Treatment for hot flashes and night sweats

Hot flashes and night sweats are the most common symptoms of the menopause transition. In a large U.S. study they lasted a median of 7.4 years, and longer for some women. Hormone therapy is the most studied treatment, and several FDA-approved non-hormonal medicines are also available. The right choice depends on your health history.

Key facts

  • A hot flash is a sudden feeling of heat in the face, neck and chest, often with flushing, sweating and a fast heartbeat. A night sweat is a hot flash during sleep.
  • In the SWAN study of U.S. women, frequent hot flashes and night sweats lasted a median of 7.4 years in total, and 4.5 years after the final period.
  • Black women in that study had the longest median duration, about 10 years.
  • Hormone therapy is FDA-approved for moderate to severe hot flashes. Not everyone is a candidate.
  • FDA has also approved non-hormonal medicines for hot flashes: low-dose paroxetine, fezolinetant and elinzanetant. Each has its own risks.
  • At Yaso Wellness you can be seen in-clinic in San Antonio, or by telehealth if you are located in Texas.

What causes hot flashes and night sweats?

As estrogen levels drop and swing, the brain's temperature control center becomes more sensitive. Small changes in body temperature can set off a hot flash. Common triggers include alcohol, caffeine, spicy food, hot rooms and stress.

Night sweats are not always caused by menopause. Infections, thyroid problems, some medicines and, rarely, some cancers can cause them. See a clinician soon if night sweats come with fever, weight loss you can't explain, or swollen glands.

How long do hot flashes last?

Longer than many people expect. The SWAN study followed women for up to 17 years. Women who had frequent hot flashes had them for a median of 7.4 years. Women whose hot flashes started early, before their periods stopped, tended to have them the longest. Hot flashes are often strongest in the first year or two after the final period.

Hormone treatment for hot flashes

Estrogen is the most studied treatment for hot flashes and night sweats. Women with a uterus also take a progestogen to protect the lining of the uterus. For many healthy women under 60, or within 10 years of menopause, the benefits may outweigh the risks. The main risks include blood clots, stroke and, with longer combined use, breast cancer. Read more on our HRT page.

Non-hormonal treatment for hot flashes

If you can't take hormones, such as after some cancers or blood clots, or you prefer not to, other options include:

  • Low-dose paroxetine (Brisdelle). FDA-approved in 2013 for moderate to severe hot flashes. Its label carries a boxed warning about suicidal thoughts, and it can make tamoxifen work less well.
  • Fezolinetant (Veozah). Works on a brain pathway that controls temperature. In December 2024 FDA added a boxed warning about rare but serious liver injury. Liver blood tests are needed before you start and during the first months.
  • Elinzanetant (Lynkuet). FDA-approved in October 2025. Common side effects include headache, tiredness, dizziness and sleepiness. Liver blood tests are advised before starting and after three months. It should not be used in pregnancy.
  • Other medicines used off-label. Gabapentin and the blood pressure medicine clonidine are sometimes used. They are not FDA-approved for hot flashes, and the evidence for them is more limited.

What can I do at home for hot flashes and night sweats?

These steps won't stop hot flashes, but they may make them easier to manage:

  • dress in layers you can take off quickly;
  • keep your bedroom cool and use a fan;
  • notice and limit your own triggers, such as alcohol or caffeine;
  • try slow, deep breathing when a hot flash starts;
  • stay active and avoid smoking.

Be careful with supplements sold for hot flashes. Most have little proof they work, and some can interact with medicines.

What to ask your clinician

  • Are my night sweats likely from menopause, or should we check for other causes?
  • Am I a candidate for hormone therapy?
  • Which non-hormonal medicines could work for me, and what tests would I need first?
  • How will these medicines interact with what I already take?
  • How long should I try a treatment before we decide if it's working?
  • What side effects should make me call right away?

FAQs

What is the most effective treatment for hot flashes? Hormone therapy is the most studied treatment. It isn't right for everyone, and non-hormonal medicines are an option when hormones are not.

Are there non-hormonal medicines for hot flashes? Yes. FDA has approved low-dose paroxetine, fezolinetant and elinzanetant. Each has risks, and some need liver blood tests.

Why are my night sweats worse in perimenopause? Estrogen levels swing more during perimenopause, which can make hot flashes and night sweats unpredictable. Poor sleep can then make other symptoms feel worse.

Can I take something for hot flashes if I had breast cancer? Estrogen is usually not used after breast cancer. Non-hormonal options may be possible, but your plan should be made with your oncologist. Some medicines, like paroxetine, can interfere with tamoxifen.

Book a visit

Get help with hot flashes and night sweats from Leticia Vargas, MD, OB/GYN. Call (210) 903-1030 or book a visit. In-clinic in San Antonio • Telehealth for women located in Texas Yaso Wellness Health Clinic, 1907 Goliad Rd, San Antonio, TX 78223

About the clinician: Leticia Vargas, MD, OB/GYN, founder of Yaso Wellness Health Clinic. About Dr. Vargas

Sources

Education only, not medical advice or a diagnosis. In an emergency, call 911.