Vasomotor symptoms (VMS) is the umbrella term for hot flashes, also known as hot flushes and night sweats, the most common menopause symptoms. Hot flashes and night sweats affect up to 80 percent of women going through menopause.
While VMS can present differently in different women, some of its most common symptoms may include:
- An intense or mild feeling of heat, particularly in your chest, neck, and face
- Red or flushed skin
- Rapid heartbeat
- Sweating
- Feeling chilled as the hot flash goes away
- Anxiety
Decreasing and fluctuating hormone levels trigger VMS in menopause. Possible risk factors for an increased chance of experiencing hot flashes include smoking and obesity.
Healthcare professionals can usually recognize VMS just from a description of your symptoms.
Treatment and Medication Options for Vasomotor Symptoms
A variety of treatments are available for hot flashes.
Hormonal and Nonhormonal Medications
Estrogen is the main hormone prescribed for hot flashes. The U.S. Food and Drug Administration (FDA) has removed the black box warning from hormone replacement therapies used to treat symptoms of menopause.
But risks may still vary from person to person, and they may depend on things like age or whether you’ve had a hysterectomy. (Women who still have a uterus often have to take progesterone alongside estrogen to manage endometrial cancer risk.)
Nonhormonal treatments approved by the FDA for hot flashes are the antidepressant paroxetine (Brisdelle), which is a
selective serotonin reuptake inhibitor (SSRI), and fezolinetant (Veozah) or elinzanetant (Lynkuet). Both Veozah and Lynkuet are nonhormonal medications that stabilize the brain’s thermoregulatory center to reduce menopausal hot flashes. However, while Veozah selectively blocks the neurokinin 3 (NK3) receptor, Lynkuet acts as a dual NK1 and NK3 receptor antagonist.
Some medications can also be used off-label for hot flashes. ”Off-label” means using a treatment for a purpose that is not included in its official FDA approval.
Other nonhormonal treatments a doctor may prescribe off-label include:
- Other antidepressants, like venlafaxine (Effexor XR), paroxetine (Paxil), citalopram (Celexa), or escitalopram (Lexapro)
- Anti-seizure medications, like gabapentin (Neurontin) or pregabalin (Lyrica)
- Oxybutynin (Oxytrol), commonly used to treat urinary conditions
- Clonidine (Catapres-TTS-1), which is mostly used for treating high blood pressure
Talk with your healthcare professional about your particular needs. You could also see a menopause specialist who has extra training on how to care for you during your menopause transition.
It’s not possible to prevent hot flashes altogether, but they can be managed.
Beyond medication, certain lifestyle strategies may lessen the effects of hot flashes, including:
- Cutting back on smoking
- Turning down the temperature in the room where you sleep at night
- Drinking small amounts of cold water
- Maintaining a moderate weight for your age and height
- Dressing in layers that can be removed in the event of a hot flash
Diet and Dietary Changes
Avoid or limit foods that are known to trigger or aggravate hot flashes, such as:
- Alcohol
- Caffeine
- Spicy foods
- Hot beverages
Some women consume foods that contain phytoestrogens (plant estrogen) to manage the hormonal changes that come with menopause.
Phytoestrogens naturally occur in some vegetables, cereals, herbs, and legumes, including soy. While these foods are usually considered safe for most diets, research doesn’t show them to be consistently effective for managing hot flashes. Their risks and benefits are still being studied.
Herbal supplements, like black cohosh or soy isoflavones, are also not proven to help with the effects of hot flashes. In fact, they may carry risks, like liver damage.
Talk with your doctor before making changes to your diet or adding any herbs or supplements to your wellness routine.
Complementary Therapies for Vasomotor Symptoms of Menopause
Other potential complementary treatments for hot flashes include:
- Acupuncture
- Yoga
- Cognitive behavioral therapy
- Mindfulness-based interventions
The length of each hot flash can vary from one to five minutes. The frequency and intensity vary from person to person. Many women experience hot flashes for at least seven years, with some having them for more than 10 years.
While most menopause symptoms are transitory, VMS may be associated with an increased risk of other health issues.
VMS can cause disturbances in sleep. Lack of sleep can negatively affect someone’s quality of life, including their physical and mental health. VMS is also linked to negative health outcomes, like cognitive impairment and coronary heart disease.
Rachel Green
Rachel Davis
Derek Schulz
Sophia Martinez
Dr. Amara Okafor