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When it comes to how to stop hot flashes, no single fix works for everyone, but some options are backed by much better evidence than others. The Menopause Society says hormone therapy is still the most effective treatment, and its 2023 review rates cognitive behavioral therapy (CBT), clinical hypnosis, certain prescription medicines and fezolinetant among the nonhormone options with the strongest evidence (The Menopause Society, 2023). Many popular tips, such as avoiding trigger foods, exercise and supplements, have limited or inconsistent evidence.
This guide explains what a hot flash is, what you can try right now, which treatments have the strongest evidence, what we know about supplements and acupuncture, and when to see a doctor. For a full comparison of hormone therapy, nonhormone medicines and the 2025 and 2026 FDA label changes, see our guide to perimenopause treatment options, or start with our complete perimenopause & menopause guide.
Key Takeaways
- Hot flashes are the most common menopause symptom and occur in up to 80% of menopausal women (The Menopause Society). One hot flash usually lasts 1 to 5 minutes (Mayo Clinic).
- Hormone therapy remains the most effective treatment. The Menopause Society recommends CBT, clinical hypnosis, SSRIs or SNRIs, gabapentin and fezolinetant at its strongest evidence level, and oxybutynin at Levels I–II.
- Cooling techniques, avoiding triggers, exercise, yoga and supplements aren’t recommended as treatments because the evidence is limited or inconsistent, though low-risk comfort steps can still be worth trying.
- Weight loss may help some women, especially earlier in the transition, but the evidence is limited (Levels II–III).
- If hot flashes affect your daily activities or sleep, talk to a healthcare professional. Less commonly, medicines, thyroid problems or some cancers cause hot flashes (Mayo Clinic).
In this article:
- What Is a Hot Flash?
- Why Some Women Get More Hot Flashes
- What to Try Now: Comfort Steps and What the Evidence Says
- Treatments With the Strongest Evidence
- Supplements, Herbs and Acupuncture
- When Something Else Causes Hot Flashes
- How Long Do Hot Flashes Last?
- When to See a Doctor
- Hot Flashes FAQ
- Your Next Step
What Is a Hot Flash?
Mayo Clinic describes a hot flash as a sudden feeling of warmth in the upper body, most often the face, neck and chest. It can also cause sweating, flushed skin, a fast heartbeat and, afterward, a chilled feeling (Mayo Clinic). Night sweats are hot flashes that happen at night, and they can wake you from sleep. One hot flash may last 1 to 5 minutes, and most people who have them have them daily, though how often varies a lot from person to person.
Hot flashes are the most common symptom of menopause and occur in up to 80% of menopausal women (The Menopause Society, 2023). They can start in perimenopause: Mayo Clinic says changing hormone levels before, during and after menopause are the most common cause. Most research suggests that lower estrogen makes the hypothalamus, your body’s internal thermostat, react to slight changes in body temperature, which starts a chain of events to cool you down. It isn’t fully clear how the hormone changes cause this. The Menopause Society adds that small rises in core body temperature can trigger a hot flash, which is why cooling steps are so popular. Hot flashes are only one of several symptoms, and our perimenopause symptoms checklist covers the rest.
Why Some Women Get More Hot Flashes
Not everyone has hot flashes. Factors linked to having more of them include smoking, obesity or a higher body mass index, and, according to The Menopause Society, abdominal fat and surgical menopause (The Menopause Society). Mayo Clinic adds that reported rates differ by race: more Black people report hot flashes during menopause than people of other races, and Asian people report them least often (Mayo Clinic). Some of these factors, such as smoking, can be changed and others can’t, and having a risk factor doesn’t mean you will have hot flashes.
What to Try Now: Comfort Steps and What the Evidence Says
These are the steps people are most often told to try, and The Menopause Society’s 2023 review looked at each one. Its conclusion is that there is no strong evidence that lifestyle changes such as cooling techniques and avoiding triggers improve hot flashes, so it doesn’t recommend them as treatments. That doesn’t mean they can’t make you more comfortable, and most cost little or nothing (The Menopause Society, 2023).
