What to do against hot flushes: practical relief during perimenopause and menopause

If you’ve ever woken up drenched in sweat or found yourself fanning your shirt in a meeting, you know how annoying and disruptive hot flushes can be. They’re one of the most common symptoms of perimenopause and menopause - and for many women, also one of the most frustrating. But there’s good news: There are ways to reduce their intensity and frequency, and to feel more in control again.

What causes hot flushes during menopause?

Hot flushes are triggered by fluctuating hormone levels, especially oestrogen. This hormone doesn’t just regulate your cycle; it also helps control body temperature. As levels decline, your brain’s thermostat (the hypothalamus) becomes more sensitive. A small rise in temperature can suddenly set off a chain reaction: blood vessels dilate, your heart rate increases, and sweat pours out as your body tries to cool down. Some women experience occasional mild flushes, while others face intense, daily episodes that disturb sleep, work, and confidence.

How long do hot flushes last?

Every woman’s experience is different. For some, they last a few months. For others, hot flushes can continue for several years into postmenopause. On average, studies suggest they last between four and seven years - but they do usually ease over time.

Lifestyle changes that can reduce hot flushes

Dressing in layers: Wearing breathable clothing that you can easily remove helps you cool down quickly when a flush starts. Cotton and natural fabrics are often more comfortable than synthetics.

Keeping your bedroom cool: Night sweats can disrupt rest, so it helps to keep the bedroom temperature low and use lightweight, breathable bedding. Some women even find cooling pillows or mattress toppers useful.

Regular movement: Exercise doesn’t just support your bones and muscles; it also helps regulate hormones, improve sleep, and lower stress - all of which can ease hot flushes. Even a daily walk makes a difference.

Managing stress: Stress is a common trigger. Techniques like meditation, deep breathing, yoga, or even a few minutes of mindful stillness can calm your nervous system and help reduce the frequency of flushes.

Nutrition and supplements for hot flush relief

What you eat can play a role in how often hot flushes strike. Some women find relief from certain foods and nutrients that support hormonal balance and temperature regulation.

Phytoestrogen-rich foods: Soy, flaxseeds, and chickpeas are good examples. These contain plant-based compounds that mimic oestrogen in the body and may help soften the impact of fluctuating hormones.

Vitamin E and folic acid: Some studies suggest that these vitamins can reduce the frequency and intensity of hot flushes. They may also support overall energy and mood, which often take a hit during menopause.

Omega-3 fatty acids: Oily fish such as salmon, sardines, and mackerel, as well as walnuts and flaxseeds, are rich in omega-3s. These healthy fats support brain and heart health and may also reduce inflammation that contributes to hot flushes.

Magnesium: This mineral helps regulate the nervous system and body temperature. Leafy greens, almonds, pumpkin seeds, and dark chocolate are excellent sources. Some women find that magnesium improves sleep as well as easing flushes.

Staying hydrated: It might sound simple, but water really matters. Regular hydration helps regulate body temperature and replaces the fluids lost through sweating during night sweats or flushes.

Supplements: Some women turn to herbal options such as black cohosh or red clover. Both have been studied for hot flush relief, with mixed results. They may work for some but not all, and black cohosh in particular should only be used under medical guidance because of rare reports of liver problems.

Medical treatments for severe hot flushes

For women whose daily lives are heavily disrupted, medical treatment may be the most effective route.

Hormone replacement therapy (HRT): HRT is considered the most effective treatment for hot flushes, as it directly restores the hormones that are declining. However, it’s not suitable for everyone, so a healthcare provider will help determine if it’s right for you.

At Flouria, we offer a personalised care trajectory for perimenopause, including consultations with perimenopause experts and prescription of HRT. For more information, click here.

Non-hormonal medications: Some antidepressants, blood pressure medicines, and anti-seizure drugs have been shown to reduce hot flushes in certain women. These can be an alternative if HRT isn’t an option.

Coping strategies when a hot flush happens

Even with prevention strategies, flushes can still appear at inconvenient moments.

Slow, steady breathing: Pausing to take calm, deep breaths can ease the nervous system and sometimes lessen the intensity of the flush.

Cool water: Sipping water helps rehydrate and cool the body from the inside out. Keeping a glass nearby - especially at night - can make a difference.

Fans and sprays: Handheld fans, cooling sprays, or a quick splash of cold water can provide instant relief, whether you’re at work, out and about, or trying to fall back asleep.

