Hot Flushes and Night Sweats: Causes and Ways to Manage Them

Woman asleep in bed

Hot flushes (also called hot flashes) and night sweats are common side effects during and after breast cancer treatment. If you’re getting sudden waves of heat, waking at night drenched in sweat, or feeling ‘overheated’ out of nowhere, you’re not alone.

Treatments such as hormone therapy (including tamoxifen and aromatase inhibitors), chemotherapy, and ovarian suppression or removal can cause a sudden drop in oestrogen. This can trigger an early or treatment-induced menopause, and the rapid hormone change can disrupt the body’s temperature regulation, leading to flushing, sweating and a faster heartbeat.

Hot flushes can feel unpredictable and may affect sleep, mood and concentration. The good news is that there are practical, evidence-based ways to manage them, including lifestyle changes and non-hormonal treatments.

In this article:

  • What hot flushes are, and why they happen
  • Who is more prone to hot flushes
  • Common triggers to look out for
  • Evidence-based ways to manage symptoms
  • Treatment options to discuss with your doctor

If hot flushes are continually affecting your quality of life, it’s important to speak to your doctor or breast care nurse about options that may help.

Tip: Use the OWise app to log hot flushes and night sweats to spot triggers. Share your notes (and questions) with your care team.

What are hot flushes?

A hot flush is characterised by a sudden sensation of intense, internal heat in the chest, face and head, and this feeling may be accompanied by flushing, sweating and chills. However, they may not always be that intense for everybody and for some, hot flushes can be a mild warming sensation which just affects the face. The body’s reaction to hot flushes generally results not just in sweating, but also in an increased heart and metabolic rate1. Hot flushes usually last about 1-5 minutes, however, some can last as long as an hour2. Many people also get hot flushes at night, which can make it difficult to get a good night’s rest. In fact, disturbed sleep due to hot flushes can result in mood changes and feeling irritable, as well as having difficulty concentrating3, 4.

Who is more prone to hot flushes?

Hot flushes have been reported to occur in 51-81% of women with breast cancer3, 5, 6, and they can be a daily occurrence for many. Furthermore, approximately two out of three postmenopausal women with a history of breast cancer experience hot flushes3, 5, 6. 

Research suggests that if you had hot flushes during your menopause you are more likely to have hot flushes as a side effect when you take tamoxifen as a breast cancer treatment.

The number of hot flushes you have and their severity is about the same with tamoxifen when compared with women going through a natural menopause4. 

Interestingly, a US study with women of different races and ethnicities going through menopause found that hot flushes are most prevalent in women of African-American and Caucasian descent, and least prevalent in women of Chinese and Japanese descent7. However, more evidence is needed to confirm whether this is actually due to differences in underlying physiological processes, or if these are just differences in the interpretation or reporting of hot flushes between the ethnic groups1, 8.

What causes my hot flushes?

Hot flushes are thought to be an exaggerated response by the body to changes in temperature 10, 11. When oestrogen levels fall, the brain’s temperature-control centre (the hypothalamus) can become more sensitive, triggering sweating and widening of blood vessels to cool the body down.

There is a process in the body called “thermoregulation” that regulates the body’s temperature and keeps it around 37 °C. For example, if your body is too hot and needs to cool down, your blood vessels will tend to increase in width, so that you can begin to sweat. 

The process that regulates your body’s temperature can identify the extremes: when you are sweating (too hot) or when you are shivering (too cold). In women with hot flushes, this process is not as accurate, which generates exaggerated sweating or shivering responses12. In these women, only a small increase in their body temperature can result in a hot flush. A similar mechanism is thought to occur in men who suffer from hot flushes whilst on treatment, however, it has not been specifically studied yet1. 

It is not yet known why this disruption in the system that regulates the body temperature occurs in menopausal women, however, studies have shown links to changes in some neurochemicals such as noradrenaline and serotonin1, 11 , and the sex hormone oestrogen. 

A study investigating hot flushes from breast cancer treatment asked women to keep a log of the frequency and intensity of their hot flushes, as well as to write descriptions about them. The study reported that “Moderate hot flashes caused irritation, agitation, annoyance, fatigue, and embarrassment, and were memorable. One woman wrote that she felt the energy draining out through the bottom of her feet.” (Finck et al., 1998)

Tips to help manage hot flushes

Triggers vary from person to person, so keeping a diary can help. Note of what you were doing, eating or drinking when a hot flush occurred so that you can identify triggers and patterns. You can simply do this in the Notes section of the OWise app.

Common triggers include:

  • Caffeine
  • Alcohol
  • Hot Beverages
  • Spicy foods
  • Smoking and Nicotine
  • Stress
  • Hot baths and showers
  • Hot rooms

Based on feedback from our users, we introduced a Hot Flushes Trend in OWise. Tracking patterns over time can help you spot triggers and see what strategies are making a difference. 

iPhone XS Mockup of OWise app tracking hot flushessPractical ways to manage hot flushes:

1. Staying as cool as possible (especially at night)

  • Dress in layers so that you can remove clothing when a flush begins.
  • Wear loose-fitting and natural, airy fabrics such as cotton, silk, linen and rayon, as opposed to synthetic materials.
  • Keep cold or iced drinks nearby to sip.
  • Always keep a small fan (battery-operated if possible) at hand and a water spray to use on your face, chest and wrists to cool you down when needed.
  • Have a lukewarm shower or bath instead of a hot one, and try to take a cool shower before bed.
  • If you suffer from hot flushes at night, keep your room cool by having a large fan on.
  • Try using a silk pillowcase, or keeping a frozen cold pack under your pillow and turning the pillow over often. 
  • Some companies make specially designed cooling pads, sheets, pillowcases, pillows and scarves that you may want to look into.
  • Sleep on cotton sheets.
  • Lay a towel down on your bed if you suffer from night sweats.

