Hot flushes and night sweats

What they are

Hot flushes and night sweats are known together as vasomotor symptoms, and the NHS lists them among the most common symptoms of perimenopause and menopause. A hot flush is a sudden feeling of heat that spreads through the upper body and face, often with sweating, flushing and a racing heart, and night sweats are the same thing during sleep. The mechanism is specific: as oestrogen falls and fluctuates, the hypothalamus, the brain's thermostat, narrows the temperature range it treats as comfortable, so small changes that you would normally not notice trigger the body's cooling response of flushing and sweating.

How often and how severely they happen varies a great deal between women. For some they are an occasional nuisance; for others they disrupt sleep and daily life for years. Tracking how often they occur and what seems to set them off can make a conversation with your GP more useful.

What the evidence says helps

The NHS suggests practical, lifestyle-based steps first: wearing light layers you can remove, keeping bedrooms and workspaces cool, using a fan, and cutting back on common triggers such as caffeine, alcohol, spicy food and smoking where they appear to make symptoms worse. Regular exercise and steps to manage stress support general wellbeing, though they are not a guaranteed fix for flushes themselves.

For symptoms that affect daily life, NICE guidance (NG23) describes hormone replacement therapy as an effective treatment for hot flushes and night sweats for many women, and sets out the benefits and risks to weigh up with a clinician. NICE also recognises that some women cannot or prefer not to take HRT, and that a GP can discuss non-hormonal options and talking therapies. The right choice is individual, which is why it is a clinical decision rather than something to self-manage with products bought online.

Where supplements fit

No supplement is authorised to claim it treats hot flushes, and the evidence for the botanicals most often marketed for them, such as black cohosh and red clover, is mixed and inconsistent. Some can interact with medication or, in the case of black cohosh, have been linked in rare cases to liver problems, so the standing advice is to tell your GP or pharmacist before trying one. Because hot flushes are driven by hormonal change rather than diet, this is one of the symptoms where supplements have least to offer. Our guide to supplements for menopause sets out what the evidence does and does not support.

When to see your GP

See your GP if hot flushes or night sweats are affecting your sleep, work or daily life, or if you want to discuss treatment options such as HRT. The NHS encourages seeking help rather than struggling on. A GP can also rule out other causes of flushing and sweating, which is worth doing rather than assuming everything is hormonal.