Hot flashes and night sweats in perimenopause and menopause

Written by the Progyny Editorial Team. Reviewed by the Progyny Clinical Team — July 2026.

Hot flashes and night sweats are the most common symptoms of peri/menopause (perimenopause and menopause). They affect up to 80% of people going through menopause, and up to half of those people have severe symptoms.

Hot flashes can be very uncomfortable, feeling like a sudden wave of heat starting within your body and spreading over your face and chest. You may sweat and/or have chills, and it can wake you at night (night sweats).

Fortunately, there are safe and effective ways to find relief. Let’s learn more and walk through the common treatment options.

What causes hot flashes?

Hot flashes and night sweats are called vasomotor symptoms. The word vasomotor refers to the widening and narrowing of blood vessels. Blood vessels widen when you’re hot to help you give off heat and cool down.

Why do hot flashes happen? Well, estrogen plays a role in how your brain and body manage your temperature. Estrogen levels become less predictable and go down during peri/menopause, and you may become more sensitive to small changes in temperature or heat triggers.

Hot flashes can happen without an outside trigger. But for some people, they can be brought on by:

• Alcohol
• Caffeine
• Spicy foods
• Smoking
• Stress
• Warm temperatures
• Change in temperature

What does a hot flash feel like?

People experience hot flashes differently. They can be mild or very uncomfortable. You may have:

• Intense heat spreading over your chest, neck, and/or face
• Sweating
• Chills or a clammy feeling
• Flushed, red skin
• Feelings of anxiety or doom
• Fast or fluttering heartbeat (heart palpitations)

Hot flashes typically last for 1 to 5 minutes. They can happen many times a day and be highly disruptive. It’s also common to have them at night (night sweats), which disrupts sleep. And of course, poor sleep affects your energy and mood.

What can I do for relief?

Work with a healthcare provider trained in menopause on a personalized plan based on your health history, symptoms, and preferences. You may end up trying multiple approaches until you find what works best.

Menopause hormone therapy

Menopause hormone therapy (MHT) is the most effective treatment for hot flashes and night sweats. It’s not right for everyone, so ask your healthcare provider what’s recommended for you.

It’s important to note that systemic therapy (which travels through your body) is effective for hot flashes. Local vaginal therapy (which is inserted into your vagina and does not travel through your body) is not.

Systemic MHT is available in many forms, including:

• Pill taken by mouth
• Patch
• Spray
• Gel
• Vaginal ring

Non-hormonal medicine options

Non-hormonal medicines are also available to help treat hot flashes. The FDA-approved medicines for hot flashes are:

• Fezolinetant (Veozah®), elinzanetant (Lynkuet®): medicines that work through the body’s thermometer (in the brain) to reduce hot flashes and night sweats. Elinzanetant may also help with disrupted sleep.
• Paroxetine: a type of selective serotonin receptor inhibitor (SSRI). SSRIs are antidepressant medicines that allow serotonin (a chemical that helps regulate temperature and mood) to stay in your body longer. Paroxetine is effective for treating hot flashes and night sweats without the side effects of higher doses of SSRIs. It is not meant to treat depression.

Medicines that may be prescribed off-label to treat hot flashes include:

• Other types of antidepressants: other SSRIs and a similar type of antidepressant called serotonin-norepinephrine reuptake inhibitors (SNRIs) may be used off-label. These can be used to treat hot flashes even if you don’t have depression.
• Gabapentin: a medicine developed to treat seizures and pain. Its effects in the brain have made it effective for hot flashes and night sweats.
• Oxybutynin: a medicine developed to treat overactive bladder. One of its effects is to reduce sweating, and it also helps reduce hot flashes and night sweats.

Lifestyle and other approaches

Other strategies may help hot flashes. They can be used on their own or with hormones and medicines. Many of these are low-risk and have helped some people, but more research is needed.

Lifestyle and temperature control

• Dress in layers and use layered bedding to help regulate your temperature.
• Keep a fan nearby and have a cool drink if you begin to feel warm.
• Avoid triggers like alcohol, caffeine, or spicy foods.
• Try relaxation techniques like deep breathing or meditation.
• Take steps towards losing weight, a risk factor for hot flashes.
• Get help quitting smoking, which makes hot flashes more likely.

Professional therapy

• Cognitive behavioral therapy has been shown to help hot flashes (well supported by research)

Alternative approaches

• Acupuncture
• Clinical hypnosis (well supported by research)

Many supplements are marketed for menopause symptoms. Please take caution with these and review everything you take with your provider. Supplements are not regulated by the FDA. They may have unknown ingredients, dangerous side effects, or interactions with other drugs.

Partner with your healthcare team

Work with your team on a personalized plan for managing hot flashes. It may take a little trial and error, but relief is available. You have the right to speak up about how you feel, receive appropriate care, and ask anything that’s on your mind.

You can also reach out to your Progyny Care Advocate for support and guidance. We’re here for you.

Explore related topics in this series: 

Explore related: 

• Perimenopause: What can I expect? 

• Menopause hormone therapy: Is it right for me? 

• Sleep problems in perimenopause and menopause 

Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.