| Approach | What the 2023 review found |
|---|---|
| Cooling techniques: dressing in layers, breathable clothing, fans, a cooler room, a cold pack under the pillow | Only small trials. One small trial of a nighttime cooling device found no objective change in the number or duration of night-time hot flashes, though women reported some sleep improvement. Larger controlled trials are needed (Level II; not recommended as a treatment). |
| Avoiding triggers: alcohol, caffeine, spicy or hot foods and drinks | No clinical trials have tested it. One study of 4,595 Chinese women linked alcohol to more hot flashes, but other studies haven’t found that (Level II; not recommended). |
| Exercise and yoga | Women who exercise regularly report fewer hot flashes in observational studies, but several Cochrane reviews found insufficient or poor evidence that exercise treats them, and exercise may trigger hot flashes in some women. It has other health benefits (Level II; not recommended for hot flashes). |
| Weight loss | Women with obesity are more likely to report frequent and severe hot flashes, and weight loss from behavioral programs has been linked to fewer hot flashes. The studies were small or weren’t designed for this, and it may help more earlier in the transition (Levels II–III; recommended for some women). |
| Diet changes | Limited evidence (Level III; not recommended). |
| Paced breathing | Unlikely to provide any benefit for hot flashes (Level I; not recommended). |
| Mindfulness-based programs | Not enough data to recommend them for hot flashes specifically (Level II; not recommended). |
Low-risk steps are still reasonable to try: dress in layers you can remove, use a fan, keep your bedroom cooler and put a cold pack under your pillow. It also helps to note when hot flashes happen for a few weeks so you can see your own patterns and have something concrete to bring to an appointment.
Treatments With the Strongest Evidence
The Menopause Society’s review sorts evidence into levels: Level I is good and consistent scientific evidence, Level II is limited or inconsistent evidence, and Level III is consensus and expert opinion (The Menopause Society, 2023). The options with the strongest evidence are:
- Hormone therapy. It remains the most effective treatment and should be considered in menopausal women younger than 60, within 10 years of their final period and without contraindications. Our guide to perimenopause treatment options covers who it suits, its risks and what changed with FDA labels.
- Cognitive behavioral therapy (CBT). CBT reduces how much hot flashes are rated as a problem. In two double-blind trials, 65% to 78% of women in the CBT groups reached a clinically significant improvement, more than in the usual-care groups, and the gains held at 26 weeks. One study in breast cancer survivors found that CBT reduced how bothersome hot flashes were but not how many there were.
- Clinical hypnosis. In a trial of 187 postmenopausal women with at least 50 hot flashes a week, self-reported hot flash frequency fell 74% with hypnosis versus 17% in the comparison group, and monitored hot flashes fell 57% versus 10%. The program was five weekly sessions plus home practice, and it can be delivered by a trained provider or through a smartphone app.
- Prescription nonhormone medicines. SSRIs or SNRIs (certain antidepressants), gabapentin and fezolinetant are recommended at Level I, and oxybutynin, a bladder medicine, at Levels I–II. Oxybutynin’s most common side effects are dry mouth and urinary difficulties, and long-term use of anticholinergic medicines may be linked to cognitive decline in older people. The FDA also approved elinzanetant in October 2025. Fezolinetant and elinzanetant carry important safety warnings, which our treatment guide covers.
Guidelines differ by country. The UK’s NICE guideline says to offer hormone replacement therapy for hot flashes and to consider menopause-specific CBT. It recommends fezolinetant when HRT is unsuitable, and it says not to routinely offer SSRIs, SNRIs or clonidine as first-line treatment for hot flashes alone (NICE). Ask your clinician which options fit your health history.
Supplements, Herbs and Acupuncture
The Menopause Society notes that evidence on dietary supplements is limited by a shortage of rigorous trials and by a lack of government regulation to ensure purity and safety, even though products are marketed with symptom claims. Its 2023 review did not recommend supplements or herbal remedies as treatments (The Menopause Society, 2023). What it found for the most common ones:
- Black cohosh. It is the most purchased botanical for menopause symptoms. A 2012 Cochrane review of 16 trials with 2,027 women found no significant difference from placebo in how often hot flashes happened, and safety data were inconclusive. Reports of possible liver problems led a US Pharmacopeial Convention expert committee to direct that products carry a warning to stop use and consult a healthcare practitioner if you have a liver disorder or symptoms of liver trouble, such as abdominal pain, dark urine or jaundice.
- Soy foods and extracts. Trials are hard to compare because they tested very different products, from soy drinks to isoflavone tablets to mixes with other supplements (Level II; not recommended).
- Acupuncture. Reviews found it may ease some menopause-related symptoms, such as mood, sleep and pain, but it had little to no clinical benefit for hot flashes compared with sham acupuncture (Level II; not recommended).
NICE takes a somewhat different view of the herbal evidence. It says there is some evidence that isoflavones or black cohosh may relieve hot flashes, but that many preparations are available, their safety is uncertain, they can vary, and interactions with other medicines have been reported (NICE). Whichever guideline you follow, talk to a clinician or pharmacist before starting a supplement, especially if you take other medicines.
