What Are Vasomotor Symptoms During Menopause?

Updated on June 03, 2023

Medically reviewed by Kiarra King, MD

This article is part of Health Divide: Menopause and Black Women, a destination in our Health Divide series.

Vasomotor symptoms (VMS) include hot flashes and night sweats. These symptoms are prevalent during perimenopause (the time leading up to menopause) and menopause (having no period for 12 straight months). They are the most common symptom people seek treatment for during menopause.

VMS affects as many as 75% of North Americans going through perimenopause, and about 25% of them seek medical treatment for their symptoms. But these symptoms affect people differently and in different frequencies. For example, Black people are more likely to experience them than White people.

This article discusses vasomotor symptoms during menopause.

A woman not feeling well on a bed at home — FG Trade / Getty Images

Vasomotor Symptoms and Black People

Decades of research have found that Black people approaching menopause experience vasomotor symptoms at a rate of 46% compared to 37% of White people. They are also less likely to receive hormone therapy or medical or mental health services.

Vasomotor Symptoms: Hot Flashes and Night Sweats

Hot flashes can occur for different reasons, including when your body experiences changes in hormone levels, which is why they are so common during menopause and the years leading up to menopause.

Hot flashes come on suddenly and last for a brief period, usually just a few minutes. During a hot flash, you may experience a sudden (and often overwhelming) sensation of warmth, skin flushing, and sweating.

Your brain's hypothalamus, which produces hormones to control many body systems, triggers a hot flash by increasing body temperature to signal you might be too warm. When hot flashes occur during sleep, they are called night sweats.

With night sweats, you may perspire profusely to the point of which your bed linens are soaked, and you need to change your clothes.

What Causes Vasomotor Symptoms?

Hormonal fluctuations (changes) cause menopausal vasomotor symptoms. By way of a normal, physiologic process, the ovaries stop functioning as they used to before menopause, and your body makes less estrogen and progesterone. Experts believe these declining hormones are responsible for VMS during menopause.

Vasomotor Symptoms Risk Factors

Researchers have found several factors that place people at risk for menopausal vasomotor symptoms, including:

Being a current or former smoker
Depressive symptoms
Older age
Being perimenopausal
Having excess weight

However, higher estradiol (the primary form of estrogen in your body during childbearing years) and progesterone levels were associated with a lower risk of hot flashes.

Statistics on Vasomotor Symptoms by Ethnicity

The Study of Women’s Health Across the Nation (SWAN), a multiracial and multiethnic study, found that ethnicity affects many outcomes. In one study, the duration of hot flashes varied as follows:

4.8 years for people of Japanese descent
5.4 years for people of Chinese descent
6.5 years for non-Hispanic White people
8.9 years for Hispanic people
10.1 years for Black people

How Are Vasomotor Symptoms Treated?

Vasomotor symptom treatment includes hormone therapy, medications, complementary and alternative medicine (CAM) therapies, and lifestyle changes.

Hormone Therapy

The goal of hormone therapy is to reduce VMS. Hormones also effectively reduce vaginal dryness, insomnia, and bone density. Hormone therapy may be estrogen-only or estrogen and progesterone. Systemic (in the bloodstream) estrogen therapy is most effective for hot flashes.

Hormone therapy may come in the following forms:

Pills
Patches
Gels
Sprays
Vaginal ring or tablet
Vaginal cream
Intrauterine device (IUD)

While hormone therapy is effective, it comes with risks and isn't for everyone. Estrogen-only therapy is associated with a higher risk of endometrial cancer and therefore is not recommended for women with a uterus. Combined hormone therapy slightly increases the risk of breast cancer but decreases the risk of colon cancer.

Hormone therapy also increases the risk of a heart attack in older people. In addition, it slightly increases the risk of stroke, blood clots, and gallbladder disease.

Medications

Some nonhormonal medications can also reduce hot flashes, including:

Selective serotonin reuptake inhibitors (SSRIs), like Brisdelle (paroxetine), Celexa (citalopram), and Lexapro (escitalopram)
Other antidepressants, like Effexor (venlafaxine) and Pristiq (desvenlafaxine)
Neurontin (gabapentin), a anti-seizure medication
Oxybutynin, a drug used for overactive bladder
Veozah (fezolinetant), the first neurokinin 3 (NK3) receptor antagonist approved by the FDA to treat hot flashes caused by menopause

Nonhormonal medication may be a good alternative to hormone therapy for those at higher risk.

Alternative Treatments

Alternative treatments often have limited evidence to support their use. However, some people prefer to try less-invasive treatments first. Alternative therapies for VMS include:

Acupuncture
Yoga
Meditation
Breathing exercises

One study found that acupuncture improved menopausal hot flashes when compared to no treatment but not compared to sham acupuncture, suggesting a placebo effect.

A randomized clinical control trial found that when people practiced yoga compared to just receiving health and wellness education or waiting and watching, hot flash frequency declined significantly. By week 10, the yoga group had a reduced frequency of 66%, the health and wellness group by 63%, and the control group by 36%.

Another study found that mind-body care, like meditation, can ease menopausal symptoms.

Lifestyle Changes

Some lifestyle changes can help you manage vasomotor symptoms. These include:

Dressing in layers
Keeping a portable fan nearby
Avoiding alcohol, spicy foods, and caffeine
Quitting smoking
Maintaining a healthy weight preferably within the range best suited for your body type as discussed with your healthcare provider.
Exploring mind-body practices

For night sweats, keep your bedding layered so it's easy to remove or add warmth. You can also turn down your thermostat at night, open a window, and keep a fan on. Keeping a change of clothes beside your bed may also help if you get too sweaty.

Can Vasomotor Symptoms Be Prevented?

Unfortunately, there isn't a way to prevent menopausal vasomotor symptoms. However, if you begin to have hot flashes or night sweats, treatment methods can reduce the frequency of the symptoms and sometimes eliminate them.

Summary

Vasomotor symptoms during menopause include hot flashes and night sweats. They are prevalent, affecting the majority of people who go through menopause. Smoking, having excess weight, depression, older age, and being in perimenopause increase the risk of experiencing VMS. Treatments include hormones, nonhormonal medication, alternative therapies like meditation and relaxation, and lifestyle changes.

12 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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By Kathi Valeii
As a freelance writer, Kathi has experience writing both reported features and essays for national publications on the topics of healthcare, advocacy, and education. The bulk of her work centers on parenting, education, health, and social justice.

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