Hot flashes are sudden waves of heat across the chest, neck and face, often with sweating and a fast heartbeat. Each one usually lasts 1 to 5 minutes. They are most often caused by changing hormone levels around menopause and, on average, come and go for more than seven years. Night sweats are hot flashes at night.
This is general information, not medical advice. Talk to your doctor or pharmacist about your own situation.
Mayo Clinic describes these common signs:
A sudden feeling of warmth spreading through the chest, neck and face
Skin that looks flushed and blotchy
A fast heartbeat
Sweating, mostly on the upper body
Feeling chilled as the hot flash fades
Feeling anxious
Hot flashes are very common. The Menopause Society says they affect up to 80% of women. How often they happen differs from person to person, but Mayo Clinic says most people who get them have them daily. Some people have them for more than 10 years.
Changing hormone levels before, during and after menopause are the most common cause. Mayo Clinic explains that it is not fully clear how this works. Most research suggests that lower estrogen levels make the body's internal thermostat, the hypothalamus, more sensitive to small changes in temperature. When it thinks you are too warm, it sets off a chain of events to cool you down.
Less often, something other than menopause is behind them. Mayo Clinic lists medicine side effects, thyroid problems, some cancers and side effects of cancer treatment.
Some things make hot flashes more likely:
Smoking. The Menopause Society says both current and past smoking raise the risk.
Higher body weight. Mayo Clinic links a higher BMI with more hot flashes, and The Menopause Society points to higher belly fat.
Hot flashes can begin before your periods stop. If you are not sure which stage you are in, our guide to perimenopause vs menopause explains the difference.
The NHS, Mayo Clinic and The Menopause Society name these common triggers:
Spicy food
Hot drinks and hot food
Caffeine
Alcohol
Smoking
Triggers vary from person to person, so it helps to find your own. For two weeks, jot down a few details after each hot flash:
The date and time
What you ate or drank in the hour before
Where you were and how warm the room was
How stressed you felt
How strong it was, from 1 to 10, and roughly how long it lasted
Patterns often show up quickly. For example, you might notice that your worst evening flashes follow a glass of wine or a hot curry.
Dress in layers. Wear lightweight clothing you can take off quickly.
Cool down fast. The NHS suggests a cool shower, a fan or a cold drink. Mayo Clinic suggests sipping something cold as soon as you feel a hot flash coming on.
Keep your bedroom cool at night. Use a fan or air conditioning if you can.
Lower your stress. Mayo Clinic says some people get relief from mild hot flashes with meditation or slow, deep breathing.
Do not smoke. Smoking is linked to more hot flashes.
Exercise regularly and keep to a healthy weight. Mayo Clinic says weight loss in people with overweight or obesity may improve hot flashes.
Ask about CBT. Cognitive behavioral therapy is a type of talking therapy. The NHS says it can help manage hot flashes, and The Menopause Society lists CBT and clinical hypnosis among the approaches with good support.
For night sweats, set up your bedside before you sleep. Keep a glass of cold water, a small fan, a spare top and light layers of bedding you can push off without fully waking up.
If hot flashes are wearing you down, there are proven medical options. A doctor can help you weigh the benefits and risks for your health history.
The Menopause Society says hormone therapy is FDA approved as a first-line treatment and is the most effective treatment for bothersome hot flashes. Estrogen is the main hormone used. If you still have a uterus, you also need a progestogen to protect it. Mayo Clinic says to use the smallest dose of estrogen that manages symptoms.
If hormone therapy does not work for you, you cannot take it or you would rather not, the NHS says other treatments are available. Options your doctor may mention include:
Low-dose paroxetine, an antidepressant that is FDA approved for hot flashes
Fezolinetant or elinzanetant, hormone-free medicines that work on the brain pathways that help manage body temperature
Other antidepressants, gabapentin, pregabalin, oxybutynin or clonidine, which are sometimes used for hot flashes
Black cohosh and red clover are often sold for menopause symptoms. The NHS says there is very little evidence on how well they work or how safe they are, and some can cause serious side effects with other medicines. Mayo Clinic warns that dong quai and high doses of vitamin E may raise bleeding risk. Tell your doctor about any supplement you take.
Mayo Clinic suggests bringing a few notes, and says to expect questions about your periods and what makes symptoms better or worse. A simple list to take:
How many hot flashes you have a day and how bad they are
Every medicine and supplement you take, with doses
When your last period was
What makes your hot flashes better or worse
Your questions, written down, plus a notebook or phone for notes
If hot flashes affect your daily activities or your sleep. Mayo Clinic notes that over time they can lead to long-term sleep loss.
If you are not sure why you are getting them, or they come with other new symptoms. Medicines, thyroid problems and some cancers can also cause hot flashes.
If you have had breast cancer. The Menopause Society advises talking to a healthcare professional about using antidepressants for hot flashes.
If you would like to explore hormone therapy or other options. The NHS suggests talking to a doctor, nurse or pharmacist.
Each one usually lasts 1 to 5 minutes. Over the years, Mayo Clinic says people who get them have them for more than seven years on average, and some for more than 10.
Spicy food, hot drinks and hot food, caffeine and alcohol are the most common triggers named by the NHS and Mayo Clinic.
Yes. Hormone changes before, during and after menopause can all cause them, so many people notice hot flashes during perimenopause.
Yes. Night sweats are hot flashes that happen at night, and they can disturb your sleep.
My Midlife Story: Menopause is a symptom journal for iPhone and iPad. You can log hot flashes, night sweats, sleep and brain fog with one tap, each saved with the date and time, mark "Something changed" when a symptom or treatment shifts, and turn chosen notes and questions into a one-page visit brief you can edit, print or save as a PDF. It does not diagnose or recommend treatment, it needs no account and has no ads, and it is free with an optional Premium upgrade.
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