When Something Else Causes Hot Flashes
Menopause is the most common cause, but Mayo Clinic says that less commonly, hot flashes and night sweats come from medicine side effects, thyroid problems, some cancers and the side effects of cancer treatment (Mayo Clinic). If your hot flashes are new and unexplained, or you take a medicine that could cause them, ask a clinician. If you’re in your 40s and your periods are changing too, our guide to irregular periods in perimenopause explains how doctors rule out other causes.
How Long Do Hot Flashes Last?
The Menopause Society says hot flashes last a mean of 7 to 9 years and, in one-third of women, more than 10 years (The Menopause Society, 2023). Mayo Clinic gives a similar picture: on average more than seven years, and more than 10 for some people (Mayo Clinic). That is a long time to wait it out, which is why the options above matter. For how this fits the wider timeline, see our article on how long perimenopause lasts, and for how long different symptoms last, see the hot flash section of our treatment guide.
When to See a Doctor
Mayo Clinic advises talking to a healthcare professional about treatments if hot flashes affect your daily activities or your sleep. Night sweats can wake you from sleep and, over time, cause long-term sleep loss (Mayo Clinic). Consider booking an appointment if: If poor sleep is leaving you exhausted, see our guide to causes of constant fatigue in women.
- Hot flashes or night sweats are disrupting your sleep, work or relationships.
- You want to explore treatment options, including hormone therapy or nonhormone medicines.
- Your hot flashes are new and unexplained, or you take a medicine or have a condition that could cause them, such as a thyroid problem.
- You want to try a supplement or herbal product, especially if you take other medicines or have a history of liver problems or breast cancer.
- As a precaution, we suggest seeking emergency care if a fast heartbeat comes with chest pain, fainting or shortness of breath.
Research suggests people who have hot flashes may have a higher risk of heart disease and greater bone loss than people who don’t (Mayo Clinic). That is an association, not proof that hot flashes cause these problems, but it is one more reason to mention frequent or severe hot flashes at your check-ups. Our appointment steps can help you get ready.
Hot Flashes FAQ
Can you stop hot flashes naturally?
Not reliably. The Menopause Society found no strong evidence that lifestyle changes such as cooling techniques and avoiding triggers improve hot flashes, and it did not recommend supplements or herbal remedies. Some steps can still add comfort. CBT and clinical hypnosis, which don’t involve medicine, are recommended at its strongest evidence level (The Menopause Society, 2023).
What triggers hot flashes?
The Menopause Society says small rises in core body temperature can trigger them. Women are often told to avoid alcohol, caffeine, spicy foods and hot foods or drinks, but no clinical trials have tested whether avoiding them helps. A diary can show whether any of these set off your own hot flashes.
Do hot flashes start in perimenopause?
They can. Mayo Clinic says changing hormone levels before, during and after menopause are the most common causes of hot flashes (Mayo Clinic). Our perimenopause symptoms checklist covers the other symptoms to look for.
How do I stop night sweats?
Night sweats are hot flashes that happen at night. The cooling measures listed in The Menopause Society review include a fan, a lower room temperature, a cold pack under the pillow and breathable clothing. The same evidence caveat applies, so if night sweats keep disrupting your sleep, talk to a clinician about treatment.
Can hot flashes be a sign of something else?
Usually they are linked to menopause, but Mayo Clinic lists medicine side effects, thyroid problems, some cancers and cancer treatment as less common causes. Research also suggests an association with heart disease and bone loss. Mention new or severe hot flashes to your clinician.
Your Next Step
Start by tracking when hot flashes happen, how strong they are and how they affect your sleep for a few weeks, using our perimenopause symptoms checklist as a guide. Then use the appointment steps in our treatment guide to talk through your options. For related reading, see perimenopause vs menopause, how long perimenopause lasts and irregular periods in perimenopause, and everything in our Hot Flashes and Night Sweats category.
Sources: The 2023 nonhormone therapy position statement — The Menopause Society (NAMS) · Full text (PDF) — The Menopause Society · Hot flashes — The Menopause Society · Hot flashes: symptoms and causes — Mayo Clinic · Menopause: identification and management (NG23) — NICE · Featured image: Shixart1985 / Wikimedia Commons (CC BY 2.0)
About the author: Jessica Bordo writes Daily Health Cycle, where she shares practical, evidence-based women’s health information. Articles are informed by sources such as the NHS, CDC and Mayo Clinic, and we link to our main sources. No medical reviewer is listed for this article, so use it to prepare questions for your own clinician, not to replace their advice. Our authors page explains how we approach accuracy and disclaimers.
This article is for general education and isn’t medical advice. Read our Medical Disclaimer and talk with a qualified clinician about your own care.
