Hello, Hot flashes are most commonly caused by changing hormone levels before, during and after menopause. A few causes of hot flashes are decreased estrogen levels, side effects of medications, thyroid dysfunction, treatment for various cancers, risk factors are smoking and obesity. In order to avoid hot flashes, few triggers are to be avoided like stress, caffeine, alcohol, spicy foods, tight clothing, heat, and cigarette. To reduce hot flashes, stay cool. At night, a chill pillow filled with water or other cooling material might help. Wear lightweight, looser-fitting clothes made with natural fibers such as cotton. Try deep, slow abdominal breathing (6 to 8 breaths per minute). Practice deep breathing for 15 minutes in the morning, 15 minutes in the evening, and when a hot flash starts. Exercise daily. Walking, swimming, bicycling, and dancing are all good choices. Soy products are known to reduce the symptoms so have soy products like tofu regularly. The main treatment is hormone replacement therapy for limited time, after stopping hormone replacement therapy. What is indicated are low-dose depression drugs like fluoxetine (Prozac, Rapiflux), paroxetine (Paxil, Pexeva), or venlafaxine (Effexor), Clonidine, a blood pressure medication, Gabapentin, an anti-seizure drug, Brisdelle, a paroxetine formula specifically for hot flashes, Duavee, a conjugated estrogens / bazedoxifene formula designed to treat hot flashes, Tab. Evion LC daily once for at least 4 months. Tab. B complex to be taken daily. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pallavi M., Anesthesiologist