Managing Menopause Symptoms: Hot Flashes and Night Sweats

If you’re a woman in your 40s, have you noticed your menstrual cycle becoming irregular? Or perhaps you’ve experienced sudden, unexplained sweating or a flushed and overheated face? These changes could be early signs of menopause. While the term "menopause" may seem daunting, it is, in fact, a natural phase in a woman’s life. This article will delve into two common menopause symptoms—hot flashes and night sweats—and offer management strategies to help you transition through this stage with confidence and comfort.

Understanding Menopause

Menopause is the phase of a woman’s life highlighted by the complete cessation of menstruation, typically beginning in a woman’s 40s and lasting several years (the perimenopause stage). Medically, menopause is defined as the point when a woman has not had her period for 12 consecutive months.

As women enter their 40s, the ovaries gradually reduce the production of the hormones oestrogen and progesterone, leading to various physical and emotional changes. This natural process signifies the end of reproductive years and is not a disorder or health imbalance.

Blood tests can help determine if a woman is entering menopause by assessing hormone levels. Menopause is diagnosed when follicle-stimulating hormone (FSH) levels exceed 30 mIU/mL and oestrogen (E2, estradiol) levels fall below 20 pg/mL. Anti-Müllerian hormone (AMH) levels, which reflect ovarian reserves, also decline during menopause and drop to zero postmenopause. AMH testing can indicate whether a woman is approaching or has entered menopause.

OT&P Healthcare offers a range of women’s health services, including hormone level testing (FSH, E2, and AMH). Contact us for more details.

When Does Menopause Happen?

Menopause typically occurs between the ages of 45 and 55, with the median age for Hong Kong women being 51. However, the actual age of menopause varies from person to person.

How Long Do Menopause Symptoms Last?

Before officially reaching menopause, women may experience related symptoms for up to a decade. On average, these symptoms persist for approximately seven years. Most women report that once they enter the "postmenopause" phase the discomfort associated with these symptoms tends to diminish or disappear entirely.

Common Menopause Symptoms

During menopause, women may encounter the following symptoms:

Irregular periods: Changes in menstrual frequency, flow, or duration.
Hot flashes: Sudden episodes of facial and body heat, often accompanied by redness and sweating.
Night sweats: Excessive sweating during sleep, soaking clothes and bedding.
Vaginal dryness: Reduced oestrogen causes thinning, less mucus and loss of elasticity in the vaginal lining, leading to dryness and discomfort.
Urinary urgency: A frequent and strong urge to urinate.
Insomnia
Mood swings: Irritability, depression, or anxiety.

Other possible symptoms include heart palpitations, headaches, joint and muscle pain, changes in libido, difficulty concentrating, memory lapses, weight gain, hair thinning, and more.

Managing Hot Flashes

Hot flashes are one of the most common menopause symptoms, affecting nearly three out of four women during the perimenopause phase. The severity, duration, and frequency of hot flashes vary between individuals, typically lasting 1–5 minutes per episode every day. Some women may experience more than 10 episodes in a single day.

Medication

1. Hormone Replacement Therapy (HRT)

HRT increases hormone levels to alleviate menopause symptoms and is highly effective in treating hot flashes. Available forms include oral tablets, subcutaneous implants, gels/patches, or vaginal creams. Common options include:

Oestrogen + progestin (for women with a uterus)
Oestrogen only (for women who have had a hysterectomy)

Common Side Effects of HRT

Cyclical bleeding (in women with a uterus)
Breast tenderness
Fluid retention leading to weight gain
Nausea

Who Should Avoid HRT?

Women allergic to HRT
Those with unexplained vaginal bleeding
Those with a history of venous thromboembolism
Those with acute liver disease
Those with breast or uterine cancer
Those with heart disease

2. Non-Hormonal Prescription Medications

Medications typically used for depression, anxiety, sleep disorders, or bladder issues can also reduce the frequency and severity of hot flashes. FDA-approved options include paroxetine and fezolinetant (though neither is yet registered in Hong Kong). Other non-hormonal medications include:

Fluoxetine
Desvenlafaxine
Escitalopram
Oxybutynin
Gabapentin

Lifestyle Adjustments

1. Increase Phytoestrogen Intake

Consume foods rich in plant-based oestrogens, such as soybeans, chickpeas, lentils, flaxseeds, and whole grains.

2. Incorporating lifestyle changes can help reduce the frequency and discomfort of hot flashes

Keep your living environment cool
Use cool compresses during hot flashes for relief
Maintain a healthy weight
Quit smoking
Avoid alcohol
Maintain an active lifestyle via exercise, strength training, balance exercises and low-impact activities such as long walks, yoga & pilates

Managing Night Sweats

Medication

1. HRT

Use oestrogen alone or oestrogen + progestin therapies.

2. Non-Hormonal Medications

Options include anticonvulsants, antidepressants, clonidine, megestrol, and oxybutynin.

Lifestyle Adjustments

1. Establish a sleep-friendly routine

Use pillows and mattress covers with cooling gel
Wear loose, lightweight cotton or linen sleepwear
Use breathable, removable bedding
Practise deep breathing or meditation before bed
Keep your bedroom cool with open windows, fans, or air conditioning
Avoid alcohol, spicy foods, caffeine, smoking, and vigorous exercise before bedtime

Navigating Menopause Smoothly

Menopause is a natural stage in a woman’s life. If you are experiencing prominent menopause symptoms, such as hot flashes or night sweats, consulting a doctor about hormone therapy or considering lifestyle adjustments can significantly improve your comfort and well-being during this transition. Explore OT&P’s Menopause Services to learn how we can support your journey with expert care and personalised treatment.

If you are currently dealing with menopause symptoms or have concerns about this phase, it is advisable to seek guidance from a healthcare professional.

References

Peacock K, Carlson K, Ketvertis KM, (2021). Menopause. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507826/
MedlinePlus, (2023) Anti-Müllerian Hormone Test. Retrieved 22 September 2025 from https://medlineplus.gov/lab-tests/anti-mullerian-hormone-test/
World Health Organization, (2024) Menopause. Retrieved 22 September 2025 from https://www.who.int/news-room/fact-sheets/detail/menopause
Family Health Service, (2022) Dealing with Menopause. Retrieved 22 September 2025 from https://www.fhs.gov.hk/english/health_info/woman/14768.html
Cleveland Clinic, (2024) Menopause. Retrieved 22 September 2025 from https://my.clevelandclinic.org/health/diseases/21841-menopause
The Family Planning Association of Hong Kong, (n.d.) MENOPAUSE. Retrieved 22 September 2015 from https://www.famplan.org.hk/en/health-info/menopause
Family Health Service, (2019) Menopause and Hormone Replacement Therapy. Retrieved 22 September 2015 from https://www.fhs.gov.hk/english/health_info/woman/14767.html
Cleveland Clinic, (2024) Hot Flashes. Retrieved 22 September 2025 from https://my.clevelandclinic.org/health/articles/15223-hot-flashes
Cleveland Clinic, (2024) Night Sweats. Retrieved 22 September 2025 from https://my.clevelandclinic.org/health/symptoms/16562-night-sweats