All women with ovaries experience a menopausal transition, whether naturally or due to an illness, injury, or medical procedure that affects the production of estrogen and progesterone. Some of the most common symptoms that women experience during the menopause transition, such as hot flashes, night sweats, heart palpitations, anxiety, increase in blood pressure, and sleep issues, are collectively called vasomotor symptoms.

Vasomotor symptoms of menopause are believed to be neurovascular, caused by changes in the part of the nervous system that affects circulation and the constriction (narrowing) and dilation (expansion) of blood vessels. Experts think that these occur in peri- and post-menopausal women due to fluctuations in hormones that help the brain control blood pressure and body temperature. Sudden drops in estrogen levels may trigger them, but it is unclear exactly what role this hormone plays.

Hot flashes are by far the most common vasomotor symptom. While not all women experience them, up to 75% of women in the U.S. do. While hot flashes typically occur for a period of about six months to two years, they have been known to last for up to 10 years in some cases, even continuing into the post-menopausal period of life. 

The duration and frequency of individual hot flashes varies from person to person. They can last from 30 seconds to 5 or 10 minutes and can occur several times over the course of an hour or just once a week. You may discover that your hot flashes follow a unique pattern.

Hot flashes can feel like a sudden, intense spread of heat in your torso, chest, neck, and/or face. Your skin may become red or flushed, and that may be accompanied by light perspiration or copious amounts of sweat. The sweat is your body’s attempt to cool itself down. 

Hot flashes are the most common symptom of the menopausal transition.
(This image is from Shutterstock.)

‘Night sweats’ are just hot flashes that occur while you sleep. Some people are awakened by their night sweats, and find that their pajamas and bed linens are soaked through. You may also experience a temporary racing or irregular heartbeat during hot flash episodes. 

Fortunately, there are a variety of products that are designed to ease the discomfort of hot flashes during both daytime activities and sleep. 

Menopause, and its associated symptoms, may be temporary if triggered by chemotherapy or another medical treatment. Some women experience a return of their menstrual cycles, and the disappearance of menopause symptoms, after the treatments stop. 

While hot flashes happen naturally, there are a number of ordinary actions and environmental factors that can trigger hot flashes, as well. These can include: 

• Alcohol
• Bending over
• Caffeine
• Hot weather
• Obesity
• Smoking (and inhaling secondhand smoke)
• Spicy foods
• Strenuous workouts
• Stress
• Tight or constricting clothes

Other factors that can influence how long you experience hot flashes and other vasomotor symptoms include being of African or Hispanic descent.

Vasomotor symptoms can be uncomfortable and inconvenient, but they are not dangerous. It’s important to be aware, however, that hot flashes, sweating, heart palpitations, and the like may not always signal menopause. They can occur as side effects of certain medications and could be indicators of actual health issues such as:

• Heart or vascular conditions,
• Hyperthyroidism,
• Infections, or
• Nervous system conditions.

If you experience additional symptoms like unexplained weight loss, dizziness, diarrhea, or fatigue, see your doctor.

Your doctor may also be able to help you find relief from your menopausal symptoms if they are interfering with your daily activities and quality of life. 

There are a couple of ways to treat vasomotor symptoms medically: hormone replacement therapy and antidepressants. These they should not be taken lightly, as they can both have serious side effects. 

Hormone therapy (HRT) can balance your estrogen (and sometimes progesterone) levels, potentially relieving not only vasomotor symptoms but also other menopausal symptoms such as thinning skin and hair and flagging energy. You might not be a candidate for HRT if you have a personal or family history of certain cancers, heart disease, or liver disease. 

Some doctors have prescribed low-dose antidepressants. Antidepressants can balance out your levels of the neurotransmitters norepinephrine and serotonin. It’s not completely clear why these are effective when used in this way, but studies suggest that their ability to balance your body temperature makes them effective at relieving hot flashes and night sweats. These are usually reserved for severe symptoms, however. Speak with your doctor about both benefits and risks. 

While you may not be able to prevent hot flashes from occurring, there are steps you can take to ease their effects and increase your comfort. These include:

• Avoid known triggers
• Dress in layers of light, breathable fabrics
• Exercise regularly, but avoid exercising just before bed
• Keep your bedroom at a cool temperature
• Practice stress reduction techniques
• Reach and maintain a healthy weight for your frame
• Stay well-hydrated

Even easy and short exercises at home can help prevent or reduce hot flashes.
(This image is from Shutterstock.)

Some people take herbal remedies or supplements such as black cohosh and evening primrose, but their effectiveness and long-term safety are not currently supported by scientific research. Speak with your doctor or pharmacist before using herbal remedies, as even natural substances can negatively interact with medications and other remedies, and impact underlying health issues. 

There are many things that you can do to help manage the discomfort of vasomotor symptoms both during and after your menopausal transition. Explore all your options and find out what works best for you.