A GP guide
Hot flushes in menopause: causes, triggers and what helps
You are mid-sentence in a meeting, or waiting at the school gate, when heat rushes up your chest and floods your face. Once you understand what sets it off and which options work, those moments become something you can plan around, and for many women something that settles right down.
The short answer
Hot flushes are sudden waves of heat in the face, neck and chest, sometimes with sweating and a racing heart, usually lasting 30 seconds to a few minutes. Around 80% of women get them as oestrogen changes (Department of Health). Knowing your triggers, cooling strategies, CBT, hypnosis, menopause hormone therapy (MHT) and non-hormonal options can all reduce them.
What does a hot flush feel like?
Most women describe a sudden feeling of heat that starts in the chest and spreads to the neck and face. The skin may redden and sweat, and some women notice a racing heart or a wave of anxiety at the same time. Each flush usually lasts from 30 seconds to a few minutes (Department of Health; Healthdirect).
A night sweat is simply a hot flush that happens at night. Our guide to night sweats and the 3am wake-up covers the night-time side in more detail.
Hot flushes often begin in perimenopause, while periods are still coming. A large Australian study of more than 5,500 women found new hot flushes and sweats were nearly five times more likely in perimenopause than before it, and almost 40% of perimenopausal women had bothersome symptoms that were not being treated (RACGP newsGP).
Why do hot flushes happen?
Your brain keeps your body temperature inside a comfortable range. As oestrogen falls, that range narrows, so even a small rise in core temperature can set off a flush as the body tries to cool down (Healthdirect). Researchers have traced this to a group of nerve cells in the temperature-control centre of the brain, which is the target of some newer treatments (AJGP).
Bothersome hot flushes are more likely with early menopause (before 45), smoking, or past cancer treatment (Healthdirect).
How long do hot flushes last?
For some women they ease within two to five years, but the median is about seven years, and 10 to 20% of women have them for up to 12 years (Healthdirect). They can continue past 60: in one Australian study, 42% of women aged 60 to 64 were still having them (AJGP).
What triggers hot flushes?
Triggers vary from person to person. Commonly reported ones include (Healthdirect; Department of Health):
| Common trigger | Something to try |
|---|---|
| Hot drinks and spicy food | Let drinks cool, keep cold water close by |
| Alcohol and caffeine | Notice whether flushes follow them, and cut back if so |
| Stress and anxiety | Slow breathing at the first sign of a flush, and CBT for longer-term help |
| Smoking | Ask your GP about support to quit |
| Warm rooms and heavy clothing | Layers you can peel off, a fan at your desk |
A two to four week symptom diary is one of the most useful things you can bring to an appointment (Department of Health).
What can I do at home to ease hot flushes?
- Dress in layers of loose, natural fibres you can remove quickly.
- Keep cool at night with cotton sheets and light bedding.
- Cool down fast with cold water, a cool shower, or a cold pack in your hand or on the back of your neck.
These tips come from the Australian Government’s guide to managing symptoms at home (Department of Health). At work, it is reasonable to ask about a desk fan, a cooler spot, flexible uniforms or extra breaks. The government encourages employers to offer these (Department of Health).
What treatments help with hot flushes?
- Menopause hormone therapy (MHT). Jean Hailes describes MHT as the most effective medicine for reducing hot flushes and night sweats (Jean Hailes). Whether it suits you depends on your health history, so it is a decision made with a doctor.
- Non-hormonal prescription options. For women who cannot take MHT or prefer not to, several non-hormonal options are available, including a newer type that works on the brain’s temperature-control pathway (Department of Health; AJGP).
- Cognitive behavioural therapy (CBT). CBT, in a group, one on one, or through a self-help book or online program, can reduce how bothersome flushes feel and improve sleep (Jean Hailes; AJGP).
- Clinical hypnosis. This may reduce hot flushes and night sweats and improve sleep (Department of Health).
Good to know
The Australasian Menopause Society says no complementary therapy is as effective as oestrogen, and evidence for herbal products is limited (AMS). If you take supplements, tell your doctor, as some interact with other medicines (Healthdirect). If you have had hormone-sensitive breast cancer, non-hormonal options are usually the focus (Jean Hailes).
Our overview of menopause treatment options in Australia explains MHT and non-hormonal care side by side.
Could it be something other than menopause?
Sometimes, yes. An overactive thyroid, unsettled diabetes and some medicines can cause flushing (Healthdirect). Infection, anxiety or panic, and some breast cancer treatments can also cause or worsen flushes and sweats (AJGP). That is why a proper history, and sometimes a blood test, matters before putting everything down to menopause.
When to see a GP
Book an appointment if hot flushes are affecting your sleep, work or daily life (Healthdirect).
Get help promptly if:
- you have any bleeding after menopause (12 months or more without a period): it always needs checking (Department of Health)
- you have very heavy or irregular bleeding that is affecting your life, or bleeding after sex (Department of Health)
- you notice a significant unexplained change in your weight (Department of Health)
- you have chest pain or shortness of breath: seek urgent medical attention (Department of Health)
Not sure whether your symptoms add up to perimenopause? The free perimenopause self-check is a gentle place to start.
Key points
- Around 80% of women have hot flushes, often starting in perimenopause (Department of Health).
- Falling oestrogen narrows the brain’s comfortable temperature range.
- The median duration is about seven years, and some women still have them past 60.
- Hot drinks, alcohol, caffeine, spicy food and stress are common triggers.
- MHT is the most effective medicine, and non-hormonal options, CBT and hypnosis can help too.
- Bleeding after menopause, or unexplained weight change, needs prompt review.
Frequently asked questions
Can you get hot flushes before your periods stop?
Yes. Hot flushes often start in perimenopause, while periods are still happening, and an Australian study found they were nearly five times more likely in perimenopause than before it (RACGP newsGP).
Do hot flushes ever stop?
For most women they ease with time, but the median is about seven years and 10 to 20% of women have them for up to 12 years (Healthdirect). Treatment can help at any stage.
What is the most effective treatment for hot flushes?
Jean Hailes describes menopause hormone therapy (MHT) as the most effective medicine for hot flushes and night sweats. Non-hormonal options, CBT and clinical hypnosis are alternatives if MHT is not suitable (Jean Hailes; Department of Health).
Do natural remedies work for hot flushes?
The evidence is limited. The Australasian Menopause Society says no complementary therapy is as effective as oestrogen (AMS). Tell your doctor about anything you take.
Talk it through with a menopause GP
You deserve time to talk it through. Our menopause GPs offer an unhurried 40-minute consult, in person with Dr Natasha Paul at West Pennant Hills, or by video Australia-wide with Dr Priya Ashwath. No referral is needed. Initial 40-minute consult $330, about $202 out of pocket after the $128.35 Medicare rebate.
Book your appointment →Or call us02 9680 9644
This article is general information and is not a substitute for individual medical advice.
Sources
- Healthdirect: Hot flushes due to menopause (reviewed April 2025)
- Healthdirect: Menopause (reviewed November 2025)
- Jean Hailes: Treatments for menopause (updated August 2026)
- Australasian Menopause Society: Complementary medicines and therapies for hot flushes (updated April 2025)
- Australian Journal of General Practice (RACGP): An update on the use of non-hormonal therapies for vasomotor symptoms (April 2026)
- RACGP newsGP: Vasomotor symptoms key to perimenopause diagnosis (July 2025)
- Australian Government Department of Health, Disability and Ageing: Perimenopause symptoms
- Australian Government: Managing your symptoms at home
- Australian Government: Treatment options
- Australian Government: Getting help
- Australian Government: Perimenopause and menopause in the workplace