Hot flashes
Why flashes and night sweats happen, and what has evidence behind it when you want them to stop.
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Hot flashes: the overview
A hot flash (a hot flush in the UK) is a sudden wave of heat over the face, neck and chest, often with sweating and a fast heartbeat, followed by a chill. At night the same thing is called a night sweat. Falling oestrogen unsettles the part of the brain that keeps body temperature in range, so small changes trigger a full cooling response.
What has evidence behind it
HRT remains the most effective treatment, according to NICE. For women who cannot or prefer not to take hormones, NICE now recommends menopause-specific cognitive behavioural therapy for flushes and sweats, either alongside HRT or on its own (NICE, November 2024).
The Menopause Society's 2023 review of non-hormonal options gave CBT and clinical hypnosis its strongest evidence rating (The Menopause Society). There are also prescription medicines without hormones. Fezolinetant, sold as Veozah, was approved by the US FDA in May 2023 and works on the brain's temperature centre directly (review in PMC).
What the guides here cover
Articles in this topic cover what sets off a flash, home measures that make nights easier, non-hormonal medicines, and why most herbal supplements have little trial evidence.
Our editors' view: layers and a cooler bedroom make the heat easier to live with, but if it is waking you every night, that is reason enough to ask about a treatment.
Questions readers ask
How long does a flash last?
Is there a treatment without hormones?
Do herbal supplements help?
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