Hot Flashes After Menopause

More than 80% of people get hot flashes at some point before or after menopause.1

Changing hormones are believed to be the cause of hot flashes and other symptoms of menopause, including anxiety, insomnia, joint pain, and trouble with memory.

For some people, these symptoms, including hot flashes, may linger after menopause. Here’s what you should know about experiencing hot flashes after menopause, including possible causes and when you should talk to your doctor.

What Is a Hot Flash? 

A hot flash is a sudden sensation of warmth in the upper body. It’s typically felt on the face, neck, and chest. A person’s face may appear red during a hot flash, and they may sweat and feel anxious.

Hot flashes can occur both day and night. “Night sweats” is the term used to describe nighttime hot flashes, which can disrupt sleep.

Some people only experience occasional hot flashes, while others have them frequently throughout the day. Even though hot flashes are a normal response to the changes occurring in the body, they can be uncomfortable and unsettling.2

Symptoms that can occur with hot flashes include:

• Flushed appearance (red, blotchy skin)
• Warmth spreading across the upper body
• Sweating
• A chilled feeling when the hot flash stops
• Fast heartbeat
• Anxiety

Hot flashes occur when estrogen levels in the body drop. Estrogen is a hormone that is responsible for the regulation of the reproductive system in people with a uterus.

Falling estrogen levels affect the hypothalamus, the part of the brain that controls appetite, body temperature, hormones, and sleep patterns. The hypothalamus is sometimes called the body’s thermostat because of the role it plays in regulating body temperature.

Other things that can cause hot flashes include:  

• Alcohol
• Caffeine
• Cancer and/or cancer treatment 
• Medication side effects
• Pregnancy
• Thyroid issues

The intensity and frequency of hot flashes vary. Some people experience them multiple times a day, and others will only have the occasional hot flash. Hot flash episodes usually last anywhere from one to five minutes at a time.1

On average, hot flash symptoms last for seven or more years before and after menopause, though some people may have them for 10 years or longer.

The time at which you first start having hot flashes may indicate how long you’ll get them. For example, research has found that people who had hot flashes before menopause experienced them for nearly 12 years, compared to people who had their first hot flash after menopause, who experienced them for three years, on average.3

Risk Factors

Some people do not experience hot flashes as part of the menopause transition, but there are some things that might make a person more likely to get them.1

Factors that might increase your chances of having hot flashes include:

• You had premenstrual syndrome (PMS) when you were menstruating.
• Your race: Black people going through menopause experience hot flashes at a higher incidence than other races, while Asian people going through menopause report the lowest incidence of hot flashes.
• You have a high body mass index (BMI), which is associated with more frequent and intense hot flashes.
• You currently smoke or smoked in the past.

Managing Hot Flashes

You might be able to manage your hot flash symptoms with some simple home remedies. Here are a few things you can try:

• Avoid spicy foods. When you eat spicy foods, your body’s core temperature goes up and you might even start sweating. It can help to pay attention to what you eat and drink, and note if certain foods or beverages trigger a hot flash.
• Consider black cohosh. Studies have suggested that this herbal remedy might relieve some menopause symptoms, including hot flashes.5 While some research looking at specific products (Remifemin, Phytopharmica/Enzymatic Therapy) showed a modest reduction in menopausal symptoms, studies on other formulations have shown mixed results.6 Black cohosh is available in various forms in health food stores. However, as with any herbal remedy, talk to your doctor before using black cohosh. 
• Wear cotton pajamas and/or use cooling sheets. Hot flashes can prevent you from getting a good night’s sleep. Wearing cotton pajamas and/or using cotton or cooling sheets may offer relief from hot flashes and night sweats, and help you get better sleep. 
• Dress in layers. Changes in your body’s core temperature may trigger a hot flash. Dressing in layers can be helpful because it allows you to quickly remove clothing when you get warm and feel a hot flash coming on. 

• Keep it cool. Open your windows or use a fan or air conditioner to lower the temperature in your home.
• Limit alcohol and caffeine. Both of these substances may make a hot flash more likely to occur.
• Maintain your weight. Being at a higher body weight is linked to experiencing hot flashes. A nutritious diet and regular exercise can help you manage your weight.
• Meditate. A 2020 study found that meditation helps some people manage their menopause symptoms.7
• Practice mindfulness. Similar to meditation, mindfulness may help some people cope with their menopause symptoms, including hot flashes.8
• Quit smoking. Smoking is associated with a higher incidence of hot flashes. If you currently smoke, talk to your doctor about resources to quit.
• Sip cold water. Sipping on ice water, particularly at the start of a hot flash, can help cool you down.
• Use cold packs. At the onset of a hot flash, try applying a cold pack to your face or chest to soothe the warm feeling.

