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Originally published May 13, 2025
Last updated May 13, 2025
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Most readers have probably heard their mothers and grandmothers talk about feeling uncomfortable due to hot flashes. It’s a familiar complaint because hot flashes are the most common symptom of menopause, affecting as many as eight in 10 women, according to the American College of Obstetricians and Gynecologists.
“Many women say, ‘This is just part of getting older and I have to put up with it,’” shares Laila Al-Marayati, MD, an obstetrician and gynecologist who provides services at USC Verdugo Hills Hospital, part of Keck Medicine of USC.
She says because of this mindset, too many women suffer unnecessarily. “Doctors with expertise in this area can guide you through the symptoms and help you get relief.”
During a hot flash, you’ll suddenly feel very warm in your upper body. It typically begins in the chest and spreads to the neck and face.
Many patients start sweating and their face turns red. Other hot flash symptoms include heart palpitations, anxiety, chills and having clammy skin.
Hot flashes at night are called night sweats, when a patient may wake up drenched in sweat. Despite different names, hot flashes and night sweats refer to the same thing.
Dr. Al-Marayati says for women experiencing a hot flash for the first time, it can feel especially unsettling because “it’s not like anything you’ve ever felt before. It’s not like feeling warm when you go outside on a hot day.”
Hot flashes are caused by hormonal changes. During menopause – which is a normal part of aging in which a woman gradually stops having menstrual periods – the ovaries stop making as much estrogen as they used to. This significant hormone reduction is what triggers hot flashes.
Some women have their ovaries removed before reaching menopause because of medical conditions including cancer, endometriosis and pelvic inflammatory disease. This can trigger hot flashes.
As Dr. Al-Marayati explains, the vast majority of patients can feel reassured that a hot flash is not a warning sign of cancer. However, they can be a side effect of certain cancer therapies.
Patients undergoing treatment for breast or endometrial cancer may experience hot flashes. Men may also have hot flashes during treatment for prostate cancer.
Dr. Al-Marayati says while it’s normal to feel flushed or warm during pregnancy and postpartum, “the symptoms are less severe than what I see in my perimenopausal and menopausal patients.”
A hot flash may last 30 seconds or several minutes. They may occur a few times per day or, in some severe cases, as often as every 15 minutes.
Women may start experiencing hot flashes when they reach perimenopause, which is the transition period when the body begins to reduce estrogen production. A woman officially enters menopause once they’ve gone 12 months without a period, which typically occurs between the ages of 45 and 55, according to the National Institute on Aging.
The menopausal transition can last anywhere from two to 10 years. Dr. Al-Marayati says most people stop getting hot flashes once they’re fully into menopause. “Usually, hot flashes diminish two to three years after their final menstrual period,” she says.
“However,” she cautions, “there are some women who never stop getting hot flashes no matter how far they are into menopause.”
“Lifestyle changes can help with management of hot flashes,” Dr. Al-Marayati says. “But that often is not enough to provide the relief that many women need.”
Natural remedies for hot flashes include:
Hot flashes can be very disruptive at night and lead to insomnia. Turning down the bedroom temperature at night, using a fan and choosing lighter bedding can help bring relief.
“Cognitive behavioral therapy can also be beneficial for some patients,” Dr. Al-Marayati adds.
“The mainstay of treatment is to replace estrogen in the body,” Dr. Al-Marayati says. “Hormone therapy is very effective, and people can see improvement within 48 hours of starting medication, but it can take up to six weeks for others to feel the effects.”
There are risks associated with hormone therapy, which involves a combination of estrogen and progesterone. “Progesterone protects the uterus from developing uterine cancer, but long-term use of progesterone increases the risk of breast cancer,” Dr. Al-Marayati explains. Hormone therapy has been associated with the formation of blood clots in the first year of use.
She says that during hormone therapy, the general recommendation is to use the lowest dose of estrogen possible. They might not stop flashes entirely, but medication can help reduce the severity and frequency.
Dr. Al-Marayati says certain antidepressants or neurological medications have also shown effectiveness for helping to manage hot flashes.
“You shouldn’t have to put your life on hold or be forced to suffer because of hot flashes,” Dr. Al-Marayati emphasizes. “My goal is to help patients overcome this as quickly as possible. If hot flashes are interfering with your life, talk to your doctor and get relief.”
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