What are Vasomotor Symptoms in Menopause? Symptoms Explained!

Last updated 11.21.2023 | by Dr. Karen Pike | 9 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

Did you know that vasomotor symptoms, or VMS, are the most reported side effects that women go through during menopause? In fact, a staggering 80% of all menopausal women experience VMS, so knowing the signs and symptoms to look out for is essential for us all.

Like many of the women I work with, I’ve been experiencing bouts of hot flashes and night sweats. And like all menopause symptoms, this frustrating issue is caused by a change in hormones.

Are you one of the millions of women who are also struggling with vasomotor symptoms? If so, are you searching for a solution?

Well, you’re in the right place. In this post, I’ll be examining vasomotor symptoms in more detail, looking at what they are, why they happen, and what we can do to find relief.

What are Vasomotor Symptoms?

Vasomotor refers to the widening and contracting of blood vessels. The two main vasomotor symptoms are hot flashes and night sweats. However, there are more subtle symptoms, too, such as heart palpitations, an increased heart rate, flushing of the face, and a feeling of heat in the face, neck, or chest area.

Around 4 out of 5 American women experience VMS during their menopausal transition. For many of us, these symptoms are relatively mild and don’t interfere too much with our daily lives. But for some women I’ve worked with, they can be debilitating. Hot flashes can affect your ability to do your job, and night sweats can leave you chronically sleep-deprived and unable to function during the day.

Most women, including myself, first notice VMS in the early stages of perimenopause (the build-up to menopause.) During this time, hormones begin to fluctuate, and this sudden change can impact the body’s ability to control temperature.

As a result, we can find ourselves overheating, even in a cool room, and waking up in the middle of the night, dripping in sweat.

But while vasomotor symptoms can be alarming, it’s important to remember that they’re a very normal part of the menopausal process, and simply a sign that your body is going through an important change.

Everybody is different, but if your vasomotor symptoms are affecting your quality of life, talk to your doctor. There are several lifestyle changes and treatments that can help (more on this later.)

What Causes Vasomotor Symptoms?

As I mentioned earlier, vasomotor symptoms are caused by fluctuating hormones. These hormonal changes appear to have a direct effect on the way your body regulates its core temperature.

It’s thought that estrogen is the driving force behind VMS. Lower than usual levels of this reproductive hormone can cause your internal thermostat to become more sensitive to variations in temperature. However, the exact mechanisms that estrogen triggers to produce these symptoms still aren’t fully understood.

When your body detects a temperature rise, you begin to sweat, and your blood vessels automatically dilate. The enlarged vessels allow more blood to reach the surface of the skin so that you can cool down.

But during a hot flash, this response is falsely triggered. It can happen anywhere, any time, even in a cool room.

What do Vasomotor Symptoms Feel Like?

The two main vasomotor symptoms are hot flashes and night sweats.

During my hot flashes, I can be sitting comfortably one minute, and the next, I’m overheated, sweating heavily, and my face is flushed to a bright red color. These symptoms are fairly typical to most women I’ve worked with, too.

Most of the time, hot flash symptoms are located in the upper body, with the face, neck, and chest being the main affected areas. But some of us may also notice that our hearts begin to beat faster, and the fingers start to tingle.

Hot flashes come on suddenly and unexpectedly, and they can last anywhere between 30 seconds and 10 minutes.

Night sweats are the same phenomenon as a hot flash; the only difference is that they happen at night, and they can wake you from your sleep covered in sweat.

How to Find Relief From Vasomotor Symptoms During Menopause?

How to Find Relief From Vasomotor Symptoms During Menopause

If you’re anything like me, vasomotor symptoms can interfere with your life. In some cases, they can even make it difficult to function normally.

Whatever the severity of your VMS, you’re probably looking for a way to find relief.

I’ve also been on the same mission, and through my research, I’ve found a variety of lifestyle changes and things to try at home which can help.

1. Drink Cold Water

When I feel a hot flash start to rise, I take a sip of ice-cold water. Sometimes, this alone can stop it in its tracks. Even if it doesn’t eliminate the hot flash entirely, it still seems to reduce its length and severity.

Try keeping a glass of ice water by your desk at work, or carry a thermos-insulated flask that can keep water cold all day long.