Most importantly, remember that hot flushes are not something to feel embarrassed about. They’re a natural part of the body’s hormonal transition.

Key takeaways

Hot flushes are caused by changes in oestrogen levels during perimenopause and menopause.
They usually last several years but tend to ease over time.
Lifestyle changes such as stress management, movement, and cooling strategies can help.
Phytoestrogen foods, vitamin E, and folic acid may provide added relief.
HRT and non-hormonal medications are available for severe cases.
Coping strategies like breathing, hydration, and fans can help in the moment.

References:

Avis, N. E., Levine, B. J., Danhauer, S., & Coeytaux, R. R. (2019). A pooled analysis of three studies of nonpharmacological interventions for menopausal hot flashes. Menopause, 26(4), 350–356. https://doi.org/10.1097/gme.0000000000001255

Bansal, R., & Aggarwal, N. (2019). Menopausal Hot Flashes: A Concise Review. Journal of Mid-Life Health, 10(1), 6–13. https://doi.org/10.4103/jmh.JMH_7_19

Handley, A. P., & Williams, M. (2015). The efficacy and tolerability of SSRI/SNRIs in the treatment of vasomotor symptoms in menopausal women: A systematic review. Journal of the American Association of Nurse Practitioners, 27(1), 54–61. https://doi.org/10.1002/2327-6924.12137

Maghalian, M., Hasanzadeh, R., & Mirghafourvand, M. (2022). The effect of oral vitamin E and omega-3 alone and in combination on menopausal hot flushes: A systematic review and meta-analysis. Post Reproductive Health, 28(2), 93–106. https://doi.org/10.1177/20533691221083196

Palacios, S., Lilue, M., Mejia, A., & Menendez, C. (2017). Omega-3 versus isoflavones in the control of vasomotor symptoms in postmenopausal women. Gynecological Endocrinology, 33(12), 951–957. https://doi.org/10.1080/09513590.2017.1332588

Yelland, S., Steenson, S., Creedon, A., & Stanner, S. (2023). The role of diet in managing menopausal symptoms: A narrative review. Nutrition Bulletin, 48(1), 43–65. https://doi.org/10.1111/nbu.12607

If you’ve ever woken up drenched in sweat or found yourself fanning your shirt in a meeting, you know how annoying and disruptive hot flushes can be. They’re one of the most common symptoms of perimenopause and menopause - and for many women, also one of the most frustrating. But there’s good news: There are ways to reduce their intensity and frequency, and to feel more in control again.

What causes hot flushes during menopause?

Hot flushes are triggered by fluctuating hormone levels, especially oestrogen. This hormone doesn’t just regulate your cycle; it also helps control body temperature. As levels decline, your brain’s thermostat (the hypothalamus) becomes more sensitive. A small rise in temperature can suddenly set off a chain reaction: blood vessels dilate, your heart rate increases, and sweat pours out as your body tries to cool down. Some women experience occasional mild flushes, while others face intense, daily episodes that disturb sleep, work, and confidence.

How long do hot flushes last?

Every woman’s experience is different. For some, they last a few months. For others, hot flushes can continue for several years into postmenopause. On average, studies suggest they last between four and seven years - but they do usually ease over time.

Lifestyle changes that can reduce hot flushes

Dressing in layers: Wearing breathable clothing that you can easily remove helps you cool down quickly when a flush starts. Cotton and natural fabrics are often more comfortable than synthetics.

Keeping your bedroom cool: Night sweats can disrupt rest, so it helps to keep the bedroom temperature low and use lightweight, breathable bedding. Some women even find cooling pillows or mattress toppers useful.

Regular movement: Exercise doesn’t just support your bones and muscles; it also helps regulate hormones, improve sleep, and lower stress - all of which can ease hot flushes. Even a daily walk makes a difference.

Managing stress: Stress is a common trigger. Techniques like meditation, deep breathing, yoga, or even a few minutes of mindful stillness can calm your nervous system and help reduce the frequency of flushes.

Nutrition and supplements for hot flush relief

What you eat can play a role in how often hot flushes strike. Some women find relief from certain foods and nutrients that support hormonal balance and temperature regulation.

Phytoestrogen-rich foods: Soy, flaxseeds, and chickpeas are good examples. These contain plant-based compounds that mimic oestrogen in the body and may help soften the impact of fluctuating hormones.

