🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.

What you will learn in this episode

In this episode, Odile Bagot tackles the most common and debilitating symptom of menopause: hot flashes. You will understand the mechanism behind this symptom and the full range of available solutions, including for women with a history of breast cancer.

How to recognize a hot flash, and why it affects almost every woman
The true mechanism behind this symptom, which remains partially mysterious
Hormone therapy, and why it cannot always be prescribed
Specific solutions for women who have had breast cancer
Simple daily tips that make a real difference

Summary

👓 Watch the video 📓 What I'm going to learn 💡 Key figures 🎯 Take action 🔎 Definitions 🎬 Next episode ❓ Ask a question

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💡 Key figures

Fezolinetant (Veoza), the first non-hormonal treatment for menopausal vasomotor symptoms, has been available in France since April 2025 by prescription; it is not reimbursed and requires liver monitoring.

Source: Vidal.fr, "VEOZA: non-hormonal treatment for menopausal vasomotor symptoms."

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Approximately 70 to 75% of women will experience vasomotor symptoms (hot flashes, night sweats) during menopause.

Source: Vidal.fr, same article.

Recognizing a hot flash

A hot flash is a sudden sensation of dry heat that rises, sometimes starting from the chest, with the face flushing (often much less visible to others than what the woman herself feels). It comes on suddenly and disappears just as quickly. Another form it can take is night sweats, sometimes so intense that they soak your nightgown. Collectively, these are called vasomotor symptoms.

A symptom that affects almost every woman, and that lasts

At least three out of four women will experience hot flashes. They appear as early as the menopausal transition, are particularly intense during the first year without periods and the years that follow, but after five years, half of women still experience them. Some patients still have them at age 70-75. Very few women escape them entirely.

A real daily burden

Night sweats disrupt sleep. They also pose a social challenge, particularly at work (disagreements over room temperature). There is also a long-term impact on cardiovascular health, as repeated hot flashes can damage blood vessels.

Understanding the mechanism: a hypersensitive thermostat

The thermostat that regulates our body temperature is located in the hypothalamus. Normally, it tolerates variations of about 1°C before triggering regulation (vasodilation to release heat). During menopause, this thermostat becomes hypersensitive: a variation of just 0.1°C is enough to trigger a hot flash. This is under the control of estrogen : giving estrogen to a menopausal woman eliminates hot flashes in almost all cases. However, the mechanism is not fully understood: women suffering from anorexia nervosa, who also lack estrogen, generally do not experience hot flashes.

Beware of "false" hot flashes

Certain types of hypertension, severe anemia, or thyroid dysfunction can cause sensations of heat that differ from the characteristic hot flashes of menopause. If the profile is atypical, a medical consultation can help rule out these causes.

The most effective treatment: MHT

Menopausal Hormone Therapy remains the most definitive treatment, but it is theoretically only prescribed after menopause is confirmed (one full year without periods). During this transition year, which is difficult to identify until it is over, other solutions must be relied upon, particularly dietary supplements.

The specific case of women with a history of breast cancer

These women experience a true "triple burden": the cancer, the menopause they face head-on, and the inability to use hormone therapy. Furthermore, the powerful anti-estrogen treatments they receive multiply the intensity of their hot flashes. It is important to know that: menopausal hormone therapy does not increase the risk of breast cancer, but it remains contraindicated for women who have already had it, as a precaution, due to the estrogen receptors often found on these cancer cells (known as "hormone-dependent").

Fezolinetant: a new non-hormonal option

Since 2025, a new non-hormonal treatment has been available: fezolinetant (Veoza), a daily tablet that provides relief for about two-thirds of women, with no contraindications for those with a history of breast cancer. It currently costs around €80 per month (not reimbursed) and requires liver monitoring due to a risk of hepatotoxicity.

Phytoestrogens: a word of caution

Phytoestrogens (such as soy) are plant-based compounds that act like estrogen. As a precautionary measure, concentrated dietary supplements containing phytoestrogens are not recommended for women who have had breast cancer, but please note: soy in a normal diet is not a problem, and some studies even suggest a protective effect. It is the concentration in supplements that is the concern, not the food itself. When in doubt, talk to your healthcare professional.

Everyday solutions

A hand fan : simple, inexpensive, and truly effective—don't overlook it. Bedding : share a bed but use separate duvets (a thin one for yourself), use a silk pillowcase for coolness, and keep the bedroom cool. Diet : avoid spicy or very hot foods, which can worsen hot flashes (and rosacea for those affected). Psychological support does not directly treat hot flashes, but it can help you cope better if this period is difficult.

You have every right to be in the menopausal transition or early menopause, experiencing hot flashes, opening a window, and fanning yourself. There is no need to be ashamed.

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🔎 Useful definitions

Vasomotor symptoms : a combination of hot flashes and night sweats caused by a disruption of the body's internal thermostat during menopause.

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Phytoestrogen : a plant-based compound (such as those found in soy or flax, as mentioned by Odile) that acts in the body in a way similar to estrogen. It is primarily concentrated phytoestrogen supplements that should be avoided if you have a history of breast cancer, not these foods when consumed in normal amounts.

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Hormone-sensitive cancer : cancer in which the cells have estrogen and/or progesterone receptors, which influences the choice of treatment and necessary precautions (including the exclusion of MHT).

🎯 Practical actionsDon't hesitate to use a fan or cooling accessories during a hot flash—there's no need to feel self-conscious.
Adjust your bedding: use a separate, lightweight duvet, a silk pillowcase, and keep the bedroom cool.
Limit spicy or very hot foods if you experience frequent hot flashes.
If hot flashes are very bothersome, talk to your doctor about evaluating hormone therapy (once menopause has been confirmed).
If my hot flashes occur repeatedly throughout the day but the profile does not match the one described (isolated, associated with other signs), consult a doctor to rule out other causes (thyroid, anemia, hypertension).
If hormone therapy is not an option (particularly if you have a history of breast cancer), ask your doctor if fezolinetant (Veoza) is a suitable alternative.
If you have a history of breast cancer, check the ingredients of any dietary supplements you take with your healthcare provider (avoid concentrated phytoestrogens).
If you are finding the experience difficult, consider psychological support as a complement to physical solutions, not as a replacement.

⭐ The Daring Menopause series is made possible by the support of Puissante, a French brand dedicated to women's well-being and pleasure. Theepisode 8 is dedicated to them, featuring their famous Coco as well as their full range of products for intimate health.