Menopause Hot Flash Medication Effectiveness

Hot flashes are a common menopause symptom that can range from mild to severe. If a doctor prescribes medication for hot flashes, here’s how to know if it’s helping manage symptoms.

Menopause is a typical part of the aging process. It is the period in an older adult’s life in which the menstrual cycle stops permanently. At this point, a person can no longer become pregnant.

While some people may have no symptoms, others may experience mild or severe symptoms. These can include:

• moodiness or irritability
• issues with memory or concentration
• night sweats
• trouble sleeping
• joint or muscle pain
• pain during sexual intercourse
• hot flashes

The time leading up to menopause is called perimenopause. During this period, a person may also experience menopause symptoms.

Hot flashes are episodes of a sudden sensation of heat on your face, neck, and chest. You may experience flushing in your face and neck, as well as blotches on your arms, back, or chest. They come on suddenly, often seemingly out of nowhere.

Sometimes hot flashes also cause severe sweating, followed by cold shivers. You can get as many as 10 a day or more, or a few per week. Hot flashes tend to peak in frequency 1 year after you had your last period, but they’re different for everyone.

Up to 74% of women experience hot flashes in the years leading up to menopause and beyond, as well as in women who have gone through surgical or medically induced menopause.

Hot flashes are the most common symptom that women seek medical care for as they’re going through menopause.

Taking medication for hot flashes is a personal choice. Not everyone chooses it, but many find it helps reduce symptoms. Doctors may recommend it if the symptoms reduce a person’s quality of life, such as preventing them from getting enough quality sleep or doing everyday activities.

If you’ve opted for medication to manage your hot flashes, your doctor might prescribe one of the following medications:

• hormone therapy (also called hormone replacement therapy), which usually involves estrogen or estrogen plus progesterone and works by replenishing depleted hormones, which can help reduce menopause symptoms
• neurokinin 3 (NK3) receptor antagonists, such as fezolinetant (Veozah) or elinzanetant (Lynkuet), which target and block NK3 receptors that play a role in releasing hormones and can cause hot flashes
• gabapentin or pregabalin, two anti-seizure medications, which can reduce the frequency and severity of hot flashes
• a type of antidepressant medication called selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil), which can lower the rate of hot flashes
• an antidepressant, serotonin and norepinephrine reuptake inhibitor (SNRI), such as venlafaxine (Effexor) or desvenlafaxine (Pristiq), which can also lower the amount of hot flashes

The time it takes to see results with any treatment depends on which medication you’re taking. It can take a few weeks for symptoms to start noticeably decreasing.

Some people might try complementary therapies or supplements, such as:

• red clover
• soy extract
• black cohosh
• wild yam
• maca
• hypnosis
• relaxation techniques like meditation, yoga, or mindfulness practices
• aromatherapy
• acupuncture
• cognitive behavioral therapy (CBT)

Although research about these therapies is mixed and has not always found them to be effective, some people find them worth trying. Before starting any new treatment, consider speaking with your doctor first. Each option can have benefits and risks.

Here are a few signs the medication you take for hot flashes is working. It can take a few weeks for this to become apparent.

Probably the most obvious change you’ll notice is that you’re having fewer hot flashes than before you started the medication.

Counting the number of hot flashes you experience per day can help you track how this changes over time.

When your medication is effective, it will likely reduce the intensity of symptoms.

The intensity of hot flash symptoms can range from mild and tolerable to severe and debilitating, which is one reason why many women turn to medication for hot flashes in the first place.

Hot flashes can last anywhere from 30 seconds to 10 minutes at a time. If your hot flashes have been getting shorter compared with what you were experiencing before medication, it may be a sign that treatment is working.

Improved sleep quality is a major sign to look for when you’re assessing whether your medication is working because a lack of sleep is linked to your well-being in numerous ways.

Hot flashes and changes in mood can seriously impact your sleep. This can affect your physical health, such as making you more irritable or leading to you experiencing symptoms of depression. You may become more forgetful than is typical or have more falls or accidents.

Not getting enough sleep, especially during menopause, can affect your cardiovascular health and may raise your risk of diabetes. It’s also associated with chronic health issues like high blood pressure and kidney disease.

To assess your sleep quality, you can look at the number of hours you sleep each night, the number of times you wake up in the night, and how well rested you feel during the day.

Some people experience a noticeable uptick in anxious feelings when they’re having a hot flash.

Not getting enough sleep can lead to or worsen anxiety. If your medication for hot flashes is effective, it can help improve your mood and improve your sleep quality, all of which can help lower anxiety.

Experiencing intense hot flashes can impact your everyday activities and quality of life. Once your medication starts reducing hot flash symptoms, you may notice that your daily tasks feel more manageable.

Other side effects that can come with hot flashes may also dissipate over time if your medication is working correctly. You might see a decrease in symptoms, including:

• sweating
• heart palpitations
• faintness
• fatigue
• weakness
• headaches

Specific medications for hot flashes may each reduce side effects differently or may have side effects of their own. You can speak with your doctor about what to expect with your medication.

Here are a few ways to track your symptoms to help determine if your medication is working over time. It can be helpful to show these to your doctor to inform your treatment.

• Keep a symptom diary:​ Log the number of hot flashes you experience each day and their duration and intensity, along with triggers and other symptoms like sleep, mood, body temperature, or headaches.
• Use a tracker app:​ Use an app to track menopause symptoms. Health trackers and wearables can also record key health metrics like body temperature and sleep.
• Make a chart:​ A simple spreadsheet, calendar, or paper chart on the fridge can help you track the number of hot flashes you experience per day and visualize any changes in frequency over time.

It may also be helpful to track any events or stimuli that trigger hot flashes for you, such as anxiety, spicy foods, or a lack of healthy sleep.

If hot flashes are affecting your quality of life, you may want to discuss treatment options with your doctor. If you’re starting a new medication for hot flashes, tracking your symptoms during the weeks after you start can help you determine whether it’s working the way it’s intended.

If you think your menopause medication isn’t working and it might be time for a change, you can talk with your doctor about alternative treatment options.