# Hot flushes: what helps

> Cool tricks and real treatments

Category: Perimenopause · 4 min read · Written by the Splash team · Sources checked October 2026
URL: https://splash.care/learn/perimenopause/hot-flushes

## 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](https://splash.care/learn/mind-mood/luteal-anxiety). It can last several minutes. When they happen at night they are called night sweats. Together, doctors call them [Vasomotor symptoms](https://splash.care/learn/glossary#vasomotor) 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](https://splash.care/learn/nutrition/caffeine-alcohol), 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](https://splash.care/learn/cycle-basics/stress-travel-illness). Slow, paced breathing or relaxation can help some people.

## Treatments, in the order NICE puts them

- **[[hrt]]:** NICE says to offer [HRT](https://splash.care/learn/perimenopause/hrt-basics) to people with hot flushes and night sweats. For most people it is the most effective treatment.
- **[[cbt]]:** [menopause](https://splash.care/learn/glossary/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](https://splash.care/learn/conditions/talk-to-your-doctor) may suggest them in some situations.

**Myth:** Herbal 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 quiz:** Who 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

Answer: 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.

> **Splash says:** think like a shark in cool water. Layers, a fan and a cold drink are your best friends.

### When to see a doctor

See a GP if hot flushes or night sweats affect your sleep, work or life. The NHS also says to see a GP if night sweats come with a very high temperature, shivering, a cough or diarrhoea, or you are losing weight for no reason, as they can have other causes.

## Sources

1. [NHS: Things you can do to help with menopause symptoms](https://www.nhs.uk/conditions/menopause-and-perimenopause/things-you-can-do/)
2. [NHS: Treatment for menopause and perimenopause](https://www.nhs.uk/conditions/menopause-and-perimenopause/treatment/)
3. [NICE NG23: Menopause: identification and management](https://www.nice.org.uk/guidance/ng23)
4. [NICE TA1143: Fezolinetant for vasomotor symptoms](https://www.nice.org.uk/guidance/ta1143)
5. [NHS: Night sweats](https://www.nhs.uk/symptoms/night-sweats/)

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).