Symptom
Hot flushes and night sweats.
Hot flushes, night sweats and disrupted sleep are among the most common reasons women seek help in midlife. They can usually be helped, and they deserve a proper assessment rather than reassurance.
In short
Hot flushes and night sweats are usually caused by falling and fluctuating oestrogen in perimenopause and menopause, which alters the brain's temperature regulation. Thyroid disease, certain medicines, anxiety, alcohol, infection and some other conditions can produce similar symptoms, so assessment matters. Treatment options include hormone therapy where appropriate, non hormonal medication, and changes to sleep, alcohol, caffeine and triggers. Many women improve substantially with appropriate treatment.
Medically reviewed by Dr Arnav Kapur, MBBCh Cum Laude
The approach
Understand first. Then treat.
Flushes typically begin in perimenopause, while periods are still present, and can persist for years. Night sweats fragment sleep, which then drives fatigue, low mood, weight change and poor concentration.
We assess the pattern, exclude other causes, discuss the evidence on hormone therapy honestly, and build a plan around your history and preferences.
What the assessment covers
- Symptom pattern, cycle history, severity and effect on sleep and function
- Thyroid function and other causes that mimic menopausal flushing
- Cardiovascular, bone, breast and clotting history relevant to hormone therapy
- Metabolic assessment, including glucose, insulin and lipids
- Body composition and bone health considerations
- A treatment plan covering hormonal and non hormonal options
Why sleep is the priority
Night sweats break sleep repeatedly, and broken sleep worsens mood, appetite regulation, insulin sensitivity and cognition. Improving night time symptoms often improves several other complaints at once.
Hormone therapy, discussed properly
Modern hormone therapy is effective for vasomotor symptoms, and the risk and benefit picture depends on your age, time since menopause, personal and family history and the preparation used. We explain what applies to you rather than quoting headlines.
When hormones are not the right option
Where hormone therapy is unsuitable, contraindicated or unwanted, non hormonal medication, targeted lifestyle change, sleep work, alcohol and caffeine adjustment and management of coexisting conditions can meaningfully reduce symptoms.
The wider midlife picture
Perimenopause coincides with changes in weight, bone density, cardiovascular and metabolic risk. We assess these together so care addresses long term health, not only symptom relief.
Common questions
Answers before you book.
Can I have flushes while still having periods?
Yes. Vasomotor symptoms often start in perimenopause, when cycles are still occurring but hormone levels fluctuate.
Do I need blood tests to diagnose menopause?
Diagnosis is often clinical, based on age and symptoms. Testing is useful to exclude other causes such as thyroid disease, to assess metabolic health, and in younger women or unclear cases. Flushing with atypical features, such as unexplained weight loss, fever or symptoms outside the expected age range, warrants wider assessment.
How long do hot flushes last?
They commonly continue for several years, and for some women longer. Treatment does not depend on waiting them out.
This page is general health information and is not medical advice. Hormone therapy is prescription treatment that follows individual clinical assessment of benefit and risk.
Ready to start properly?
- Menopause and perimenopause care
- Women's hormone health consultation
- Why am I always tired?
- Book a consultation
Centre of Advanced Medicine, 13 Scott St, Waverley, Johannesburg
Monday to Friday, 07:40 to 17:00
011 440 8721