Hormones like Premarin control the hot flashes of menopause by delaying symptoms, but they probably do not lengthen the duration of symptoms.

Most women experience hot flashes and night sweats during the perimenopausal transition. The precise cause remains unknown, but the decrease in estrogen production from the ovaries is the trigger. Hot flashes decrease over time after menopause, though about 10% of women continue to have them into their 60s and 70s.

For severe hot flashes, estrogen therapy is a highly effective treatment. Estrogen should be used at the lowest effective dose for the shortest time necessary to control symptoms to minimize risks.

When a woman stops taking estrogen, hot flashes may return, especially if treatment is stopped abruptly. Gradually decreasing the dose of estrogen over several months usually helps to control the symptoms.

A woman who continues to have hot flashes must decide with her doctor if the symptoms are disruptive enough to justify the risks of prolonged hormone treatment.

Low-dose antidepressants called SSRIs (selective serotonin reuptake inhibitors) help some women. Some women may benefit from lifestyle changes such as increasing exercise and maintaining good hydration by drinking plenty of water.