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Hot flushes: what helps

Cool tricks and real treatments

Perimenopause4 min read

Written by the Splash teamSources checked

On this page 4 sections
  1. Quick answer
  2. Things you can try
  3. Treatments, in the order NICE puts them
  4. Sources

Quick answer

  • Hot flushes and night sweats are classic perimenopause symptoms.
  • Layers, cool rooms and avoiding triggers help.
  • NICE says HRT first, with CBT as an option; fezolinetant is for when HRT is unsuitable.
  • Check herbal products with a pharmacist, as they can interact with medicines.

A hot flush is a sudden wave of heat, often across your face, neck and chest, sometimes with sweating, redness, a racing heart or anxiety. It can last several minutes. When they happen at night they are called night sweats. Together, doctors call them vasomotor symptoms symptoms.

Things you can try

  • Wear light layers you can take off
  • Keep your bedroom cool and use a fan
  • Keep cold water nearby, or take a cool shower
  • Notice your triggers: spicy food, caffeine, hot drinks, alcohol and smoking are common ones
  • Stay active and keep to a healthy weight if that is a goal for you
  • Try to lower stress. Slow, paced breathing or relaxation can help some people.

Treatments, in the order NICE puts them

  • [[hrt]]: NICE says to offer HRT to people with hot flushes and night sweats. For most people it is the most effective treatment.
  • [[cbt]]: menopause-specific CBT is an option alongside HRT, instead of it if HRT is not suitable, or if you would prefer not to take it.
  • Fezolinetant: since March 2026 NICE recommends this non-hormonal medicine for moderate to severe hot flushes and night sweats when HRT is unsuitable. Ask a GP or menopause specialist whether it fits you.
  • Other medicines: antidepressants (SSRIs or SNRIs) and clonidine are not routinely first-line for hot flushes alone, but your doctor may suggest them in some situations.
MythHerbal remedies are a safe, proven alternative.
Fact

The NHS says there is very little evidence on how well they work or how safe they are. NICE says some products (like black cohosh or isoflavones) may help a little, but the quality and strength vary, and they can interact with other medicines. St John’s wort in particular can interact with tamoxifen, blood thinners and some epilepsy medicines. Speak to a pharmacist or GP first.

Quick quizWho can fezolinetant be offered to under the 2026 NICE guidance?
  1. Anyone with a hot flush
  2. People with moderate to severe hot flushes when HRT is unsuitable
  3. Only people under 40
Show the answer

B. People with moderate to severe hot flushes when HRT is unsuitable

NICE TA1143 says fezolinetant can be used for moderate to severe hot flushes and night sweats when HRT is not suitable.

Sources

  1. NHS: Things you can do to help with menopause symptoms
  2. NHS: Treatment for menopause and perimenopause
  3. NICE NG23: Menopause: identification and management
  4. NICE TA1143: Fezolinetant for vasomotor symptoms
  5. NHS: Night sweats

Written by the Splash teamSources checked

This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US). How we write and check articles.

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