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What causes hot flashes and how are they treated?

Medically reviewed by Dr. Nathan Roth, MDCM, FRCSC, FACOG · Updated 2026-07-26

What causes hot flashes and how are they treated?

Hot flashes and night sweats (vasomotor symptoms) are caused by changing estrogen levels that disrupt the brain’s temperature-control centre. Hormone replacement therapy is the most effective treatment for moderate to severe symptoms; non-hormonal medications and lifestyle strategies also help. HormoneFit physicians treat hot flashes for women across Ontario via virtual care.

  • Driven by estrogen fluctuation affecting thermoregulation
  • Often begin in perimenopause and can last years
  • HRT is first-line for moderate–severe vasomotor symptoms when appropriate
  • Non-hormonal options include certain antidepressants and other prescription therapies
  • Cooling strategies and trigger reduction help milder cases

Why hot flashes happen

As ovarian estrogen declines, the hypothalamus becomes more sensitive to small temperature changes. Blood vessels dilate, skin flushes, and sweating follows — sometimes overnight as night sweats that fragment sleep. Frequency and intensity vary widely between women.

Treatment options

Systemic hormone therapy is the most effective option for many candidates. Non-hormonal prescription options and lifestyle measures (layered clothing, cooler rooms, limiting alcohol/spicy triggers, paced breathing) support milder symptoms or women who cannot take HRT. See Is HRT safe? and hormone therapy at HormoneFit.

Care with HormoneFit in Ontario

HormoneFit is a physician-led virtual menopause clinic. If hot flashes disrupt work, sleep, or quality of life, book a consultation for individualized treatment.

Related HormoneFit resources

References & guidelines

  1. North American Menopause Society (NAMS) — vasomotor symptom guidance
  2. Society of Obstetricians and Gynaecologists of Canada (SOGC)

This page is educational and does not replace personalized medical advice. HormoneFit physicians assess each patient individually. Women in Ontario can book a virtual consultation.

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