Hot flashes 101: What triggers them, how long they last and what you can do to cool down fast (2025)

It starts innocuously enough — maybe you're in a meeting or standing in line at the grocery store — when suddenly it feels like someone cranked an invisible furnace to hellish proportions. Within seconds, you're sweating, shivering and feeling your heart race. If you're a woman of a certain age, welcome to the world of hot flashes, menopause's most common and notorious symptom. Research in the Journal of Mid-Life Health shows that more than 80% of women experience these unpredictable waves of intense heat during this natural transition. But what exactly causes a hot flash? And aside from taking up permanent residence in your freezer, are there any real hot flash remedies? We turned to the experts to find out. But first, what is a hot flash anyway?

Table of contents

• The science behind hot flashes

• When do hot flashes start?

• What do hot flashes feel like?

• How long do hot flashes last?

• Lifestyle changes to manage hot flashes

• Consider medications

• Cooling products for hot flash relief

• Meet the experts

The science behind hot flashes

Hot flashes are all in your head — literally. They start in the hypothalamus, the temperature-control center in your brain. Normally, this area keeps your body temperature in check with the precision of a NASA engineer. But during perimenopause and menopause, your hypothalamus can, well, freak out.

"During perimenopause, the hypothalamus becomes overly sensitive due to fluctuating and declining estrogen levels," says Dr. Sherry Ross, ob-gyn and women's health expert at Providence Saint John's Health Center in Santa Monica, Calif. "Even a small shift in temperature can be misinterpreted as overheating, prompting your body to launch a full-on cool-down response: dilated blood vessels, sweating and all."

In scientific terms, these temperature swings are known as vasomotor symptoms (VMS) — and they're anything but subtle. When estrogen levels dip, the delicate balance of brain chemicals like norepinephrine and serotonin goes awry, as noted in StatPearls, a peer-reviewed medical reference. These neurotransmitters help regulate your temperature, so when they're thrown off, your hypothalamus hits the panic button and — voila! — a hot flash. This is why medications like selective serotonin reuptake inhibitors (SSRIs) that target these chemicals have been shown to help cool things down. More on that later.

When do hot flashes start?

Hot flashes often emerge when estrogen levels start fluctuating in the initial stages of perimenopause, which can start up to a decade before menopause officially begins. That means hot flashes can strike as early as your 30s. A 2025 report in NPJ Women's Health found that more than half of women ages 30 to 35 experience moderate to severe symptoms associated with menopause, including hot flashes.

What do hot flashes feel like?

The most recognizable symptom of a hot flash is a sudden, intense sensation of heat throughout your body, usually starting in your chest or face. Red blotches may dot your chest, back and arms. "These episodes tend to last one to five minutes, leaving you flushed, sweaty, clammy or even with heart palpitations," says Ross.

Night sweats — aka hot flashes that happen during sleep — are also common. These after-hours symptoms can easily disrupt your slumber, leaving you wide-eyed, drenched and exhausted. And, over time, this pattern can lead to long-term sleep disruption, wreaking havoc on everything from your cardiac health to your mood.

The severity of these symptoms varies dramatically from person to person. "While hot flashes may be milder for some, others can experience them as frequent and intense enough to interfere with daily life," says Ross.

How long do hot flashes last?

"For most women, hot flashes last about three to five years, but for others, they can persist for a decade or more," says Dr. Rhonda Voskuhl, a neurologist for the Comprehensive Menopause Care Program at the University of California, Los Angeles. In fact, some battle the heat for a gobsmacking 14 years, according to research in JAMA Internal Medicine. But before you lose your cool (wink, wink), Voskuhl notes: "Everyone experiences hot flashes differently — some people may have more than 10 hot flashes a day, while others might only deal with them occasionally."

While hot flashes are typically a normal part of the menopause journey, in rare cases they can be symptoms of other conditions, such as thyroid disease or certain cancers, or they can be side effects from certain medications, like SSRIs, says Ross. That's why it's important to consult your health care provider, especially if symptoms feel unusual or appear earlier than expected.

