Vasomotor Symptoms in Menopause

Understanding Hot Flashes and Night Sweats

Pills on a night table and senior woman sleeping

Vasomotor symptoms of menopause are hot flashes or night sweats that result from hormonal fluctuations.

What are Vasomotor Symptoms?

Vasomotor symptoms are the medical term for hot flashes, the most common symptom of the menopause transition and menopause. Many women call hot flashes "night sweats" when they happen at night. (Very rarely, hot flashes occur for reasons other than menopause, such as with a condition called carcinoid syndrome.)

What Do Hot Flashes Feel Like?

Hot flashes usually start suddenly, with a feeling of heat around the upper chest and face that then spreads. The feeling of heat, accompanied by heavy sweating and sometimes palpitations, lasts for around two to four minutes. After that, some women feel chills, shivering and a feeling of anxiety.

Some women average just one hot flash a day, while others have one every hour all day and night. When hot flashes occur at night, they can be very disruptive to sleep.

How Common Are Hot Flashes in Menopause?

Hot flashes are extremely common in menopause. Up to 80 percent of menopausal women in the U.S. experience hot flashes. They are more common late in the menopause transition into early post-menopause.

Although it was once that that hot flashes stopped within a few years, there's growing research that they can last far longer than previously believed. According to the North American Menopause Society, for most women, hot flashes last for five to seven years, but for others they can last for longer than 10 to 15 years.

Some women may even experience hot flashes for more than 20 years.

What Causes Vasomotor Symptoms?

During the menopause transition, levels of the hormone estrogen fall. Estrogen withdrawal is the cause of hot flashes. The loss of estrogen disrupts the body's ability to regulate heat properly, causing a sweating response at lower-than-normal core body temperatures.

During a hot flash, the feeling of heat is caused by the sudden opening of the blood vessels close to the skin, followed by increased blood flow. Sweating lowers the core body temperature, and then may lead to shivering to increase the temperature back to normal.

Hormonal Treatments for Vasomotor Symptoms

Menopausal hormone therapy (MHT) is very effective for treating vasomotor symptoms that are moderate to very severe.

If you no longer have your uterus, you can take estrogen alone. Women who still have their uterus will be prescribed a combination of estrogen and progestin. Progestin is needed to prevent uterine cancer.

However, because MHT is associated with heart attacks, breast cancer, blood clots and strokes in older postmenopausal women, women are advised to use the smallest dose for the shortest amount of time possible (no longer than five years).

Women with a history of certain conditions - breast cancer, coronary heart disease, blood clots, heart attack and stroke - should consider alternatives to hormone therapy.

Women at high risk for these complications should also consider alternatives.

Non-Hormonal Treatments for Hot Flashes

Women who can't use hormones, or who choose not to, do have many other alternatives.

The North American Menopause Society released a position statement in 2015 on non-hormonal treatments for vasomotor symptoms in menopause. Here's what they said:


Recommend with caution (additional studies of these therapies are warranted):

  • weight loss
  • mindfulness-based stress reduction
  • the S-equol derivatives of soy isoflavones
  • stellate ganglion block

Do not recommend at this time (there are negative, insufficient or inconclusive data suggesting the following should not be recommended as proven therapies for managing VMS):

  • cooling techniques
  • avoidance of triggers
  • exercise
  • yoga
  • paced respiration
  • relaxation
  • over-the-counter supplements
  • herbal therapies
  • acupuncture
  • calibration of neural oscillations
  • chiropractic interventions

‚ÄčOf course, the best treatment for you is what works for you. Many women with mild hot flashes say they find relief from strategies such as lowering the room temperature, using fans, dressing in layers that can be easily shed and avoiding triggers like spicy foods.

Pronunciation: Vay-zoh-MO-ter Simp-tums

Also Known As: Hot Flashes, night sweats, sweats, flushes

Examples: Nancy noticed that her vasomotor symptoms diminished about a year after menopause.


Menopausal hot flashes. UpToDate. February 16, 2016.

Treatment of menopausal symptoms with hormone therapy. UpToDate. December 15, 2015.

Patient information: Menopausal hormone therapy (Beyond the Basics). UpToDate. July 6, 2015.

Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause: The Journal of The North American Menopause Society. Vol. 22, No. 11, pp. 000-000.

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