Hot flushes and night sweats: what's happening and what helps
6 min read
Around 75% of women experience hot flushes during menopause. They're one of the most disruptive symptoms — affecting sleep, concentration, and confidence. Understanding what triggers them, and what the options are, can make a real difference.
What causes hot flushes?
Hot flushes are caused by oestrogen's effect on the hypothalamus — the brain's temperature-regulation centre. As oestrogen declines, the hypothalamus becomes more sensitive to small changes in body temperature, triggering inappropriate cooling responses: blood vessels dilate, you sweat, your heart rate rises. A flush typically lasts 2–4 minutes.
Common triggers
Triggers vary between women, but commonly include: alcohol (particularly wine), caffeine, spicy food, hot drinks, stress, a warm room, synthetic clothing, and vigorous exercise. Tracking helps you identify your personal triggers — the pattern often isn't obvious in the moment but becomes clear over weeks.
What actually helps?
Menopause-specific CBT is one non-hormonal option recommended by NICE for vasomotor symptoms. Cooling strategies, breathable clothing and noticing personal triggers may also make episodes easier to manage.
HRT: Hormone replacement therapy is an effective treatment for vasomotor symptoms. Whether it is suitable depends on your symptoms, health history, preferences and individual risk factors, so discuss the benefits and risks with a qualified healthcare professional.
Non-hormonal options: Several prescription treatments are available when HRT is not suitable or preferred. A clinician can help identify an appropriate option.
Night sweats
Night sweats are hot flushes that occur during sleep. The sleep disruption can add to fatigue, mood changes and difficulty concentrating. A cooler room, breathable bedding and easy access to water may help. If symptoms are persistent or disruptive, ask a healthcare professional about treatment options.
Clinical reference points
Reviewed against these public guidance sources in September 2026. Content is educational and is not represented as clinician-reviewed.
Educational content only. This guide is intended to inform, not to replace medical advice. Always discuss symptoms and treatment options with a qualified healthcare provider who knows your full history.
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