You Don’t Have To Live With Hot Flashes And Night Sweats

You know the feeling. It begins as a sudden, intense sensation of heat in the chest that quickly spreads to the neck and face. Your skin flushes, your heart pounds, and your body temperature rockets from normal to volcanic in under a minute.

It’s a hot flash, and it’s horrible.

Hot flashes and night sweats (hot flashes that happen at night and can drench pyjamas) are one of the most common and disruptive menopause symptoms, affecting up to 60-80 per cent of women. Known collectively as vasomotor symptoms (VMS), they can begin in perimenopause (the transition stage into menopause when your period becomes irregular), ranging from mild to severe. According to Dr. Alison Shea, a Hamilton, Ont.-based obstetrician, gynecologist and menopause specialist, they can last for “an average of seven to 10 years,” impacting everything from long-term health to professional success to social confidence.

Why vasomotor symptoms (VMS) happen

While we often think of hot flashes as a hormone problem, the root cause actually lies within the brain. According to Dr. Shea, VMS is driven by a narrowing of the thermoregulatory zone in the hypothalamus.

Learn more about the symptoms of VMS

Serving as an internal thermostat, the hypothalamus relies on a specific group of neurons to maintain body temperature. Normally, estrogen acts like a balanced hand on the dial, but as estrogen levels drop during menopause, those neurons go into overdrive. They begin sending signals to the rest of the body to cool down immediately, even when it isn't actually hot. This false alarm triggers the body’s cooling mechanisms—like sweating and flushing—resulting in a sudden, explosive feeling of heat.

The true impact of VMS spans work, health and quality of life

Hot flashes aren’t just a nuisance; they are a legitimate health concern, says Dr. Shea, with ripple effects that can impact other areas of the body. “Long-term, untreated hot flashes increase one’s risk for cardiac events and white matter changes in the brain,” says Dr. Shea.

VMS are also associated with a higher risk of developing metabolic syndrome and an increased risk of diabetes.

The everyday impact can be life-changing as well. When the body is stuck in a cycle of heat spikes, the lack of quality sleep creates a chain reaction. “When you are not sleeping well, you increase inflammation in your body,” Dr. Shea explains, noting that this can also make it harder to manage weight, be productive at work or maintain a steady mood.

Get the facts on managing VMS

New options for VMS treatment

Even as the conversation around menopause begins to heat up, the stigma remains deeply rooted, with 54 per cent of women still viewing the topic as taboo. “Some may find it embarrassing, or think they simply need to suffer through,” Dr. Shea notes. By treating VMS, women aren't just stopping a hot flash; they are protecting their long-term health and quality of life.

Fortunately, there are multiple treatment options available. The most common treatment is menopause hormone therapy (MHT), which uses a combination of prescribed estrogen and progesterone to manage hot flashes and night sweats. 

For women who don’t want MHT, or can’t take estrogen, there are also effective non-hormonal therapies that specifically target VMS. These options are expanding thanks to a new class of medications: Neurokinin Receptor Antagonists (NKRA). Medical treatments address the biological cause, but lifestyle modifications can offer secondary support. Dr. Shea notes that regular exercise, stress management and limiting triggers like caffeine and alcohol can help manage day-to-day comfort.

Get more information on the treatment of VMS

Empowering women to seek help

While 75 per cent of Canadian women report feeling confident speaking to a healthcare provider about their symptoms, only 26 per cent feel they are actually aware of the full range of treatment options available, according to a 2026 Angus Reid poll. This awareness gap contributes to a startling reality: over half (56.9 per cent) of women are not getting treatment for their VMS.

The "menopause taboo" is often reinforced in the exam room, as many healthcare providers receive minimal menopause education during their training, according to the Menopause Foundation of Canada. Dr. Shea notes that because only 27 per cent of physicians actively initiate these discussions with their patients, it’s essential for women to lead the conversation and advocate for the support they deserve.

How to prep for your appointment

Here is how Dr. Shea suggests preparing for a successful, productive appointment about VMS:

• Book a Dedicated Slot: Ensure menopause care isn't an afterthought by booking a specific time to discuss it.
• Track Your Symptoms: Use this free tracker from the Menopause Foundation of Canada to note the frequency and impact of your symptoms before your visit.
• Bring the "Impact" List: Share how VMS is affecting your sleep, mood and work productivity.
• Ask About the Latest Science: Ask your doctor about NKRA—the non-hormonal treatment class approved by Health Canada for VMS.
• Download a Guide: Visit WhatsVMS.ca to download the Doctor Discussion Guide.