Chances are you’ve at least heard about hot flashes. Maybe you have experienced them yourself, or you know someone who has them. Hot flashes are one of the more common symptoms of perimenopause and menopause – and they can be rather inconvenient. One minute, you’re freezing cold. The next minute, you’re burning up and stripping down to a tank top. They can happen during the day or wake you up in the middle of the night.

The good news is you don’t have to let hot flashes disrupt your life. In this article, I’ll share some ways you can lessen the severity of hot flashes.

What is a hot flash?

First, let’s start by explaining what happens when you have a hot flash. According to The Menopause Society, the exact cause is unknown. They are thought to result from changes in the hypothalamus, the part of the brain that regulates the body’s temperature. Everyone’s hot flashes are different, but when you have a hot flash, you usually get a sudden feeling of warmth in your upper body and face. You may get flushed, experience a rapid heartbeat, and/or start sweating. Your brain thinks you are too hot, and your body is trying to get rid of heat. Some women experience a sense of panic.

Hot flashes vary in severity and frequency. The Study of Women’s Health Across the Nation (SWAN) found that they last an average of 7.4 years, although the range is wide. About 15% of American women never experience a hot flash, and others continue to have them into their 60s or 70s.

Ways to reduce hot flashes

There are measures you can take to reduce hot flashes, ranging from lifestyle changes to prescription medication. Many women have triggers or activities that set off hot flashes. If you can identify and eliminate your triggers, you can help reduce them. Some common triggers include:

• Hot beverages
• Spicy/hot food
• Alcohol
• Caffeine
• Smoking cigarettes
• Stress
• Being in a warm/hot room

Keeping a diary of what you eat and drink and when you have hot flashes might help you make a connection. In addition to identifying and avoiding triggers, here are some other remedies to help with hot flashes:

• If you smoke, get help in trying to quit.
• Dress in light, breathable layers so you can remove layers when a hot flash strikes.
• Keep a fan at your desk at work.
• Running your hands under cold water when you get a hot flash can help cool you down.
• If your hot flashes happen at night, keep your room cool. Try putting a cold pack under the pillow and flipping your pillow throughout the night. You can also keep a fan or thermos of ice water by your bed.
• Evidence has shown that diaphragmatic breathing helps to alleviate hot flashes.
• Try practicing yoga, acupuncture, massage, or meditation to reduce stress.

Many of my patients ask me about over-the-counter medications. Walk into any drug store, and you’ll see dozens of non-prescription medications that claim to help with hot flashes. The government does not regulate these products, so we don’t know all about their quality or the potential risks and side effects, and I don’t generally recommend them to my patients. That said, some non-prescription remedies have been found to decrease hot flashes in some studies, including soy (tofu, tempeh, soy milk, or roasted soy nuts), supplements containing soy isoflavones, or herbs such as black cohosh.

The most effective prescription medication for severe hot flashes is hormone therapy. Certain anti-depressants can be used to treat hot flashes, and gabapentin, a medication prescribed for nerve pain and seizures, has been found especially effective in helping women who experience hot flashes at night.

In May 2023, a new drug, VEOZAH, which is not a hormone, was approved for hot flashes. It is effective but expensive and not always covered by insurance, and as is the case with all new drugs, not that many people have used it, and more will undoubtedly be revealed.

Help for hot flashes

If you’ve tried lifestyle changes and non-prescription options and hot flashes are still disrupting your life, talk with your primary care provider or OB/GYN about prescription options.

For more specialized menopause care, Atrius Health offers menopause consultation services.