Hot flashes and night sweats: practical ways to cope and treatments that work

What is a hot flash?

A hot flash is a sudden feeling of heat that usually spreads across your face, neck and chest. Your skin may go red, you might sweat, and your heart may race. It can last from a few seconds to several minutes, and some people feel chilly or shivery afterwards.

Night sweats are hot flashes that happen while you sleep. They can be intense enough to soak your nightclothes and bedding and disturb your sleep, which in turn can affect your mood and energy.

They happen because falling oestrogen affects the part of your brain that controls body temperature, making it more sensitive to small changes.

Quick ways to cool down

When a flash starts, these can help:

• Dress in layers you can take off easily, ideally in breathable fabrics like cotton or linen
• Keep a small fan or a cold water spray to hand
• Sip cold water
• Try slow, deep breathing — some people find paced breathing helps them ride out a flash
• Run your wrists under cold water or hold something cool

It can also help to remember that a flash will pass, and that people around you usually notice far less than you think.

Tips for night sweats and better sleep

• Keep your bedroom cool and well ventilated
• Use light, breathable bedding, and layers you can push off
• Keep a glass of cold water and a fan by the bed
• Have a spare set of nightclothes and a towel nearby so you can change quickly
• Avoid alcohol, caffeine and big meals close to bedtime
• Keep a regular sleep routine, and get up for a while if you can't get back to sleep

If poor sleep is wearing you down, mention it to your doctor — it's one of the most common reasons women seek treatment.

Know your triggers

Common triggers include:

• alcohol
• caffeine
• spicy food
• hot drinks
• smoking
• stress
• hot rooms, hot baths or heavy clothing

Triggers vary from person to person. Keeping a simple diary of when your flashes happen can help you spot your own patterns. Regular exercise, a healthy weight and stopping smoking may also help reduce symptoms.

Treatments that help

If hot flashes are affecting your life, talk to a doctor. Options include:

• HRT — the most effective treatment for hot flashes and night sweats. It replaces the hormones your body is making less of. For most women the benefits outweigh the risks, but it isn't suitable for everyone, so your doctor will discuss your personal health history.
• Non-hormonal prescription medicines — several options can reduce hot flashes for people who can't or don't want to take HRT.
• CBT — a talking therapy that has good evidence for helping women cope with hot flashes, night sweats, sleep problems and low mood.

Many herbal and 'natural' remedies are sold for hot flashes, but evidence for them is mixed, their quality and strength can vary, and some can interact with other medicines. Check with a doctor or pharmacist before trying them.

When to see a doctor

See a doctor if:

• hot flashes or night sweats are affecting your sleep, work or wellbeing
• you're under 45 and having symptoms, or under 40, as this could be early menopause
• you have night sweats along with unexplained weight loss, fever, a persistent cough or swollen glands
• you have sweats that don't fit the usual pattern, or you're not sure they're menopause-related
• you have any vaginal bleeding after menopause

Night sweats can have causes other than menopause, including infections, some medicines and, rarely, more serious conditions, so it's worth getting checked if anything feels unusual.