Read in 30s

Hot flashes are sudden sensations of warmth, often felt in the face, neck, and chest. When they occur during sleep, they’re known as night sweats. These symptoms are common during menopause, though other factors like alcohol, caffeine, and certain medications may contribute. Treatments vary and may include lifestyle changes, medication, and hormone therapy—based on individual needs and medical assessment.

Introduction

Hot flashes are known as vasomotor symptoms—they affect the body’s ability to regulate temperature. They’re most common during the menopause transition but can also occur:

• During perimenopause
• After surgical menopause (e.g., oophorectomy)
• Following certain cancer treatments
• In individuals undergoing gender-affirming hormone therapy

Night sweats are hot flashes that occur during sleep and may be accompanied by sweating, restlessness, or disturbed sleep cycles.

Hot Flashes in Women

Hot flashes can begin years before menopause and may persist for several years after. They’re linked to hormonal fluctuations—especially the drop in estrogen during the menopause transition.

• Some women in their 20s or 30s may experience hot flashes related to PMS, hormonal disorders, or other medical conditions.
• Perimenopausal and menopausal women often report hot flashes lasting 5–10 years.
• Postmenopausal hot flashes may still occur depending on hormone balance.

Research also shows differences across ethnicities in frequency and severity of symptoms. While most common in cisgender women, hot flashes can affect transgender individuals and others undergoing hormone-related medical care.

👉 Learn more about hormone health for women

Which Factors May Trigger Hot Flashes?

Although exact causes aren’t fully understood, hot flashes are believed to stem from changes in the hypothalamus—the part of the brain that regulates temperature. Possible triggers include:

Alcohol

Both current alcohol use and alcohol withdrawal have been associated with increased vasomotor symptoms.

Caffeine

Caffeinated beverages may increase the frequency or severity of hot flashes, especially in postmenopausal individuals.

Spicy Foods

Spices such as chili peppers can temporarily dilate blood vessels, contributing to warmth and flushing.

Smoking

Smoking is associated with earlier onset and increased intensity of menopausal symptoms, including hot flashes.

Tight or Non-Breathable Clothing

Wearing synthetic fabrics or tight clothing may trap body heat and worsen discomfort during a hot flash.

Stress and Mental Health

Stress can activate the body’s heat-response mechanisms, potentially triggering or amplifying hot flashes.

Environmental Factors

Hot and humid surroundings, physical exertion, and even body posture (e.g., bending over) may trigger symptoms in some individuals.

Can Hot Flashes Be Prevented?

Prevention isn’t always possible, but lifestyle strategies may help reduce frequency or intensity:

• Wear loose, breathable clothing
• Keep indoor temperatures cool
• Limit caffeine, alcohol, and spicy foods
• Stay hydrated
• Engage in regular physical activity
• Practice mindfulness or relaxation techniques
• Seek support for stress and mental health

Some individuals may find relief through alternative therapies like acupuncture or hypnosis, though evidence is mixed.

Medication Options for Hot Flashes

For individuals who are not candidates for hormone therapy—or who prefer nonhormonal options—prescribers may consider:

• SSRIs/SNRIs: such as paroxetine or venlafaxine
• Neurokinin-3 receptor antagonists: such as fezolinetant
• Gabapentin or clonidine: in select cases

These medications are typically prescribed when hot flashes significantly impact quality of life. Always speak to a healthcare provider before starting any medication.

Supplements and Natural Remedies

Some individuals explore supplements such as:

• Black cohosh
• Soy isoflavones
• Vitamin E
• Flaxseed
• DHEA

⚠️ Important: Scientific evidence for these supplements is limited and mixed. They may not be suitable or safe for everyone. Consult your provider before use.

Hormone Therapy for Night Sweats

Hormone therapy—typically involving estrogen alone or estrogen plus progesterone—may reduce hot flashes and night sweats in eligible individuals.

However, hormone therapy is not suitable for everyone, especially those with a history of:

• Stroke or cardiovascular disease
• Breast or uterine cancer
• Blood clots
• Liver disease

Treatment decisions should always be made with a licensed healthcare provider who can assess individual risks and benefits.

Bioidentical Hormone Replacement Therapy (BHRT) for Hot Flashes

BHRT refers to the use of plant-derived hormones that are chemically identical to those produced by the body. These may be formulated as:

• Pills
• Patches
• Gels
• Creams
• Vaginal rings

⚠️ Not all BHRT products are Health Canada- or FDA-approved. Some compounded formulas are not standardized, and long-term safety data is still under review.

👉 Learn more about BHRT options

If BHRT is considered, it should only be prescribed by a licensed provider following a full assessment and ongoing monitoring.

Final Thoughts

Hot flashes and night sweats are common, but they don’t have to take over your life. From lifestyle strategies to medical therapies, there are ways to manage symptoms and improve comfort. Speak with your healthcare provider to determine the right path for your body and your stage of life.