Hi, First the cause of spotting must be ruled out.Post menopausal spotting or bleeding should be thoroughly investigated. There can be several causes of postmenopausal bleeding. The most common causes are inflammation and thinning of the vaginal lining caused by lower oestrogen levels, cervical or womb polyps ,non cancerous growths and cancerous growths. Several medications have been shown to help with hot flashes, including clonidine, low doses of certain antidepressants such as venlafaxine and fluoxetine), and gabapentin. Non-medical recommendations include: - Keep well-hydrated with eight glasses of water daily.Drink ice water or apply an ice pack at the onset of a hot flash.Wear cotton or lightweight, breathable fabrics. - Exercise on a regular basis. - Try practicing meditation or relaxation exercises to manage stress. - Avoid triggers such as warm rooms, spicy foods, caffeinated beverages, and alcohol. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician