Hot flashes are one of the most common (and most uncomfortable) symptoms of menopause. And while there’s no way to completely prevent them, some very simple strategies can help you reduce their intensity and frequency. That includes avoiding triggers, limiting stress, and using helpful gear such as water bottles and portable fans. There are also treatments available—like hormone therapy and low-dose SSRI/SNRI medications—which have been proven effective in treating hot flashes.

What are hot flashes?

Hot flashes (sometimes called hot flushes) cause a rapid, uncomfortable sensation of heat—often focused on the face, neck, and chest. For many people, this is accompanied by flushing and sweating. A hot flash can last from 30 seconds to five minutes, and you may experience them infrequently (e.g. once every few days) or almost constantly (e.g. every hour). When hot flashes occur while you are sleeping, they can leave your sheets and sleepwear drenched—hence the term night sweats.

Hot flashes are complex events triggered by the major hormonal shift we see during perimenopause. As your levels of estrogen and progesterone begin to fall, changes occur in almost every organ and body system—including your brain, which is rich in estrogen receptors. A part of the brain called the hypothalamus, which helps regulate body temperature, is particularly affected. As your hypothalamus struggles to adjust to the new hormonal environment, it sends out inappropriate signals to your body, causing overheating.

Strategies for dealing with hot flashes

There’s no silver bullet to create instant relief from hot flashes and night sweats. There are, however, techniques and medications that will reduce their frequency and intensity. There are also behavior shifts that will lessen their psychological impact and improve your quality of life. Here are our 6 favorite tips:

Tip #1: Bring down your stress

You may have noticed that stressful situations seem to cause hot flashes. This isn’t your imagination. Many people find that stress is a hot flash trigger, and research has shown that people with higher mindfulness scores are less likely to have menopause symptoms like hot flashes. Meanwhile, people who carry more physical anxiety are more likely to have hot flashes. It’s also been shown that stress reduction techniques (such as Mindfulness-Based Stress Reduction) can help reduce the psychological impact of hot flashes.

Of course, life will never be entirely stress-free. But little things that protect your peace of mind really do add up. Here are a few daily practices you can try:

• Nature walks. Getting out in green space brings peace to mind and body.
• Deep breathing. A quick round of breathing exercises can be a powerful stress reliever.
• Meditation. Even a 5-minute practice has proven benefits.

Tip #2: Safeguard your sleep

Night sweats can do a number on your slumber by waking you up repeatedly and reducing sleep quality. That’s why it’s more important than ever to practice good sleep hygiene during menopause. Keep your bedroom cool and dark, avoid caffeine after 2pm, only use your bed for sleep and sex, and try to wind down at the same time every night. It can also be useful to follow a calming nighttime ritual before you go to sleep.

When hot flashes do wake you up, a few pieces of helpful gear can go a long way. Try keeping an electric fan near your bed, as well as an insulated bottle of ice water. You might also want a frozen ice pack under your pillow to chill your head or feet, and a cooling spray or herbal mist. Finally, make sure to sleep in a lightweight, breathable, sweat-wicking fabric (search for “cooling pajamas”). 

Tip #3: Stay hydrated

Drinking sufficient water plays three important roles during menopause. First, many people find that staying hydrated helps them reduce the frequency of hot flashes. Second, a bottle of ice water offers a quick and healthy way to cool down during the hot flash itself. And third, extra hydration is necessary to replace the fluids you’re losing via sweat.

If you don’t have one already, invest in a high-quality steel water bottle. (You might be surprised how much more appealing water is when you adore the container it’s in!) Silicone water bottles are also safe and handy, and can be rolled up in your purse when they’re empty. Leaving carafes of water in convenient places can also remind you to stay hydrated. And if you’re not a big water drinker, try flavoring it with lime, lemon, cucumber, or herbal tea.

Tip #4: Avoid triggers

Hot flash triggers vary from person to person, but there are some broad commonalities across the menopause experience—and avoiding these triggers can help you prevent hot flashes and night sweats before they take hold. That includes alcohol and caffeine, spicy food, and hot liquids like soup. Smoking is another typical hot flash trigger, and tobacco use is closely linked with hot flash severity and frequency.

Some people also find that tight, restrictive clothing and high air temperature can trigger hot flashes. Try dressing in light, loose clothing that can easily be removed during a hot flash (and replaced afterwards). If you’re in an environment where you can’t control the air temperature (like a heated office), try using a personal fan to cool down your immediate area.

Tip #5: Consider medication

If you’re dealing with persistent, moderate-to-severe hot flashes, no medication is more powerful and effective than menopausal hormone therapy (MHT). Menopausal hormone therapy works by boosting your falling natural estrogen and progesterone levels. MHT has been proven to reduce hot flash frequency and severity, and has been recognized by the North American Menopause Society as the most effective treatment for hot flashes and night sweats. MHT also improves other menopause symptoms like joint pain, painful sex, mood changes, and insomnia.

While MHT is considered the first-line treatment for menopausal hot flashes, some people cannot take hormonal medications for medical reasons. Others would simply prefer not to. In these cases, your doctor may prescribe an alternative treatment: SSRI/SNRI medication. SSRIs (and their chemical cousins, SNRIs) were originally developed to treat depression and anxiety. But when prescribed at lower doses, they are also highly effective at treating hot flashes and night sweats. We don’t fully understand the science of how they work, but these medications may help restore the neurotransmitter balance in the hypothalamus, allowing it to function properly.

Tip #6: Try Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a psychological treatment designed to help you identify negative thought patterns and change them. And while that may sound too good to be true, there’s a major body of scientific research showing that it works. 

In particular, for people with hot flashes, CBT has been proven to improve the insomnia that results from night sweats. In other words, it can help you stop stressing and get back to sleep after uncomfortable night sweats. In fact, CBT has been endorsed by the North American Menopause Society as an effective treatment for hot flashes.

Final thoughts

While you may not be able to completely halt hot flashes and night sweats, you can take steps to reduce their severity and frequency. Small lifestyle shifts that lessen your stress, safeguard your sleep, and improve your hydration will go a long way. Safe and effective medications, including menopausal hormone therapy and SSRI/SNRI drugs, are another option. However you choose to move forward, remember that menopause symptoms are a real quality of life issue, and you deserve top-tier care in addressing them.