurston, but this occurrence is less common compared to menopause.

What is the most common treatment for hot flashes?

Hot flash treatments vary based on their intensity, frequency, and underlying causes. “For those with milder symptoms, we recommend avoiding triggers such as spicy foods, caffeinated drinks, and alcohol, and suggesting lighter clothing options,” says Nonacs.

For more severe cases that disrupt sleep or daily functioning, “a variety of effective medications are available,” she mentions. These may include antidepressants that influence hormonal activity, like sertraline (Zoloft) and fluoxetine (Prozac). Although not specifically approved by the FDA for this purpose, doctors often prescribe gabapentin (Neurontin) for managing hot flashes.

This past year, the FDA approved a new medication specifically designed for moderate to severe hot flashes, called fezolinetant (brand name Veozah),” shares Nonacs.

Minkin also notes that some herbal remedies and supplements can be beneficial. Additionally, low-dose estrogen replacement therapy might be prescribed when symptoms are particularly severe or when other treatments are less tolerable or ineffective. “Today, we have many safe options for this,” she adds.

“For many women, hot flashes are just a minor inconvenience, while for others, they can disrupt daily life significantly,” remarks Thurston. “For those who are truly struggling, seeking help is advisable.”