Hot flashes — the sudden and intense feelings of heat and perspiration — are one of the most common symptoms of menopause. For many people, hot flashes can be more than a minor annoyance. They can have a serious impact on quality of life, making it difficult to sleep, work and even enjoy a night out. They can also be embarrassing and socially isolating.

"It is the first medication for menopause symptoms to target the neurons in the hypothalamus, which are responsible for the regulation of body temperature," says Traci A. Kurtzer, MD, a gynecologist and menopause specialist at the Northwestern Medicine Center for Sexual Medicine and Menopause.*

What are hot flashes?

Hot flashes are common and occur in about 80% of menopausal people. Symptoms — often called vasomotor symptoms (VMS) — include:

• A sudden, unexpected feeling of warmth on the face and upper body
• Flushed appearance on the skin
• Upper-body perspiration
• Elevated heartbeat
• Chills as the hot flash goes away

If you've experienced hot flashes during menopause, you know they sneak up when you least expect them — like in the middle of a work meeting, dining out with friends or quietly reading a book. Hot flashes also commonly happen at night and can wreak havoc on sleep quality and quantity.

"When you're not sleeping well, your body feels constantly under stress from the deficit, and stress hormones are not good for overall health," says Dr. Kurtzer, who is also a NAMS Certified Menopause Practitioner. "There is a connection between severity of vasomotor symptoms and worse long-term cardiovascular health, so it is important to find effective treatment."

There is also a connection between severity of VMS, and race and ethnicity. Research shows that Black and Hispanic women† can experience earlier and more intense hot flashes than women who are non-Hispanic white, Chinese or Japanese. Dr. Kurtzer says that the clinical efficacy trials of fezolinetant included women of color, an important group for which to have more treatment options. 

Medication Education

If you are considering taking fezolinetant, there are some important things to know:

• It is a prescription medication to be taken under the guidance of a physician.
• Bloodwork should be done before you take the medication and every three months for the first nine months of using the medication. The bloodwork will check your liver's health and make sure that the medication does not cause any damage.
• If you have cirrhosis, severe renal damage or end-stage renal disease, do not take this medication.
• This medication cannot be used with CYP1A2 inhibitors.

While taking this medication, if you experience any symptoms related to liver damage — such as nausea, vomiting or yellowing of the skin and eyes — contact your physician.

Hormone vs. Non-hormone Therapy for Hot Flashes

Dr. Kurtzer says that fezolinetant is an effective non-hormone therapy for treating moderate-to-severe hot flashes. "Fezolinetant is a good choice for people who cannot or choose to not use hormone therapy due to concerns about potential negative side effects," she says.

It may not be as helpful as hormone therapy for treating some of the other conditions associated with menopause, such as vaginal dryness, or in preventing osteoporosis or thinning of the bones, which increases the risk of fractures in menopausal women.

What about mild hot flashes?

If you have mild hot flashes that do not impact the activities of your daily life overall, there are several lifestyle changes you can try to help relieve symptoms:

• Lower your room temperature.
• Use a portable cooling fan.
• Invest in a pillow and/or mattress cover with a cooling gel.
• Wear lightweight clothing with breathable fabrics (such as linen, rayon and cotton).
• Avoid spicy foods, hot drinks and alcohol.
• Reduce stress with relaxation and breathing techniques.
• If you smoke, try to quit.

When to Seek Medical Treatment

Menopause does not have to be miserable. If you find that hot flashes are interfering with your daily activities or nighttime sleep, talk to your physician about treatment options.

*Disclosure: Dr. Kurtzer was a paid member of the advisory board for Astellas Pharma, the company that developed fezolinetant.

†Scientists do not always collect information from participants about gender identity. To avoid misrepresenting the results of this research, we use the same terminology as the study authors.