One minute you're fine; the next, a wave of heat climbs your chest and neck, your face flushes, and you're fanning yourself with whatever's nearest. At night, you wake up throwing off the duvet, damp and wide awake. If this is you, you're in good company — hot flushes and night sweats (doctors call them "vasomotor symptoms") are among the most common experiences of the menopause transition.

What's actually happening. Deep in your brain sits your internal thermostat, the hypothalamus. As oestrogen levels fluctuate and fall, this thermostat becomes more sensitive — its "comfortable" temperature range narrows. So a small rise in body heat that you'd never normally notice suddenly registers as "too hot," and your body slams on its cooling system: blood vessels near the skin widen (the flush) and you sweat to cool down. It's not a malfunction so much as an over-reaction.

Common triggers worth noticing. Many women find flushes are set off by heat, spicy food, caffeine, alcohol (red wine is a frequent culprit), and stress. You can't always avoid them, but tracking your own pattern for a couple of weeks often reveals two or three reliable triggers you can dial down.

What helps — the practical layer:

• Dress in layers you can shed, and keep your bedroom cool; a lightweight, breathable duvet and a fan by the bed help night sweats enormously.
• Mind the obvious triggers — easing back on alcohol and caffeine, especially in the evening, is one of the highest-impact changes.
• Lower the simmer of stress. Slow breathing, regular movement, and anything that calms your nervous system can reduce both frequency and intensity.
• Keep cool deliberately — a sip of cold water at the first sign, a cooler room, looser clothing.

What helps — the medical layer. For flushes that are frequent or severe, this is treatable. HRT remains the most effective option for many women, and there are also non-hormonal medications and newer treatments your doctor can discuss. The point worth holding onto: you do not have to grit your teeth and endure them as though there's nothing to be done. There is.

If hot flushes are disrupting your sleep or your days, that's reason enough to take them seriously — and to have a proper conversation about your options.

Common questions

What triggers hot flushes?

Common triggers include heat, spicy food, caffeine, alcohol and stress.

What's the most effective treatment for hot flushes?

HRT is the most effective option for many women; non-hormonal treatments exist too — discuss them with your doctor.

Keep reading: The truth about HRT · How hormones hijack your sleep · Take the free Hormone Quiz