Vitamin E and folic acid: Some studies suggest that these vitamins can reduce the frequency and intensity of hot flushes. They may also support overall energy and mood, which often take a hit during menopause.

Omega-3 fatty acids: Oily fish such as salmon, sardines, and mackerel, as well as walnuts and flaxseeds, are rich in omega-3s. These healthy fats support brain and heart health and may also reduce inflammation that contributes to hot flushes.

Magnesium: This mineral helps regulate the nervous system and body temperature. Leafy greens, almonds, pumpkin seeds, and dark chocolate are excellent sources. Some women find that magnesium improves sleep as well as easing flushes.

Staying hydrated: It might sound simple, but water really matters. Regular hydration helps regulate body temperature and replaces the fluids lost through sweating during night sweats or flushes.

Supplements: Some women turn to herbal options such as black cohosh or red clover. Both have been studied for hot flush relief, with mixed results. They may work for some but not all, and black cohosh in particular should only be used under medical guidance because of rare reports of liver problems.

Medical treatments for severe hot flushes

For women whose daily lives are heavily disrupted, medical treatment may be the most effective route.

Hormone replacement therapy (HRT): HRT is considered the most effective treatment for hot flushes, as it directly restores the hormones that are declining. However, it’s not suitable for everyone, so a healthcare provider will help determine if it’s right for you.

At Flouria, we offer a personalised care trajectory for perimenopause, including consultations with perimenopause experts and prescription of HRT. For more information, click here.

Non-hormonal medications: Some antidepressants, blood pressure medicines, and anti-seizure drugs have been shown to reduce hot flushes in certain women. These can be an alternative if HRT isn’t an option.

Coping strategies when a hot flush happens

Even with prevention strategies, flushes can still appear at inconvenient moments.

Slow, steady breathing: Pausing to take calm, deep breaths can ease the nervous system and sometimes lessen the intensity of the flush.

Cool water: Sipping water helps rehydrate and cool the body from the inside out. Keeping a glass nearby - especially at night - can make a difference.

Fans and sprays: Handheld fans, cooling sprays, or a quick splash of cold water can provide instant relief, whether you’re at work, out and about, or trying to fall back asleep.

Most importantly, remember that hot flushes are not something to feel embarrassed about. They’re a natural part of the body’s hormonal transition.

Key takeaways

Hot flushes are caused by changes in oestrogen levels during perimenopause and menopause.
They usually last several years but tend to ease over time.
Lifestyle changes such as stress management, movement, and cooling strategies can help.
Phytoestrogen foods, vitamin E, and folic acid may provide added relief.
HRT and non-hormonal medications are available for severe cases.
Coping strategies like breathing, hydration, and fans can help in the moment.

References:

Avis, N. E., Levine, B. J., Danhauer, S., & Coeytaux, R. R. (2019). A pooled analysis of three studies of nonpharmacological interventions for menopausal hot flashes. Menopause, 26(4), 350–356. https://doi.org/10.1097/gme.0000000000001255

Bansal, R., & Aggarwal, N. (2019). Menopausal Hot Flashes: A Concise Review. Journal of Mid-Life Health, 10(1), 6–13. https://doi.org/10.4103/jmh.JMH_7_19

Handley, A. P., & Williams, M. (2015). The efficacy and tolerability of SSRI/SNRIs in the treatment of vasomotor symptoms in menopausal women: A systematic review. Journal of the American Association of Nurse Practitioners, 27(1), 54–61. https://doi.org/10.1002/2327-6924.12137

Maghalian, M., Hasanzadeh, R., & Mirghafourvand, M. (2022). The effect of oral vitamin E and omega-3 alone and in combination on menopausal hot flushes: A systematic review and meta-analysis. Post Reproductive Health, 28(2), 93–106. https://doi.org/10.1177/20533691221083196

Palacios, S., Lilue, M., Mejia, A., & Menendez, C. (2017). Omega-3 versus isoflavones in the control of vasomotor symptoms in postmenopausal women. Gynecological Endocrinology, 33(12), 951–957. https://doi.org/10.1080/09513590.2017.1332588

Yelland, S., Steenson, S., Creedon, A., & Stanner, S. (2023). The role of diet in managing menopausal symptoms: A narrative review. Nutrition Bulletin, 48(1), 43–65. https://doi.org/10.1111/nbu.12607

What to do against hot flushes: practical relief during perimenopause and menopause