While hot flashes are common during menopause, some people get them intensely and often. In some cases, hot flashes are disruptive to a person’s life and can greatly affect their well-being.

If your hot flashes are interfering with your day-to-day life or preventing you from getting a good night’s sleep, talk to your doctor. There are some treatments that you might be able to try that can help control hot flashes.

Medications 

If lifestyle changes and home remedies do not give you relief from hot flashes, your doctor may prescribe medication to help.

Hormone Replacement Therapy

Hormone replacement therapy (HRT) uses medications that contain synthetic hormones to help replace the sex hormones that the body stops making after menopause.

Estrogen is most often prescribed, but if you still have a uterus, your doctor will likely also prescribe progesterone to protect against endometrial cancer (which is associated with using only estrogen therapy).

The time that you will need to use HRT will depend on how intense your symptoms are and how long they last.

Antidepressants 

Low doses of antidepressant medications may help reduce symptoms of menopause, including hot flashes. Though these generally are not as effective as hormone replacement therapy, they are an option for people who are unable to take HRT medications.

However, other antidepressants have been shown to be moderately effective at reducing symptoms, including paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and venlafaxine (Effexor).

A clinical trial in 2014 found that a low dose of Effexor worked almost as well as hormone replacement therapy for reducing hot flashes.9

Oral Contraceptives 

Oral contraceptives, or birth control, contain combinations of estrogen and progesterone. Though menopause marks the end of a person’s childbearing years, birth control can be prescribed to help regulate hormones and reduce hot flashes and night sweats.

These medications are often prescribed before menopause (perimenopause) when your periods are irregular and you might first start experiencing menopause symptoms.

Research suggests that these medications may improve menstrual irregularity and vasomotor symptoms (which include hot flashes) of menopause.10

Other Medications

There are also other types of medications that might help with hot flashes.2 Your doctor might also consider prescribing:

• Gabapentin: This is an anti-seizure medication that may help reduce hot flashes.
• Pregabalin (Lyrica): This is another anti-seizure medication that can effectively reduce hot flashes.
• Oxybutynin (Ditropan XL, Oxytrol): Often used to treat urinary conditions, oxybutynin may also help relieve hot flashes. 
• Clonidine (Catapres, Kapvay, and others): Typically used to treat high blood pressure, this medication may reduce hot flashes.

If your doctor prescribes medications to help manage your hot flashes, take them exactly as instructed. If you get side effects, do not stop taking your medication until you have talked to your doctor.

Frequently Asked Questions

When do hot flashes stop after menopause? 

Many people experience hot flashes for years after their final menstrual cycle. Hot flashes last for seven years after menopause, on average, though some people have them for 10 years or more. 

Can you still get hot flashes years after menopause? 

Yes. Hot flashes are common after menopause and may continue for 10 years or more after your last menstrual period.

What causes hot flashes well after menopause? 

Most hot flashes are caused by changes in hormone levels that occur before, during, and after menopause. It can take the body years to adjust to the drop in estrogen, and some people still get hot flashes well into their 70s. 

What causes night sweats years after menopause? 

People sometimes continue to have nighttime hot flashes, known as “night sweats,” well after menopause. A decrease in estrogen levels is the primary cause of night sweats after menopause. 

How soon do hot flashes start after surgical menopause? 

Surgical menopause essentially begins on the day of the surgery. The abrupt loss of hormones produced by the ovaries can cause intense hot flashes immediately after the procedure.

A Word From Verywell

Menopause is a time of major change and transition in a person’s life. The shift in hormone levels can cause unsettling symptoms like hot flashes that can affect your physical and mental well-being.

While hot flashes are common for people as they go through the menopause transition—and even after—the symptom can be disrupting. If you are having hot flashes that interfere with your ability to get restful sleep and are affecting your daily activities, talk to your doctor.

There are some home remedies, like keeping your home cool and avoiding foods or drinks that trigger hot flashes, that might help. If these changes are not enough, your doctor might be able to prescribe medication to help ease your hot flashes