What Are Hot Flashes and Night Sweats?
Hot flashes and night sweats are also known as vasomotor symptoms (VMS).
A hot flash is a sudden sensation of heat that usually affects the upper body, particularly the face, neck, and chest. It may be accompanied by sweating, flushed or blotchy skin, chills, anxiety, or a rapid heartbeat.
Most episodes last only a few minutes, although the experience varies considerably from one woman to another.
Hot flashes that occur while you are sleeping are commonly called night sweats.
What Causes Them and What Can Help?
Why Do Hot Flashes Happen?
Hot flashes are linked to changes in the body's temperature-regulating system.
During perimenopause and menopause, changing estrogen levels affect signaling in the brain, including the hypothalamus, the area involved in regulating body temperature.
These hormonal changes can make the body's temperature-control system more sensitive. A relatively small change in body temperature may trigger cooling mechanisms such as increased blood flow near the skin and sweating.
This produces the characteristic sensation of sudden heat associated with a hot flash. As the body cools afterward, some women experience chills or shivering.
Other signaling pathways in the brain are also involved, which has led to the development of newer nonhormonal medications that specifically target the pathways associated with vasomotor symptoms.
Why Night Sweats Can Be Particularly Disruptive
Night sweats can range from waking slightly warm to experiencing enough perspiration that clothing or bedding becomes damp.
Repeated episodes can interrupt the normal sleep cycle. You may wake during a night sweat, need to cool down or change clothing, and then have difficulty falling asleep again.
Over time, disrupted sleep can contribute to daytime fatigue, irritability, difficulty concentrating, and brain fog.
If night sweats are frequent, severe, newly developing, or occur with other unexplained symptoms, talk with your healthcare provider. Menopause is a common cause of night sweats during midlife, but it is not the only possible cause.
What Can Trigger or Worsen a Hot Flash?
Hot flashes are related to changes occurring during the menopause transition, but some women notice that particular situations seem to bring on or worsen an episode.
Triggers vary from person to person, and not everyone will have identifiable triggers.
If your hot flashes seem unpredictable, keeping a brief symptom diary may help you identify patterns. Record when the hot flash occurred, what you were doing, what you had recently eaten or drunk, and how severe the episode felt.
Hormone Therapy
Systemic hormone therapy is the most effective treatment for bothersome hot flashes and night sweats.
Because systemic estrogen circulates through the bloodstream, it can affect temperature regulation and other symptoms throughout the body.
If you have a uterus, systemic estrogen is generally combined with a progestogen to protect the lining of the uterus from excessive growth and reduce the risk of endometrial cancer.
If you have had a hysterectomy, estrogen may usually be prescribed without a progestogen.
Hormone therapy is not appropriate for everyone. The decision to use it should take into account your age, time since menopause, symptoms, medical history, personal risk factors, and treatment preferences.
Discuss the potential benefits and risks with your healthcare provider before deciding whether hormone therapy is right for you.
Nonhormonal Prescription Treatments
Hormone therapy is not the only medical treatment available for hot flashes and night sweats.
Some women cannot use hormone therapy, prefer not to use it, or find that another approach better suits their needs.
Prescription nonhormonal treatments used for vasomotor symptoms include certain antidepressants, such as some selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
Other medications, including gabapentin and oxybutynin, may also be used in some circumstances.
A newer class of nonhormonal treatments targets neurokinin signaling in the brain, one of the pathways involved in temperature regulation and vasomotor symptoms.
Your healthcare provider can help determine which treatment may be appropriate based on your symptoms, medical history, other medications, and potential side effects.
Everyday Strategies That May Help
Lifestyle measures cannot always prevent hot flashes, but simple changes can make episodes easier to manage and support your overall health during menopause.
Keep Cool
Try dressing in lightweight, breathable layers that can easily be removed when a hot flash begins.
A portable or handheld fan can also be useful when you are away from home.
At night, consider lightweight sleepwear and breathable bedding. Keeping the bedroom comfortably cool may make nighttime episodes easier to manage.
A cool shower before bed may also feel soothing, particularly during warmer weather.
Keep Cold Water Nearby
Sweating can leave you feeling hot and uncomfortable, so keeping cold water nearby can be useful.
An insulated water bottle can make it easier to have a cold drink available at home, at work, or while traveling.
Pay Attention to Your Triggers
If you notice that alcohol, caffeine, spicy foods, hot beverages, or particular environments consistently precede a hot flash, reducing or avoiding those triggers may help.
You do not necessarily need to eliminate everything at once. Tracking symptoms can help identify the factors that matter to you.
Manage Stress
Stress does not cause menopause, but some women find that stressful situations make their hot flashes feel more noticeable or difficult to manage.
Strategies such as meditation, relaxation exercises, stretching, or slow breathing may help with overall stress management.
Stay Active
Regular physical activity provides important benefits during midlife, including supporting cardiovascular health, bone health, muscle strength, sleep, and emotional wellbeing.
Exercise should therefore remain an important part of a healthy menopause lifestyle even though evidence that exercise directly reduces hot flashes is limited.
If You Smoke, Consider Quitting
Smoking is associated with a greater likelihood of experiencing hot flashes as well as numerous other health risks.
If you smoke, talk with your healthcare provider about resources that can help you quit.
When Should You Talk to Your Healthcare Provider
Hot flashes and night sweats are common during the menopause transition, but you do not have to wait until symptoms become severe before asking for help.
Consider talking with your healthcare provider if:
- Hot flashes or night sweats interfere with sleep or daily activities.
- Symptoms are affecting your work, relationships, mood, or quality of life.
- You are unsure whether your symptoms are related to menopause.
- Night sweats begin unexpectedly or become significantly worse.
- You experience other unexplained symptoms along with night sweats.
- You would like to discuss hormone or nonhormonal treatment.
- You are considering supplements and want to check for possible risks or interactions.
Your healthcare provider can also consider whether another medical condition or medication could be contributing to your symptoms.
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Want a More Comprehensive Guide?
Looking for a complete guide to every stage of menopause? Explore Menopause Spotlight: Your Essential Guide to Perimenopause, Menopause, and Beyond.
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