What are hot flashes and how long do they last?

What do hot flashes feel like?

A hot flash feels like sudden heat in the upper body: the face, neck and chest feel very hot or cold, sometimes with sweating, palpitations, anxiety or dizziness. One episode lasts several minutes. Hot flashes are common and normal during the menopause transition.

Night sweats are hot flashes that happen at night, and they can worsen sleep problems. Night sweats and early waking become common in perimenopause. A steady sleep routine, a cool room and treating the flashes themselves are the steps that help.

Hot flashes are usually worst in the year or two around the final period, and they usually ease after menopause. Postmenopause covers the rest of life after menopause, often a third of a woman's lifespan or more, and low estrogen keeps affecting bone, muscle, heart, brain and vaginal health through those years.

It also helps to know when to see a doctor: see your provider if you have unexplained weight loss alongside hot flashes or night sweats, or if your symptoms are getting worse.

What does the evidence say about stopping hot flashes?

Hormone therapy is the most effective treatment for hot flashes and night sweats. Hormone therapy for hot flashes, known as HRT or MHT, uses estrogen, which relieves hot flashes, night sweats and many mood and sleep symptoms and also protects bone. The Menopause Society's 2022 position statement says that for most healthy women under 60, or within 10 years of their last period, the benefits usually outweigh the risks. If you have a womb, you also need a progestogen alongside estrogen. Patches, gels and sprays (transdermal estrogen) do not raise blood clot risk the way tablets do.

A non-hormone medicine is an option if hormone treatment is not right for you or you prefer not to take it. One is fezolinetant, an oral NK3 receptor antagonist that the FDA approved on May 12, 2023 for moderate to severe hot flashes caused by menopause. Its label carries a warning for liver injury, and liver blood tests are required before starting and then every 3 months for the first 9 months. That schedule is worth talking through with your provider.

Cognitive behavioral therapy (CBT) and paced breathing reduce how much hot flashes bother you, and layers, fans and cold drinks help you cool down when a flash arrives. These are a good place to start, because you can try them today.

For how to stop hot flashes in the moment, cool down: take off a layer, turn on a fan and have a cold drink. Over the longer term, reduce your own triggers, since alcohol, spicy food and caffeine can set flashes off for some women. If flashes disrupt your life, ask about HRT or a non-hormone medicine. That threshold is yours to judge, whether the effect shows up in your work, your relationships or your sleep.

How long do hot flashes last, and what helps day to day?

Menopause symptoms usually last 7 to 9 years, sometimes longer, according to the NHS, and they can change over time: hot flushes may ease and be replaced by other symptoms such as low mood and anxiety. There is no set number of flashes that counts as too many. If they disrupt your life, that is reason enough to get treatment.

When poor sleep continues, our page on insomnia covers other options. Caffeine and spicy food are fine as tolerated, so notice your own triggers gently, one at a time.

Alcohol is the trigger most worth reducing. It worsens sleep and hot flashes and is linked to breast cancer risk, so the advice is as little as possible: ideally none, and at most a few drinks a week. US guidance advises drinking less, and the UK limit is 14 units (about 8 US drinks) a week.

Fluids matter more when you are sweating. Aim for about 8–10 cups (2–2.5 liters) a day, and more with training and heat.

What did the studies show, and what did they not show?

The studies show that hormone therapy is the most effective treatment for hot flashes and night sweats, and they do not show which option is right for any one woman. The Menopause Society's wording describes most healthy women, so your own health history still matters.

The FDA's figure of around 80% describes menopausal women as a group and does not predict what will happen to you. The NHS figure of 7 to 9 years is a usual range for menopause symptoms in general, not a countdown and not for hot flashes alone.

Food shows a smaller effect than hormone therapy. Soy foods such as edamame, tofu and soy milk are safe at 1–2 servings a day, with a modest effect on hot flashes for some women. Our page on herbal menopause supplements looks at those products separately.

CBT and paced breathing make flashes less bothersome, which is different from stopping them. Whether you have a womb, how close you are to your last period and how much flashes disrupt your life all shape the choice.

Next steps

If hot flashes or night sweats are disrupting your days or your sleep, a good place to start is a short note of when they happen and what seems to set them off, then a conversation with your provider about HRT, CBT or a non-hormone medicine. In the meantime, layers, a fan, a cool bedroom, cold drinks and less alcohol are steps you can try now. See your provider promptly if you have unexplained weight loss or symptoms that are getting worse. Weigh the options against your own health, your preferences and your stage, and choose what fits you, because this is not one size fits all.