What to Know About Menopausal Hot Flashes
MenopauseManaging Hot Flashes During Menopause

Everything You Need to Know About Menopausal Hot Flashes

Everything You Need to Know About Menopausal Hot Flashes
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Updated on November 6, 2025
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About 1.3 million people enter menopause every year, and up to 80 percent of them will experience those most famous of all menopause symptoms: hot flashes.

If you’ve never experienced one before, you may assume that it’s a temporary — albeit, intense — sensation of warmth that spreads across the face and body. But in fact, there’s more to it than that.

“Hot flashes go well beyond just getting hot,” says Mary Jane Minkin, MD, a clinical professor in the department of obstetrics, gynecology, and reproductive sciences at the Yale University School of Medicine in New Haven, Connecticut, and thefounder of the website Madame Ovary.

Wondering what you can expect from a hot flash? (Or, more importantly, when will they finally go away?) Here are the answers to some of the most commonly asked questions.

What Causes Hot Flashes During Menopause?

Hot flashes may be common, but there’s a lot that researchers don’t know about them — including why, exactly, they occur. The leading theory is that menopausal hot flashes are caused by hormonal changes — such as a decline in estrogen levels — that occur before, during, and even after menopause, says Dr. Minkin.

This may then trick your hypothalamus, the region of the brain that controls the body’s internal thermostat, into assuming you’re too hot. In response, your blood vessels widen (vasodilate), which boosts your blood flow and allows more heat to escape to the skin’s surface. The result: a hot flash.

What Can Trigger Hot Flashes?

Hot flash triggers run the gamut from strong emotions to spicy food and hot drinks to (you guessed it) heat. Hot baths or too much clothing can trigger a hot flash, likely because they can cause the body’s internal temperature to rise, which causes the blood vessels to dilate, Minkin says.

Other common triggers include alcohol and caffeine; other times, stress can trigger a hot flash.

 “Some women report emotional triggers such as feeling anxious or angry,” says Kristi Tough DeSapri, MD, a clinical assistant professor of obstetrics and gynecology and internal medicine at Northwestern University in Chicago.

How Common Are Hot Flashes Related to Menopause?

About 75 percent of women begin having hot flashes when they enter perimenopause — the roughly two to eight years prior to actual menopause (defined as 12 consecutive months without menstruating).

 During perimenopause, hormones begin to fluctuate and a person’s periods become irregular and unpredictable.
An older study published in the journal Menopause found that of people who have hot flashes, about 9 percent describe them as severe, 56 percent as moderate-intensity, and 33 percent as mild.

At What Age Do Menopausal Hot Flashes Start Occurring?

“Generally, the most intense symptoms are one to two years before and after the final menstrual period,” explains Dr. DeSapri. The menopausal transition usually begins between ages 45 and 56, and tends to last for about seven years.

How Long Do People Typically Experience Hot Flashes?

For the vast majority of people, hot flashes related to menopause will last anywhere from six months to two years.

 Some women, however, can experience them for 10 years, says DeSapri.

Minkin also estimates that about 10 percent of women will have hot flashes beyond 10 years — and, for a small percentage of women, hot flashes will never go away.

Black women may also have more severe hot flashes than white women. Research published in 2022 from the Study of Women’s Health Across the Nation (SWAN), which tracks approximately 3,300 menopausal women, many of whom were born or grew up during the Jim Crow era, found that Black women were 50 percent more likely to have hot flashes and night sweats than white women.

 (Night sweats are essentially hot flashes that occur while you’re sleeping, waking you up at night.) Their hot flashes also tended to be more frequent, occurring at least every day.

But because each woman is different, there’s no way to tell how long they will last, just as there’s no way to predict when or how long a woman will go through menopause.

Could a Hot Flash Be Caused by a Condition Other Than Menopause?

Yes. Hot flashes can be common in early pregnancy; they can also be a sign of hyperthyroidism (an overactive thyroid).

 In fact, Minkin tells physicians to give their patients a pregnancy test followed by a thyroid test before assuming their hot flashes are related to menopause.

“You’d be surprised how many women in their late forties are pregnant and experiencing hot flashes,” she says. If a pregnancy test comes back negative, and the thyroid test is normal, then hot flashes may be related to perimenopause or menopause, she says.

