Dr. Jen Ashton’s Hot Flash Relief Tips: ‘There’s No One-Size-Fits-All Solution’ (EXCLUSIVE)
Find out what treatments work, from hormone therapy to non-hormonal options
With 1.3 million women in the U.S. entering menopause each year, women are starting to open up more about symptoms like vaginal dryness, insomnia and irritability. But one of the most common complaints during this stage of life is hot flashes. That’s why Jennifer Ashton, MD, OB-GYN, a women’s health expert specializing in menopause and obesity medicine and the founder of Ajenda, says the bothersome symptom is no trivial matter. Here, Dr. Ashton shares everything you need to know about how to get quick hot flash relief.
What is a menopausal hot flash?
Dr. Ashton explains that in medicine, hot flashes are part of a group of symptoms known as vasomotor symptoms or VMS. They’re incredibly common, and at least half of women who are perimenopausal or menopausal will experience them in a moderate to severe manner. Some women won’t experience them at all, but “there’s an estimate that by 2025, there will be 21 million women in the United States who experience VMS,” says Dr. Ashton. “That’s a lot of hot flashes.”
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She goes on to explain that hot flashes can be sudden, unpredictable and disruptive, occurring at random times throughout the day or even at night (these are considered night sweats). “They are a sudden, intense heat that generally starts in a core, like the center of a woman’s torso or chest, and goes up into the neck, face and head,” says Dr. Ashton. “Hot flashes can be associated with drenching sweat, redness, flushing (or not), but they can also be associated with chills.”
The result? Your mood, sleep, concentration and productivity can all take a nosedive when you’re dealing with disruptive hot flashes.
Some women experience hot flashes for a decade
It’s important to recognize that hot flashes and other symptoms can start seven to 10 years before a woman enters menopause, which is known as perimenopause. However, Dr. Ashton points to new research that suggests some women deal with them for shorter or longer periods based on their race and ethnicity.
“So, Black women, on average, can experience hot flashes that can last a decade or eight years, while white women experience them for a little over six years,” says Dr. Ashton. “It’s a reminder that menopausal symptoms don’t have a one-size-fits-all approach.”
Dr. Ashton adds that recent studies show that women who have more severe vasomotor symptoms are also at higher risk for certain types of cardiovascular or brain issues, such as high blood pressure and blood clots.
Can you prevent hot flashes?
While you can dress in layers, adjust the temperature in your home or avoid spicy foods that worsen hot flashes, there’s no real way to prevent them from happening. Dr. Ashton says to start by recognizing how common hot flashes are and how severe they are for you. “It’s important to start there and realize that they can’t be prevented, per se,” she says.
Hot flashes occur due to hormone fluctuation and can’t necessarily be stopped. As your estrogen levels drop, a brain chemical called neurokinin B (NKb) triggers hot flashes by disrupting your body’s temperature control. “When NKb is unopposed by estrogen as a woman goes into menopause, then that binding—it’s like a lock and key—docks in the hypothalamus of the brain, which can trigger a hot flash.”
3 effective hot flash treatments
Even though you can’t prevent vasomotor symptoms like hot flashes, there are easy ways to manage them. “Women need to consider a menu of options, and that’s where the individualized [approach] idea falls into place,” says Dr. Ashton. Here, various hot flash treatments that can provide relief from symptoms:
- Hormonal options: These are your traditional hormone replacement therapies (HRTs) such as pills, patches and creams, explains Dr. Ashton. She notes a variety on that list, including bioidentical and natural HRT. They work by rebalancing hormone levels that change during menopause to help ease hot flashes and other menopausal symptoms.
- Non-hormonal medications: In the past, non-hormonal medications were typically used off-label and not approved by the U.S. Food and Drug Administration (FDA). That is until Veozah, a hormone-free medication meant to reduce hot flashes, became FDA-approved in 2023. “Veozah specifically blocks the binding of NKb and can prevent the hot flash from occurring,” Dr. Ashton says. “In clinical studies, it was shown to reduce the frequency and severity of hot flashes in some women as early as a week.”
- Alternative therapies: Dr. Ashton notes that not every woman dealing with VMS can take hormones, and some may not necessarily want to. “Something like cognitive behavioral therapy, which, as per The Menopause Society, has been studied and is low risk, high benefit for some women, is another treatment option,” she says. CBT helps treat hot flashes by teaching women techniques to manage stress and improve their response to symptoms.
Tips for advocating for hot flash relief with your doctor
First and foremost, it’s important to be able to talk about your experiences, says Dr. Ashton, since all women experience this transition. Finding resources to help you understand your symptoms and the changes they bring can also improve your quality of life.
Dr. Ashton, who’s partnered with Veozah for its “Cooler Moments effort,” recommends starting there. “This has incredible tips on how women can advocate for themselves in their doctor’s office or in their community, with their friends, with their family but most importantly, with their healthcare provider,” she says.
Some of the tips include:
- Understanding hot flash terminology and its severity.
- The VMS hot flash quiz to help determine treatment options.
- Support from other women dealing with VMS.
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