2. Wear Loose Clothing in Layers

Wearing layers means you can quickly shed one in a warm room or when a hot flash begins to rise.

Since I’ve started wearing looser clothing, my sweating has been kept to a minimum and I’m able to maintain a cooler body temperature.

3. Take a Cold Shower

Of course, it’s not always possible to take a cold shower when you feel the onset of a hot flash, but when it happens at home, the cold water can quickly cool down your core temperature and stop a hot flash from getting worse.

I like taking cold showers before I go to bed, as this helps to keep my body cool and avoid night sweats.

4. Keep the Room Cool

Hot flashes and night sweats tend to be much worse if the environment is already warm. So, where possible, keep the thermostat low. Like me, you might also want to consider using a fan in the office or the bedroom to keep the air circulating.

5. Avoid Alcohol, Nicotine, and Caffeine

These substances can trigger hot flashes and make them worse. Even a small cup of coffee in the morning can lead to more frequent and severe hot flashes, and drinking alcohol before you go to bed can increase the likelihood of night sweats.

Since I’ve given up caffeine, I’ve noticed a definite improvement in my VMS.

6. Lose Weight

Menopausal women who are obese or overweight suffer from more severe vasomotor symptoms than women with a healthy body mass index. So, if you could do with losing a few lbs, there’s no better time to try than during menopause.

Many other classic menopause symptoms, such as insomnia, mood swings, and hair loss, can also be improved by getting down to a healthy weight.

What Medical Treatments Are Available for Vasomotor Symptoms?

If the tips and lifestyle changes above don’t help you find relief from VMS, consider speaking to your doctor. Certain prescription-only treatments are available that can help to reduce the severity of vasomotor symptoms during menopause.

1. Hormone Replacement Therapy (HRT)

The most commonly prescribed treatment plan for symptoms such as hot flashes and night sweats is hormone replacement therapy (HRT). Many of my patients say that HRT not only reduces the frequency and severity of their vasomotor symptoms, but it also helps to alleviate menopause rage and mood swings, boost their libido, and improve their energy levels.

Talk to your doctor before deciding on this type of treatment plan. They can assess your medical history and help you make an informed decision.

2. Non-Hormonal Medication

Certain medications which are used to treat depression and epilepsy can also help to alleviate vasomotor symptoms. Examples include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and gabapentin. However, these medications also carry risks of side effects and aren’t meant to be a long-term solution.

3. Natural Remedies

Certain plants and supplements have been shown to help reduce hot flashes and night sweats if you prefer to take a more natural approach. My favorites are black cohosh, red clover, flaxseed, and soy-based foods or supplements. These work by providing the body with phytoestrogens, which mimic the role of natural estrogen.

What are Some other Causes of Vasomotor Symptoms?

What are Some other Causes of Vasomotor Symptoms

If you’re a woman in your 40s or 50s and you’re experiencing hot flashes and night sweats, chances are you’re experiencing a normal side effect of menopause.

However, in some rarer instances, these vasomotor symptoms can be a sign of an underlying condition, such as:

  • Infection
  • Thyroid issues
  • Low blood sugar
  • Anxiety
  • Hyperhidrosis
  • A side effect of certain medications, such as antidepressants and hormone-blocking drugs
  • Certain types of cancer


When do vasomotor symptoms typically begin?

Most women tend to notice hot flashes and night sweats in their mid to late 40s. This is typically when perimenopause begins. However, some people start perimenopause and notice VMS in their early 40s or even their late 30s.

How long do vasomotor symptoms last?

Research suggests that most women experience VMS for around seven years. However, some women I’ve worked with have struggled with hot flashes and night sweats for longer, even after they officially reach menopause.
Women of African descent tend to experience more frequent and severe vasomotor symptoms.

What can trigger vasomotor symptoms?

Vasomotor symptoms can come seemingly out of nowhere. However, there are some common triggers, including hot weather, stress, alcohol, nicotine, spicy food, and caffeine.


Vasomotor symptoms are the most commonly reported symptom of menopause, and the majority of menopausal women will experience them as they go through this transitional time.

VMS can range from mild and manageable to overwhelming and intense. If you’re suffering from frequent and bothersome hot flashes and night sweats, don’t hesitate to contact your doctor. They can assess your symptoms, rule out any underlying causes, and help you find a treatment plan that works for you.


  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.