What Are Vasomotor Symptoms During Menopause?

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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

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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:

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.


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:

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.


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.
  1. North American Menopause Society. Menopause FAQs: Hot flashes.

  2. Miller SR, Gallicchio LM, Lewis LM, et al. Association between race and hot flashes in midlife women. Maturitas. 2006 Jun 20;54(3):260-9. doi:10.1016/j.maturitas.2005.12.001

  3. University of Michigan. 25 years of research shows insidious effect of racism on Black women's menopausal transition, health.

  4. University of Washington Medicine. What happens to your body during a hot flash?.

  5. National Institute on Aging. Hot flashes: What can I do?.

  6. Gallicchio L, Miller SR, Kiefer J, et al. Risk factors for hot flashes among women undergoing the menopausal transition: baseline results from the Midlife Women's Health StudyMenopause. 2015;22(10):1098-1107. doi:10.1097/GME.0000000000000434

  7. Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transitionJAMA Intern Med. 2015;175(4):531-539. doi:10.1001/jamainternmed.2014.8063

  8. American College of Obstetricians and Gynecologists. Hormone therapy for menopause: Frequently asked questions.

  9. UpToDate. Patient education: non-estrogen treatments for menopausal symptoms.

  10. Ee C, French SD, Xue CC, Pirotta M, Teede H. Acupuncture for menopausal hot flashes: clinical evidence update and its relevance to decision makingMenopause. 2017;24(8):980-987. doi:10.1097/GME.0000000000000850

  11. Avis NE, Legault C, Russell G, Weaver K, Danhauer SC. Pilot study of integral yoga for menopausal hot flashes. Menopause. 2014;21(8):846-854. doi:10.1097/GME.0000000000000191

  12. Sung MK, Lee US, Ha NH, Koh E, Yang HJ. A potential association of meditation with menopausal symptoms and blood chemistry in healthy women: A pilot cross-sectional studyMedicine (Baltimore). 2020;99(36):e22048. doi:10.1097/MD.0000000000022048

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.