Here’s Why You Experience Hot Flashes During Menopause—And How To Treat Them

Hot flashes and night sweats—also known as vasomotor symptoms—will affect 75 percent of people in menopause.
An illustration of a woman, wearing a red jumpsuit and hoop earrings, holding a tabletop fan propped up on her knee as she experiences a hot flash (Illustration: Nicole Rifkin)

Out of nowhere, an intense heat rises up like a wave. Your face flushes. Trickles of sweat drip down your neck. You frantically fan yourself. Then the fiery burst leaves as quickly as it arrived.

Hot flashes and night sweats—also known as vasomotor symptoms—will affect 75 percent of people in menopause, says Dr. Stephanie Faubion, medical director for The Menopause Society (formerly known as the North American Menopause Society, or NAMS). Studies have found that these symptoms vary by race, with Black and Indigenous people experiencing the most frequent and bothersome hot flashes and Chinese and Japanese people the fewest.

As estrogen levels decrease during menopause, this triggers overactivity in a set of neurons in the brain collectively called KNDy (pronounced “candy”)—made up of kisspeptin, neurokinin B and dynorphin. When these temperature-regulating neurons don’t have estrogen to help control their activity, a hot flash hits.

A hot flash lasts for less than a minute, but the heat can take longer to dissipate, depending on the intensity of the flash. The sensation can range from slight warmth to pouring buckets of sweat. Other related symptoms include nausea, dizziness, elevated heart rate and anxiety, says Jerilynn Prior, a professor of endocrinology and metabolism at the University of British Columbia. A 2018 study published in the National Library of Medicine found that the average person in perimenopause will experience hot flashes for about 10 years.

The most effective treatment, Faubion says, is menopause hormone therapy, or MHT, which can reduce symptoms by up to 95 percent. Prior recently published a double-blind randomized trial that found that progesterone alone improves night sweats and sleep quality.


When it comes to non-hormonal treatments, there are no guarantees. But this June, The Menopause Society released a position statement recommending cognitive behavioural therapy, clinical hypnosis, SSRIs and weight loss.

Hot flashes can be frustrating, but don’t be afraid to seek help. “There are many effective therapies,” says Faubion. “People don’t need to suffer.”


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