Can You Do Anything for Hot Flashes?

While menopausal hot flashes can’t be cured, they can be managed. “Too often women are told they have to suffer through hot flashes, but that’s definitely not the case,” says Lauren Streicher, MD, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago.

She recommends finding a menopause expert via the Menopause Society’s directory, which allows you to search based on your zip code.

Some lifestyle changes may help ease hot flash symptoms. These include losing weight (for people who need to) and kicking the habit (for people who smoke).

A study published in Menopause found that women who have overweight or obesity are over twice as likely as those with a normal body mass index (BMI) to experience hot flashes.

 “The idea is that fat functions as an insulator,” says Minkin. “So the more body fat you have, the harder it is to dissipate the heat from a hot flash.
Likewise, another study found that women who smoked for less than 10 years (or not at all) experienced less intense menopausal symptoms than women who smoked for longer time periods, although researchers aren’t sure why smoking makes hot flashes worse.

Another way to treat hot flashes is with hormone therapy. If you have a uterus, hormone therapy contains estrogen and progestin; if you don't have a uterus (because you've undergone a hysterectomy), it contains only estrogen. (Taking estrogen without progesterone can increase the risk of cancer of the endometrium, or uterine lining.)

Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) can sometimes be prescribed to lower the frequency and severity of hot flashes.

 Most SSRIs are used off-label, but one of them, paroxetine, has been approved by the U.S. Food and Drug Administration (FDA) to treat hot flashes.
In addition to lifestyle changes, some people will also take botanicals such as black cohosh, chasteberry, and red clover. According to Dr. Streicher, though, the benefits (if any) may be due to the placebo effect. Note that dietary supplements and herbal remedies are not approved by the FDA, and they can interact with other medications.

 Speak to your doctor before starting any new supplements.

The Takeaway

  • Hot flashes occur in up to 80 percent of women in the years leading up to menopause (perimenopause) and during menopause, but they can also be a symptom of pregnancy or thyroid disorders.
  • Hot flashes can be triggered by spicy foods, caffeine, alcohol, and even stress. Avoiding triggers can help minimize hot flashes. Quitting smoking and losing weight can also help improve hot flashes.
  • The duration of hot flashes varies from person to person, often ranging from 2 to 10 years.
  • Lifestyle changes can help ease symptoms, but if you find your hot flashes or night sweats unmanageable, speak to your doctor about possible medication options.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Peacock K et al. Menopause. StatPearls. December 21, 2023.
  2. MacMillan C. Hot Flashes: How to Get Relief Before, During, and After Menopause. Yale Medicine. December 18, 2024.
  3. Hot Flashes. Cleveland Clinic. October 21, 2024.
  4. Huffman E. A Season of Transition: Three Things You Need to Know About Perimenopause. Harvard T.H. Chan School of Public Health. October 14, 2025.
  5. Aminimoghaddam S et al. A Review of Management of Perimenopausal Hot Flashes. Journal of Obstetrics, Gynecology, and Cancer Research. November 14, 2022.
  6. Gallicchio L et al. Risk Factors for Hot Flashes Among Women Undergoing the Menopausal Transition: Baseline Results From the Midlife Women’s Health Study. Menopause. October 2015.
  7. Harlow SD. Disparities in Reproductive Aging and Midlife Health Between Black and White Women: The Study of Women’s Health Across the Nation (SWAN). Women’s Midlife Health. February 8, 2022.
  8. Why You Get Hot Flashes During Pregnancy. Cleveland Clinic. January 8, 2025.
  9. Hot Flashes. Mayo Clinic. March 4, 2025.
  10. Karim R et al. Association of Hot Flashes With Ghrelin and Adipokines in Early Versus Late Postmenopausal Women. Menopause. January 29, 2021.
  11. Dotlic J et al. Patterns of Smoking and Menopause-Specific Quality of Life: Smoking Duration Matters More. Behavioral Medicine. November 27, 2020.
  12. Hormone Therapy for Menopause Symptoms. Cleveland Clinic. March 12, 2024.
  13. Hot Flashes: Diagnosis & Treatment. Mayo Clinic. March 4, 2025.
  14. Herbal Medicine. Johns Hopkins Medicine.
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