2. Diet and Exercise

  • Maintaining a healthy body weight (BMI up to 27 kg/m2) is associated with fewer hot flushes in some studies 12,13,14,15.
  • Regular physical activity may also reduce severity and frequency, and can improve sleep and overall wellbeing14, 16,17,18,19.
  • Remember to go slow and don’t overdo it, as strenuous exercise can raise the core body temperature and may trigger a hot flush.

3. Reduce stress 

  • Try slow, deep breathing when a hot flush starts.
  • Practice relaxation, mindfulness or meditation.
  • If you can, reduce stressful triggers and build in short recovery breaks.
  • Some people find yoga helpful for managing symptoms.

What treatments are available to manage hot flushes?

If lifestyle changes are not enough, speak with your doctor or breast care team. For many people with a history of breast cancer, hormone replacement therapy (HRT) is not recommended, but there are non-hormonal options that can help.

Non-hormonal medicines that may help:

  1. Antidepressants

Some antidepressant medicines can help to reduce the number and severity of hot flushes24, 25. Antidepressants that may be prescribed for hot flushes include:

  • Venlafaxine
  • Paroxetine (not whilst on tamoxifen)
  • Fluoxetine (not whilst on tamoxifen)
  • Citalopram
  • Escitalopram

Certain antidepressants, such as paroxetine and fluoxetine have the ability to greatly reduce the effectiveness of tamoxifen, therefore they should not be prescribed in conjunction with it. Check out our blog post on “Tamoxifen: what you should and shouldn’t avoid” for more information and ask your doctor before starting with an antidepressant.

  1. Neurokinin (NK) blockers

Fezolinetant (Veozah® / Veoza®) is a non-hormonal medicine approved for moderate to severe menopausal hot flushes and night sweats37,39. It blocks NK3 receptors involved in temperature regulation, and your prescriber may arrange liver blood tests before and during treatment.

Elinzanetant (Lynkuet®) is another non-hormonal option approved for menopausal hot flushes40. It also targets the neurokinin pathway (NK1/NK3) and may require liver monitoring and checks for medicine interactions, so suitability should be discussed with your doctor, especially if you’ve had breast cancer or are on treatment.

  1. Clonidine
Clonidine is a blood pressure medicine that can help some people with hot flushes. Side effects can include dry mouth, dizziness and constipation, so it is not suitable for everyone12,26, 27, 28. 
 
  1. Gabapentin and pregabalin
These medicines are often used for nerve pain or epilepsy, but may also reduce hot flush severity and improve sleep for some people. Common side effects can include sleepiness and dizziness12, 29, 30. They have been found to reduce both the severity of hot flushes and how long they last31, 32. Interestingly, it was by total accident that gabapentin was first discovered to reduce hot flushes 12. 
 
  1. Cognitive behavioural therapy (CBT)

Researchers have been looking into whether CBT can help in the management of hot flushes. CBT is a type of talking therapy which focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour, and aims to change how you respond to certain situations and emotions by providing you with coping skills. It combines cognitive therapy (examining the things you think) and behaviour therapy (examining the things you do) 33. 

Some studies have found that CBT, even delivered in group or self-help format, can reduce hot flushes and night sweats in women34, 35. The reductions in hot flushes continued after therapy had ended, and helped women to have a better mood and quality of life.

  1. Be careful with alternative medicines

You may hear of some alternative medicines, such as black cohosh, helping to combat hot flushes. However, if you are on Tamoxifen, black cohosh, as well as other foods, drinks and herbal medicines, may reduce the drug’s effectiveness. Check out our blog post on “Tamoxifen: what you should and shouldn’t avoid” for more information. Always speak to your doctor before trying out alternative medicines.

We hope that you now better understand hot flushes and how to manage them. Our aim is to make sure you are always kept informed so make sure to follow our Instagram and Facebook accounts for any updates.

If you would like to start monitoring and tracking your hot flushes, you can download the FREE OWise app from the iOS App Store or Google Play Store. 

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Editorial information

Written by: OWise editorial team | Clinically reviewed by: A. Bruinvels, MSc PhD | Last reviewed: January 2026

Useful Links

CRUK – https://www.cancerresearchuk.org/about-cancer/coping/physically/sex-hormone-symptoms/women-coping-with-hormone-symptoms/hot-flushes-and-sweats

Breast Cancer Now – https://breastcancernow.org/information-support/facing-breast-cancer/going-through-breast-cancer-treatment/hot-flushes-night-sweats

Menopause.org – https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/breast-cancer-survivors-hot-flash-treatments 

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