Hot flushes: causes, how long they last and what helps

The NHS says perimenopause and menopause are a natural part of life that happen when your periods change and eventually stop because of lower hormone levels. Hot flushes and night sweats are among the commonest symptoms. The NHS adds that ethnic background can affect symptoms and how severe they are and how long they last: women from a Black ethnic background are more likely to have hot flushes that are severe and continue longer.

Perimenopause is the time before your final period, when periods may become more or less frequent and bleeding heavier or lighter. Menopause is when you have not had a period for 12 months; after that it is called postmenopause. Symptoms can happen during perimenopause and menopause and after menopause has ended.

Hot flushes can also have other causes. The NHS says to contact a GP if you are unsure whether symptoms are menopausal, and a GP may check for other causes of sweats such as thyroid problems or medicines, so ask for an assessment if the pattern is unusual for you.

The NHS describes a sudden feeling of heat or cold across the face, neck and chest, with heavy sweating, palpitations, anxiety or dizziness, lasting several minutes. At night the sweats can wake you and make you irritable, stressed and anxious the next day.

Other menopause symptoms the NHS lists include changes to periods, sleep problems, mood changes, poor memory and brain fog, weight gain, vaginal dryness and itching, more urinary tract infections, palpitations, weakening bones, joint pains, hair thinning, skin changes and reduced sex drive.

The NHS says symptoms of menopause and perimenopause usually last for 7 to 9 years, sometimes longer, and during this time they can change. For example, you may get hot flushes and night sweats for a while but they may improve and be replaced by other symptoms such as low mood and anxiety, and some symptoms such as joint pain and vaginal dryness may continue after menopause.

An individual hot flush lasts several minutes. How often they happen and for how long overall varies a lot between people, and the NHS notes that women from a Black ethnic background are more likely to have severe hot flushes that continue longer.

The NHS says to talk to a doctor, nurse or pharmacist about HRT and other options if you have symptoms. HRT replaces the hormones that are falling. Oestrogen is the main type and can help manage symptoms, taken as tablets or used as patches, spray or gel. If you have not had a hysterectomy you also need progestogen to protect the womb, as tablets, part of a combined patch or the hormonal coil.

If HRT does not work, you cannot take it or you do not want to, the NHS says other treatments are available. For hot flushes and night sweats you may be offered cognitive behavioural therapy (CBT), or if that does not help a doctor may suggest clonidine or an antidepressant.

The NHS says herbal remedies and complementary medicines such as red clover and black cohosh are sometimes sold for menopause symptoms, but there is very little evidence to show how well they work or how safe they are, and some may cause serious side effects when taken with other medicines. Talk to a doctor before taking them.

NICE guideline NG23 on menopause covers diagnosing and managing menopause in people aged 40 or over and premature ovarian insufficiency in people under 40, and recommends discussing management options individually.

The NHS lists practical steps for hot flushes and night sweats, and lifestyle changes that help the wider picture of menopause.

• Wear lightweight clothing and keep your bedroom cool at night.

• Take a cool shower, use a fan or have a cold drink.

• Find ways to reduce stress, and avoid triggers such as spicy food, caffeine, hot drinks, smoking and alcohol.

• Exercise regularly and keep to a healthy weight.

• Try CBT, which can also help sleep problems and mood changes.

• Do not smoke, as this can make menopause symptoms worse, and keep alcohol within recommended limits.

The NHS says it is possible to get pregnant during perimenopause, so you still need contraception for 1 year after your final period if you are 50 or over and for 2 years if you are aged 40 to 49. HRT is not contraception.

Hormonal contraception can make it harder to tell if you have reached perimenopause or menopause, because it can make periods irregular or stop them. The NHS says the combined pill is not recommended if you are aged 50 or over because the risks generally outweigh the benefits, and a GP may recommend progestogen-only contraception instead.

The NHS says to contact your GP if you think you have symptoms of menopause or perimenopause and want to know your options, if you have a fast heartbeat or palpitations, if you still have periods but are bleeding more than before, or if you have not had a period for 12 months or more and have any vaginal bleeding.

Postmenopausal bleeding, even once or only a small amount, needs to be checked, because it is not usually serious but can be a sign of cancer, which may be easier to treat if found early. Early advice can help reduce the effects of menopause on your health, relationships and work.

On the NHS, a GP, practice nurse or pharmacist can discuss HRT and other options. The NHS says testosterone for low libido may be available on prescription from a menopause specialist.

Private menopause clinics offer longer appointments and prescribe HRT. The same NICE guidance applies, and the NHS cautions that herbal and complementary products have little evidence, so check claims about "natural" treatments carefully.