The most effective treatment for hot flashes is hormone therapy, according to The Menopause Society. Women who cannot take hormones, or prefer another route, have proven non-hormonal options: the prescription medicines Veozah and Lynkuet, low-dose paroxetine, gabapentin, oxybutynin, cognitive behavioral therapy, clinical hypnosis and weight loss.
Sources: The Menopause Society; Contemporary OB/GYN, October 2025.
A member of our community, almost a year into menopause, asked: “My biggest struggle was with hot flashes. Anyone have good solutions for that?” Here is what the current evidence supports.
What is a hot flash, and how long do hot flashes last?
A hot flash is a sudden wave of heat, often with sweating and a flushed face. At night it is called a night sweat. The Menopause Society reports that hot flashes occur in up to 80% of women, last a mean of 7 to 10 years, and that each one typically lasts between 1 and 5 minutes. Some women also notice chills afterward, which we cover in cold flashes in menopause.
What is the most effective treatment for hot flashes?
Hormone therapy. The Menopause Society calls it the most effective treatment for bothersome hot flashes. Its 2022 hormone therapy position statement says that for most healthy, symptomatic women under 60 and within 10 years of menopause onset, the benefits of hormone therapy outweigh the risks.
In late 2025 the FDA updated the labels on menopause hormone therapy. We explain the change in what the FDA label updates mean for women. Whether hormone therapy is right for you depends on your health history, so this is a conversation to have with a menopause-trained clinician.
Which non-hormonal prescriptions work?
The Menopause Society’s 2023 nonhormone therapy position statement recommends several options:
- Veozah (fezolinetant). A non-hormonal medicine that acts on the brain’s temperature control pathway. In December 2024 the FDA added a boxed warning about rare but serious liver injury. Blood tests are done before starting, every month for the first three months, and again at six and nine months.
- Lynkuet (elinzanetant). Approved by the FDA in October 2025 for moderate to severe hot flashes due to menopause. In the OASIS-3 trial, daily hot flashes fell from 6.7 to 1.6 with elinzanetant, compared with 6.8 to 3.4 with placebo. It was approved after the 2023 statement was written.
- Low-dose paroxetine. An FDA-approved non-hormonal option.
- Certain other antidepressants, gabapentin and oxybutynin. These are used off-label.
What helps hot flashes without a prescription?
Three approaches are recommended in the 2023 statement:
- Cognitive behavioral therapy (CBT). It reduces how much hot flashes bother you and disrupt your day.
- Clinical hypnosis. A structured program delivered by a trained provider.
- Weight loss. For women who are carrying extra weight, losing some can ease hot flashes.
Practical comfort measures are a sensible first step as well: dress in layers, keep the bedroom cool, use a fan and keep cold water close by.
Do supplements, soy or trigger avoidance help?
The 2023 statement reviewed these and did not recommend supplements and herbal remedies, soy products, cooling techniques, trigger avoidance, exercise, yoga or acupuncture as treatments for hot flashes, because studies have not shown a consistent benefit for hot flashes specifically.
Many of these habits still support your sleep, mood, heart and bones, so they remain worth doing for your overall health. If you want to try a supplement, talk with your clinician first, especially if you take other medicines.
My hot flashes are easing. Do I still need to do anything?
If they are becoming less frequent and no longer disrupt your sleep or your day, you may not need treatment. Keep tracking for a few more months so you can see the trend clearly. If they return, intensify or wake you at night, bring your log to your clinician.
How should I track hot flashes?
Hot flashes happen several times a day, so the most useful log is one you can update in the moment. On iPhone, say “Siri, log a hot flash in the Harmoni app” and it is recorded. To our knowledge, Harmoni® is the only perimenopause tracking app that logs symptoms through Siri.
Over time, Harmoni shows how your hot flashes line up with sleep, alcohol, stress and movement, and it produces a 30, 60 or 90-day trend report for your appointment. Our definitive guide to tracking perimenopause symptoms explains what to log, and our comparison of perimenopause tracking apps shows how the options differ.
Count your hot flashes for two weeks. Harmoni® is free to download, and Premium includes a 7-day free trial.
Live in Arizona or Nevada? Amsara Health, our sister telehealth practice, offers visits with menopause-trained clinicians who prescribe hormone therapy and non-hormonal options when appropriate.
Frequently asked questions
What is the most effective treatment for hot flashes?
Hormone therapy. The Menopause Society describes it as the most effective treatment for bothersome hot flashes, and its 2022 position statement says that for most healthy, symptomatic women under 60 and within 10 years of menopause onset, the benefits outweigh the risks. Your clinician can tell you whether it fits your health history.
How long do hot flashes last?
According to The Menopause Society, hot flashes occur in up to 80% of women and last a mean of 7 to 10 years. A single hot flash typically lasts between 1 and 5 minutes.
What can I take for hot flashes without hormones?
Non-hormonal prescription options include Veozah (fezolinetant), Lynkuet (elinzanetant), low-dose paroxetine, certain other antidepressants, gabapentin and oxybutynin. The Menopause Society also recommends cognitive behavioral therapy, clinical hypnosis and weight loss.
Do supplements help hot flashes?
The Menopause Society reviewed the evidence in 2023 and did not recommend supplements, herbal remedies or soy products as treatments for hot flashes, because studies have not shown a consistent benefit. Talk with your clinician before starting a supplement, especially if you take other medicines.
Can I log hot flashes by voice?
Yes, on iPhone. Say “Siri, log a hot flash in the Harmoni app” and it is recorded. You can do this each time one happens, which gives you an accurate daily count. Voice logging is available on iPhone.
Sources
- The Menopause Society. Hot Flashes (patient education). Updated 2025.
- The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause. 2022;29(7):767-794.
- The 2023 Nonhormone Therapy Position Statement of The North American Menopause Society. Menopause. 2023.
- U.S. Food and Drug Administration. FDA adds warning about rare occurrence of serious liver injury with use of Veozah (fezolinetant). Updated December 2024.
- Contemporary OB/GYN. FDA approves elinzanetant (Lynkuet) for vasomotor menopausal symptoms. October 24, 2025.
This article is for education and is not medical advice. Talk with your clinician about your own symptoms and treatment options.
