Medically reviewed by Dr. Tamara Neuhaus MD

Hot Flashes & Night Sweats During Perimenopause & Menopause

They’re nothing like walking into a sauna. I love saunas! Instead, the heat starts on the inside and quickly rushes from my chest, up and out until it consumes me in a sweaty panic. A minute or two later, I’m looking for the clothes or blankets I just peeled off, because I’m freezing. - Michelle, 51

What are they?

Hot flashes and night sweats, a.k.a. “vasomotor symptoms,” are the most common symptoms of peri/menopause. While they may sound innocuous, or even pleasantly warming to the outsider, women who experience them know better. Not all hot flashes are as intense as Michelle’s. But even the mildly annoying ones are, well, annoying. Hot flashes and night sweats can bring with them a rapid heartbeat (hence the panicky feeling), perspiration (obvs.) and a flushed appearance. They come with varying frequency and intensity and keep coming for an average of seven years. 

Why do they happen?

The exact mechanics aren’t entirely clear yet. But we do know that your body’s thermostat (the hypothalamus) becomes hypersensitive as your hormone levels start to change during perimenopause. So it may overcompensate for otherwise imperceptible shifts in your body temperature with surges of heating (flashes) or cooling (sweats) in an attempt to bring your temperature back to normal. 

What can you do about them?

The great news is that there are many ways to ward off the unwelcomed warmth. Let’s break them down by treatment type:

Lifestyle Adjustments

Stress can trigger hot flashes. So daily practices like yoga, tai chi, prayer, meditation, or walking in nature may help reduce them. Caffeine, nicotine, alcohol, sugar, spicy food and hot food/drinks are also known triggers. So avoiding these can decrease the number and severity of hot flashes as well.

Herbal Supplements

Published research shows that Maca, Siberian Rhubarb, Black Cohosh, and Schisandra Chinensis may provide relief from hot flashes. It’s best to consult your primary care provider before you add any supplement to your routine, to ensure it’s safe and appropriate for your unique needs. 

Hormone Therapy (HRT)

Available by prescription, HRT nips hot flashes and night sweats in the bud by replacing the hormones your ovaries are no longer producing with fidelity. When prescribed by physicians who are well versed in menopause care, HRT is a safe and effective treatment for many women.

Non-hormonal Prescription Meds

For women who have health histories that are incompatible with hormonal therapy (prior breast cancer or a prior blood clot) there are non-hormonal prescription alternatives. Some are as effective as hormones in treating hot flashes and mood changes. Common prescriptions include very low doses of SSRIs, like Paxil, as well as an anti-seizure and nerve pain medication called Gabapentin.



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At The Cusp, we provide expert menopause care. We are a comprehensive, convenient virtual healthcare service dedicated to help you feel better.