Hot Flashes Fact Sheet

About 75% of perimenopausal women experience hot flashes. Find out what may be triggering your hot flashes and discover ways to get relief.

What are hot flashes?

Imagine that you’re sitting on the couch and suddenly feel overwhelmed by a sensation of heat. Your face, neck and chest become flushed. Your heart rate starts to climb and you start sweating like you just ran a half marathon. This is what it feels like to have a hot flash.

Hot flashes are very common during menopause, affecting as many as 75% of women. They can come on at random, or on a regular basis and typically last between two and four minutes. Hot flashes usually aren’t debilitating, but when they happen at night, also called night sweats, they can interfere with a woman’s sleep.

How long will I have hot flashes?

The length and severity of hot flashes vary among women. Some women only have hot flashes for a few months, while others experience hot flashes for as many as 14 years, according to one study.

What causes a hot flash?

The jury is still out on the exact cause of hot flashes. Researchers believe that lower estrogen levels are most likely to blame. Estrogen appears to play a role in regulating body temperature. When estrogen levels start to drop during menopause, the hypothalamus has trouble controlling temperature effectively. That’s because estrogen normally helps control another hormone called norepinephrine that is used to regulate body temperature by triggering blood vessels in the skin to dilate and sweat glands to start producing more sweat. During menopause, the hypothalamus has to relearn how regulate temperature without estrogen and will sometimes trigger blood vessel dilation and sweating at the wrong time.

What can trigger hot flashes?

There are a lot of different things that can trigger hot flashes. Caffeine, alcohol, heat, stress, wearing tight clothes, eating spicy foods, drinking hot beverages and smoking are all common culprits. Keeping a journal of what you were doing when a hot flash hits can help you identify your hot flash triggers.

How can I minimize hot flashes?

Most women can manage hot flashes by making simple lifestyle changes:

  • Avoiding hot beverages and spicy foods.
  • Cutting back on caffeine and alcohol.
  • Quitting smoking.
  • Exercising regularly.
  • Losing weight.
  • Staying cool whenever possible.
  • Sleep in a cool room with breathable sheets and clothes.
  • Drink cool water when you feel a hot flash coming on.

Hormonal and non-hormonal medications are also available for women with severe hot flashes not controlled with lifestyle changes. Medications have their pros and cons, so it’s important to talk with your doctor about what options may be appropriate for you.

  • Hormone Replacement Therapy (HRT): HRT replaces the hormones that drop during menopause with low level amounts to ease the transition. It’s not right for everybody, so be sure to talk to your doctor about the risks and benefits.
  • Clonidine: This high blood pressure medication helps decrease hot flashes and night sweats. This medication has side effects when stopped suddenly and you should never stop taking a medication without first talking to your doctor.
  • Gabapentin: This epilepsy drug has been shown to ease severity and frequency of hot flashes.
  • Selective Serotonin Reuptake Inhibitors (SSRIs): Paroxetine is the only FDA-approved SSRI to treat moderate to severe hot flashes. Other SSRIs, like fluoxetine and venlafaxine, may also be effective. 

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