Could Hot Flashes and Night Sweats Serve as Early Signs of Poor Brain Health?

— Vasomotor symptoms have the potential to serve as female-specific midlife markers


ATLANTA -- Hot flashes and night sweats, particularly those that happen during sleep, may be an an early marker for cognitive illness, a study found.

Frequent vasomotor symptoms that occurred during sleep were associated with increased white matter hyperintensity volumes (B[SE]=0.17 [0.06], P<0.05), brain lesions that have been linked with cognitive impairment, reported Rebecca Thurston, PhD, of the University of Pittsburgh Medical Center.

Vasomotor symptoms that occurred only when participants were awake were also associated with greater white matter hyperintensity volumes, although the change was not significant (B[SE]=0.09 [0.046], P=.089), Thurston said in a presentation at the North American Menopause Society (NAMS) annual meeting. The results were also published in .

Additionally, vasomotor symptoms that occurred over a 24-hour period were linked with increased white matter hyperintensities (B[SE]=0.10 (0.05), P<0.05), she noted.

And sleep-time hot flashes and night sweats were associated with greater white matter hyperintensity volume in the deep, periventricular, and frontal regions of the brain, Thurston explained. She added that the associations between white matter hyperintensities and vasomotor symptoms were independent of the participants' sleep patterns.

"I think this underscores the parallel findings between peripheral vasculature and cerebrovasculature," Thurston said. "Vasomotor symptoms may be telling us something about women's health at midlife." This period is decades before women may go on to develop cognitive illnesses such as Alzheimer's or dementia, she said.

Approximately 70% of women experience vasomotor symptoms during the menopausal transition, with symptoms lasting for 7 to 10 years on average. While vasomotor symptoms have long been regarded as a side effect of menopause that affects quality of life, more studies are linking frequent hot flashes or night sweats to physical illnesses, such as .

Thurston and colleagues conducted the MsBrain Study in Allegheny County in Pennsylvania from 2017 to 2020. Study participants underwent physiologic monitoring of vasomotor symptoms, actigraphy assessment of sleep, physical measures, phlebotomy, and neuroimaging. The researchers adjusted for covariates including age, race, education, smoking, BMI, blood pressure, insulin resistance, and lipids.

The study had 226 women with an average age 59, and an average BMI 26.7, who were normotensive. They were not on hormone therapy. Participants were late perimenopausal or postmenopausal and had not had a period in the prior 2 months. Women with a history of stroke, dementia, brain tumors, seizures, head trauma, and other brain-related illnesses were excluded from the analysis. On average, participants had five vasomotor symptoms over a 24-hour period.

Because the majority of the study participants were white, the results may not be generalizable to a diverse population, Thurston cautioned. Also, most of the study participants were postmenopausal so the finding may not apply to all perimenopausal women.

She said that future research will look into whether the treatment of vasomotor symptoms may improve CV and cognitive health. While hormone replacement therapy is the most effective treatment for vasomotor symptoms, other therapies that do not impact the vasculature or the brain need further research, she added.

  • Amanda D'Ambrosio is a reporter on app’s enterprise & investigative team. She covers obstetrics-gynecology and other clinical news, and writes features about the U.S. healthcare system.


The study was funded by the NIH.

Thurston disclosed relationships with Astellas, Bayer, Happify Health, and Hello Therapeutics.

Primary Source

North American Menopause Society

Thurston R, et al "Menopausal vasomotor symptoms and white matter hyperintensities in midlife women" NAMS 2022; Abstract S-17.

Secondary Source


Thurston RC, et al "Menopausal vasomotor symptoms and white matter hyperintensities in midlife women" Neurology 2022; DOI: 10.1212/WNL.0000000000201401.