Vasomotor symptoms (VMS)

What is happening

Your brain keeps body temperature within a narrow comfort zone. As estrogen levels fall during perimenopause and after menopause, signaling in the brain's temperature center changes and that zone narrows. Small shifts in core temperature then trigger an outsized cooling response: blood vessels in the skin widen, you flush and sweat, and sometimes your heart races.

At night, the same process causes night sweats, which can wake you and fragment sleep. Over time, broken sleep can feed fatigue, irritability and brain fog.

How long they last

Vasomotor symptoms often start in perimenopause and can continue for years after the final period. Duration varies widely from person to person, and some women have them well into their 60s.

Hormone therapy

Estrogen is the most effective treatment for hot flashes and night sweats. Women who still have a uterus also take a progestogen to protect the uterine lining. On November 10, 2025, the FDA announced it would work to remove boxed warnings about cardiovascular disease, breast cancer and probable dementia from menopausal hormone therapy labels, while keeping the endometrial cancer warning on systemic estrogen-alone products. The FDA's labeled recommendation is to start systemic therapy within 10 years of menopause onset or before age 60.

Individual risks still matter. Your clinician weighs your history of blood clots, stroke, heart disease and breast cancer, and discusses delivery route, since skin patches and gels differ from pills.

Nonhormonal prescriptions

For women who cannot or prefer not to use hormones, the FDA approved fezolinetant (Veozah) in 2023. It blocks a brain receptor called NK3 involved in temperature regulation. It requires liver blood tests before and during the first months of treatment. Some antidepressants and other medicines are also used for hot flashes.

Everyday strategies

• Dress in layers and keep the bedroom cool.
• Notice personal triggers such as alcohol, spicy food, caffeine or warm rooms.
• Track symptoms and sleep so you and your clinician can see patterns.
• Be cautious with herbal supplements, whose effectiveness and quality vary.

At HealifyMD

The HealifyMD hormone therapy plan is $349 for the first month and then $99/month, confirmed at your eligibility review, with estradiol and progesterone products included. Many are compounded and not FDA-approved. A licensed clinician reviews your history and risks before recommending any treatment.