Original of this article was published on ZRT Laboratory Blog. Last reviewed: May 2026.
I remember the uncertain winter of my entrance into perimenopause so well. It began in my late 40s, with hot flashes that came on like heat waves every half hour. In the dead of winter, I found myself flinging open windows to let in the freezing air; I soon found out that having hot flashes in winter was nothing like having them in summer, when the added heat and humidity made them feel more like mini-meltdowns.
How to Cool Down Without Melting Down
Perimenopause is a hormonally challenged transition during which the ovaries gradually begin to make less oestrogen and progesterone; it lasts up until menopause, when the ovaries stop releasing eggs altogether. For some, perimenopause spans just a few months, but for others, it can last as long as 10 years. Regardless of its length of time, no one likes being plagued by hot flashes, night sweats, or other common symptoms such as foggy thinking, fatigue, and mood swings.
Perimenopause is a transition during which the ovaries gradually begin to make less oestrogen and progesterone… for some, this spans just a few months, but for others, it can last as long as 10 years.
During this transition, it’s important to realise that the extent to which we suffer from persistent symptoms has much to do with the extent to which our hormones are out of balance.
To help you picture that in your mind, imagine several synchronised swimmers all pointing their toes in perfect petal formation at the exact moment. Suddenly, one swims off in a different direction (let’s call her progesterone), another dives to the bottom of the pool (call her testosterone), and a few more splash up and down (diurnal cortisols) while the last of the swimmers (call her oestrogen) starts making waves that disrupt the whole routine.
It is these fluctuations of female hormones, particularly out-of-sync progesterone and oestrogen levels, that are largely responsible for hot flashes and night sweats. In fact, 80% of women with shifting and declining oestrogen levels will experience hot flashes at some point in their progression toward menopause (which is officially defined as 12 sequential months without a menstrual cycle).
To find out if you have a hormonal imbalance, hormone testing is the way to go. Our Comprehensive Female Saliva Hormone Profile (LCMS) measures oestradiol, progesterone, testosterone, DHEA-S and cortisol from a simple at-home saliva sample — identifying the specific imbalances behind your hot flashes and matching them to your symptoms.
What You Can Do
Lifestyle Changes to Reduce Hot Flashes
Avoid alcohol (especially sweet white wines), caffeine, sugars, spicy foods, and hot soups and drinks that actually trigger or worsen hot flashes.
Avoid unnecessary stress — one of the biggest causes of hot flashes and night sweats. Your body reacts to constant stress by raising cortisol levels, which alters the normal balance of hormones in the body. Vow not to let stress take centre stage in your life. Start to banish it now by breathing deeply to get oxygen to the brain; this is an instant stress reliever. Make time to read, relax, soak in the tub, go for a 20-minute walk, or take a 10-minute nap. Cancel appointments that aren’t top priority. Identify what is top priority; do whatever it takes to lower stress hormones and quell the hot flashes.
If you suspect that elevated cortisol is worsening your perimenopausal symptoms, our Adrenal Function Saliva Test Kit (LCMS) measures DHEA-S and cortisol across four time points throughout the day — revealing whether adrenal stress is amplifying your hot flashes and night sweats.
Reset the thermostat in your house to around 20°C. Sleep researchers observe that sleeping in a cooler room can lead to deeper, more restorative sleep. Night sweats can also be triggered by changes in room temperature, so if you start off cool and use minimal covers you are less likely to wake in a sweat as your body warms up through the night.
Exercise daily to release tension held in the muscles, which will allow your body to truly relax. Exercise also triggers endorphins — the “feel good” hormones that help you feel calmer and increase your overall sense of wellbeing. Experts tell us that women who make exercise a part of their daily routine have fewer hot flashes, night sweats, and other symptoms of imbalance.
What You Can Take
Natural Remedies and Supplements for Hot Flashes
Bioidentical progesterone is known to dramatically reduce the strength and frequency of hot flashes by keeping oestrogen and progesterone balanced and less prone to erratic fluctuation. Studies have shown up to 80% relief from hot flashes in women using bioidentical progesterone in a “Goldilocks” dose — no more, no less than the body needs to mimic natural physiology.
Many find that hot flashes worsen when they switch from synthetic to natural hormones, so it’s important to use test results for appropriate dosing, and to retest levels in three months to track progress and make adjustments. For example, women whose test results repeatedly show low oestrogen levels may need to supplement bioidentical oestrogen in concert with progesterone. Our Comprehensive Female Saliva Hormone Profile (LCMS) is ideal for monitoring hormone levels before and after starting any hormone therapy.
Anti-stress multivitamins and trace minerals include vitamins C, B-complex, and E to help quell hot flashes and get you through the night without breaking a sweat. Trace minerals such as zinc and selenium may also help.
Essential fatty acids balance oestrogen production and may help reduce hot flashes.
DIM (diindolylmethane), the active ingredient in cruciferous vegetables, promotes proper hormone metabolism and helps improve oestrogen/progesterone equilibrium to steady the hot flashes and related symptoms. Try eating plenty of broccoli, Brussels sprouts, cauliflower, cabbage, and kale, and/or taking additional DIM in supplement form.
Soy protein (non-GMO) in moderation has been shown in studies to relieve hot flashes and night sweats. Asian women with soy-rich diets are famous for their lack of hot flashes and menopause symptoms. The best sources are naturally fermented tofu, tempeh, miso, tamari, etc., vs. processed versions such as soy milks, cereals, chips, and bars.
Phytonutrients such as magnolia, red clover, dong quai, black cohosh, and rhodiola, among other plant-based herbs with mild oestrogenic effects, can be used as teas, tinctures, and/or supplements to cool hot flashes and help you refocus. Flaxseed contains a phytoestrogen known to help diminish hot flashes by providing natural plant-based oestrogenic nutrients.
Most women are well aware of perimenopause and menopause symptoms as they approach their 40th and 50th birthdays; they discover with hot flashes or night sweats that there is no “getting out” of menopause. However, what is not inevitable is a perpetually perspiring, red-faced woman staring back at you in the mirror. Remember that whatever the time of year, hot flashes are not forever! With a little research and help from your health care practitioner, you can find relief during this period of transition.