Hot Flashes and Night Sweats: Managing Menopause Symptoms

Hormone and non-hormone treatment options

Scripps physicians can help you find the best way to manage menopause symptoms including hot flashes and night sweats.

Hormone and non-hormone treatment options

For a woman, menopause is inevitable. In many cases, it can also be unpredictable.


“Because menopause is genetically driven, the strongest predictor of the age of menopause onset is when a woman’s own mother entered it,” says Gay Walker, MD, an internal medicine physician at Scripps Coastal Medical Center Encinitas with a special interest in women’s health issues. “But your mother’s menopause symptoms are not a strong indicator of how easy or difficult your own menopause experience may be.”


While menopause symptoms may be uncomfortable, they are manageable, she adds.

Menopause and perimenopause

Menopause is defined as the time in a woman’s life when she ceases to have menstrual periods. The ovaries stop making estrogen, a hormone that helps control the menstrual cycle. The average age that women go through menopause is 51, according to the American College of Obstetricians and Gynecologists.


The years leading up to natural menopause are known as perimenopause. A common sign of perimenopause is a change in menstrual cycle, which may become longer or shorter. Skipping periods is also common.


Menopause is diagnosed after a woman goes 12 months without a menstural period. Sudden menopause can occur when there is a surgical or medical procedure involved that removes the ovaries or disables normal hormonal functions.

Menopause symptoms

Women nearing menopause may experience a variety of symptoms, such as:


  • Hot flashes
  • Night sweats
  • Insomnia
  • Mood swings or depression
  • Vaginal dryness


It's normal for men and women experience small amount of bone loss. But women lose bone more rapidly during the first 4 to 8 years after menopause. Their risk increases for developing osteoporosis, a condition where the bones become brittle and fragile, if they they lose too much bone.


“Fit women of a normal, healthy body weight typically have fewer problems with hot flashes and night sweats, so the first thing I do for menopausal patients is encourage women to work on themselves,” says Dr. Walker.


“Too many women put themselves last when they’re in their 20s and 30s because of family and career obligations. In their 40s, when kids are leaving the nest, it’s a great time for them to take care of their bodies, get back to a healthy weight and start exercising again.”

Lifestyle changes

A healthy lifestyle can help you manage the symptoms of menopause, including the following:


  • Eating a balanced, nutritious diet before, during, and after menopause. Make sure to get enough vitamin D and calcium to ensure bone health.
  • Exercising regularly slows down bone loss.
  • Getting regular medical checkups even if you are not sick, can help catch problems early.


“Fit women of a normal, healthy body weight typically have fewer problems with hot flashes and night sweats, so the first thing I do for menopausal patients is encourage women to work on themselves,” says Dr. Walker.


“Too many women put themselves last when they’re in their 20s and 30s because of family and career obligations. In their 40s, when kids are leaving the nest, it’s a great time for them to take care of their bodies, get back to a healthy weight and start exercising again.”

Menopause treatment options

If menopause symptoms interfere with your usual activities or are worrisome, your gynecologist or primary care physician can help. There are a number of menopause treatment options, both hormonal and non-hormonal. Since every woman has a different health history and lifestyle, the most effective treatment plans for menopause really depend on individual needs. Options may include:

Non-hormonal medications

Some prescription medications, such as anti-depressants, have demonstrated benefits in reducing hot flashes and night sweats. “Other medications prescribed off-label, including an anti-seizure medication and a blood pressure control medication, may offer relief and are included in guidelines issued by the American College of Obstetrics and Gynecology,” says Dr. Walker. Talk to your doctor about non-hormonal alternatives for this purpose.

Hormone replacement therapy

Hormone replacement therapy (HRT) uses estrogen and progesterone (progestin) to raise hormone levels and help alleviate symptoms. HRT can protect against osteoporosis, have a positive effect on cholesterol levels, help with vaginal lubrication, and provide relief of hot flashes and night sweats.


However, it has risks. Studies indicate HRT may increase the risk of certain types of cancer, including breast cancer, stroke and heart attacks. Women are now urged to weigh the risks and benefits of hormone therapy with their doctor.

Moisturizers and lubricants

Moisturizers and lubricants that can be purchased over the counter can help with vaginal dryness and painful sexual intercourse that may occur during menopause. Moisturizers can be used every 2 to 3 days as needed. Lubricants can be used each time you have sex.


There are other ways to address lower libido concerns during menopause and beyond. “You need to find ways to re-kindle romance,” Dr. Walker says.


She recommends a couple of books to her patients that consist of 101 sealed romantic scenarios that couples can decide to unseal together when they are in the mood for a special romantic night. “They often come back and tell me they love it — and they tell me it works,” she says. “No hormones required.”