What's up hot stuff?
Vasomotor symptoms (VMS), commonly known as hot flashes and night sweats, are among the most common symptoms of menopause and affect up to 80% of women. For many, these symptoms are mild, but approximately 20–25% experience symptoms severe enough to interfere with sleep, work, daily activities, and overall quality of life.
Hot flashes can cause sudden feelings of intense heat, flushing, sweating, heart palpitations, and sometimes anxiety. Night sweats may disrupt sleep and contribute to fatigue, mood changes, and difficulty concentrating. These symptoms often begin during perimenopause and may last for several years, with some individuals experiencing symptoms for more than a decade.
Researchers now better understand why these symptoms occur. Hormonal changes, particularly declining estrogen levels, affect temperature regulation in the brain, leading to episodes of heat and sweating. This has led to the development of newer non-hormonal treatment options called neurokinin receptor antagonists. Fezolinetant, the first medication in this class approved in Canada, works by targeting the brain pathways involved in hot flashes and may help reduce the frequency and severity of symptoms.
Menopausal hormone therapy (MHT) is the most effective treatment for hot flashes and night sweats. It may also help improve sleep, mood, vaginal and bladder symptoms, and support bone health. Depending on your medical history and whether you have a uterus, treatment may include estrogen alone or estrogen combined with progesterone. MHT is available in several forms including pills, patches, gels, and vaginal products.
For those who cannot or prefer not to use hormones, non-hormonal prescription options are also available. These may include certain antidepressants, gabapentin, and newer medications such as fezolinetant, a non-hormonal treatment specifically developed to reduce hot flashes by targeting temperature regulation pathways in the brain.
Treatment is individualized, and together we can review the risks, benefits, and options to find the approach that best fits your symptoms, health history, and goals.