Lifestyle changes to manage hot flashes

There are several lifestyle changes that can go a long way in reducing the intensity and frequency of hot flashes, according to research in the journal Menopause. Here's what experts suggest:

Skip spicy foods

If you're a fan of heat — in your food, that is — it's a good idea to dial it down right now. Spicy dishes, especially those that contain jalapeño, habanero and serrano peppers can trigger hot flashes and sweating because they contain capsaicin, a chemical compound that produces heat sensations. "Capsaicin makes the blood vessels dilate and fill with blood, which causes a warm sensation — and hot flashes and sweating can occur as a result of this phenomenon," says Ross.

Limit alcoholic beverages

That nightly glass of wine you used to look forward to? It might be plotting against you. Research in the journal Nutrients suggests that any level of regular drinking increases hot flash risk, with moderate drinkers (one and a half to three drinks a day) showing double the risk and heavy drinkers (more than three drinks a day) showing more than triple the risk compared with women who abstain from alcohol.

While any alcohol can bring on the flash, Ross shares that red wine might be the biggest culprit. "Red wine causes the blood vessels to relax, vasodilate and expand, making you feel warm or flushed," she says. "Some experience intense hot flashes while others only feel warmer."

Exercise regularly

The Physical Activity Guidelines for Americans recommends exercising for at least 2.5 hours a week, whether you're hot flashing or not. But sticking to those guidelines is especially important for hot flash relief. Regular exercise that improves cardio fitness appears to retrain your body's temperature control system, making it more efficient at cooling down, potentially reducing both the frequency and severity of hot flashes, according to a small study in the journal Menopause.

However, jumping into super-intense workouts might have the opposite effect. A 2024 report from the Menopause Society found that sudden spikes in physical activity — doing way more than your usual routine — can trigger hot flashes in the short term. The key is consistency over intensity: building up your fitness gradually with steady, regular workouts rather than dramatic increases in activity.

Try stress-reduction techniques

Stress doesn't just mess with your mood — it can boost the intensity and frequency of hot flashes. That's because stress hormones like cortisol can further throw off your already sensitive internal thermostat.

Evidence-backed methods like cognitive behavioral therapy (CBT) and clinical hypnosis can make a real dent. In one randomized controlled trial of more than 180 postmenopausal women, those who received regular hypnosis saw a 74% drop in hot flash frequency and severity compared with a control group.

Another proven option? Mindfulness-based interventions (MBIs) — think meditation, body scans or guided breathing. A 2025 systematic review found that women practicing MBIs reported better sleep, improved mood, reduced anxiety and stress and a general boost in quality of life. Bonus: These practices are safe, accessible and easy to stick with.

Consider medications

"If hot flashes are severely interfering with daily life, sleep or mood — and lifestyle changes aren't helping — it's time to consider medical intervention," says Dr. Andrea Matsumura, board-certified sleep medicine physician and cofounder of the Portland Menopause Collective in Oregon. "Hormone replacement therapy (HRT) is the most effective option for those who are good candidates." If you're not a candidate for HRT, due to a history of breast cancer, blood clots or heart disease, other options include:

• Veozah: A newer, FDA-approved medication that helps reduce hot flashes by triggering temperature-regulating neurons in the brain.

• SSRIs and SNRIs: Low doses of certain antidepressants (like paroxetine or venlafaxine) can lessen hot flashes by calming the part of the brain that controls body temperature.

• Gabapentin: Originally used to treat seizures and nerve pain, this med has also proved to help with hot flashes — especially at night.

Cooling products for hot-flash relief

Will the just-right buy from Amazon cure you of hot flashes? If only! But certain cool-down products can help. Ross recommends using breathable, moisture-wicking fabrics — whether in clothes or bedsheets — and investing in a fan for your bedside to combat pesky night sweats. Here are a few more cooling products to consider:

Hot flashes can feel like an uncontrollable force taking over your body, but you have more power than you might think. The right mix of lifestyle tweaks, smart cooling strategies and medical backup when you need it can help you regain control. Every woman's experience is different, so work with your healthcare provider to figure out what combination will help you feel like yourself again.

Meet the experts

• Sherry Ross, MD, ob-gyn at Providence Saint John’s Health Center in Santa Monica, Calif.

• Rhonda Voskuhl, MD, a neurologist for the Comprehensive Menopause Care Program at UCLA

• Andrea Matsumura, MD, board-certified sleep medicine physician and co-founder of the Portland Menopause Collective in Oregon

Our health content is for informational purposes only and is not intended as professional medical advice. Consult a medical professional on questions about your health.