The Best Ways to Control Menopause Vasomotor Symptoms (VMS) in 2023

Somewhere between the ages of 45 and 55, it happens– menopause and the not-so-fun symptoms that come with it. But why does VMS have to occur at the most inopportune time? You’re having fun at party and then suddenly -- boom -- out of nowhere, an intense sweltering wave of heat suddenly overcomes your face and neck makeup now dripping like you were thrown into a sauna. These dreaded hot flashes and night sweats are the most iconic and common symptoms of menopause. Here is what you need to know about the causes of VMS and how you can help keep them at bay.

What are vasomotor symptoms (VMS)?

Vasomotor symptoms (VMS) are the most commonly reported menopausal symptoms. These symptoms, often called hot flashes, are characterized by a sudden increase of blood flow, often to the face, neck and chest, that causes the sensation of extreme heat and profuse sweating. When symptoms occur at night, they are called “night sweats” and can cause significant sleep disturbances.

Episodes of vasomotor symptoms can last between one to five minutes and can be associated with perspiration, flushing, chills, anxiety and even heart palpitations.

While vasomotor symptoms vary significantly in intensity and frequency among menopausal women, these are typically most debilitating during the first one to two years of menopause. For some women, however, they may persist indefinitely.

What causes VMS or hot flashes?

The cause of hot flashes is not fully understood, but it likely represents a relationship between the central nervous system (includes your brain and spinal cord) and the peripheral nervous system (includes the nerves that travel from your spinal cord and brain to supply your face and the rest of your body). Many women experience hot flashes before, during and after entering menopause. The average American woman enters menopause at age 51, but the hormone level shifts that trigger menopause can begin years earlier.

Perimenopause, also known as the menopause transition, typically starts in your 40s and can last anywhere from a few months to 10 years before the periods stop which is the hallmark of menopause. Women experience erratic hormonal changes during this stage, and their estrogen levels begin to fall. This fall in estrogen levels can directly affect the hypothalamus, the part of the brain responsible for controlling your body temperature, among many other things. While research still needs to be conducted to understand the exact reason, the drop in estrogen levels causes your hypothalamus to register that it is too hot, causing hot flashes.

While not all women who go through menopause will experience hot flashes, The North American Menopause Society reports that hot flashes are experienced by as many as 75% of perimenopausal women in the United States.

What symptoms occur when someone has VMS or hot flashes?

Symptoms of hot flashes vary among women but may include:

• A sudden feeling of heat or warmth to your face, neck and chest
• Flushed face and blotchy, red skin in affected areas
• Increased heart rate
• Tingling in your fingers
• Feelings of anxiety
• Chills as the hot flash subside

These symptoms can lead to sleep disturbances, mood issues and cognitive impairment.

What increases the chances of having VMS?

VMS is common during menopause, but not everyone experiences it. Several factors can increase someone’s chances of experiencing VMS, include:

• Smoking
• Drinking alcohol
• Obesity
• Eating food that is spicy, high in fat or high in sugar
• Being in hot temperatures
• High-stress situations

How can I prevent VMS from happening?

Identifying your triggers is the best way to prevent VMS or hot flashes. If you know certain things increase your chances of getting hot flashes, try to avoid those triggers. Some other ways to prevent hot flashes include:

• Sleep with a fan on
• Add a cooling mattress pad to your bed
• Keep a small personal fan at your desk or in areas of the house you frequent
• Avoid common triggers such as alcohol, wine, coffee or hot tea
• Wearing light, breathable layers. As you get hot, you can remove the other layers of clothing to help cool down
• Drinking cold water
• Placing an ice pack on your neck or head
• Having a healthy, well-balanced diet high in vegetables and fruits and lean meats with less processed foods and carbs

What are treatments for VMS?

If your hot flash symptoms continue to bother you or you can’t find relief, it is best to talk with your doctor to discuss the best next steps and treatment options. Treatment options might include:

• Hormone therapy with estrogen and/or possibly progesterone. Hormone therapy aims to balance hormone levels in the body. It can help relieve hot flashes and other symptoms, but it’s not suitable for everyone.
• Other medications, such as antidepressants and some anti-hypertensive drugs, might also help reduce hot flashes in different ways.

These additional medications have some risks associated with their use, so you should discuss the best plan for managing your symptoms to improve your overall well-being with your physician.

It is also essential to incorporate healthy lifestyle changes, such as exercise, healthy eating habits and quitting smoking/avoiding secondhand smoke, which can all help to reduce the incidence and severity of hot flashes.