Why Your Body Feels Like a Furnace (And What Actually Helps)
Human bodies are remarkably efficient at maintaining a stable internal temperature, constantly balancing changing environmental conditions with the body's core needs. This process is controlled by three key systems: the brain, the body's core (internal cavity), and the peripheral blood vessels.
When the body experiences heat or cold stress, temperature receptors throughout these regions send signals to the hypothalamus-the brain's temperature control centre. The hypothalamus quickly coordinates the body's response to restore balance.
In hot conditions, blood vessels widen (vasodilation), increasing blood flow to the skin and triggering sweating to release excess heat. In cold conditions, blood vessels narrow (vasoconstriction), reducing blood flow to the skin to conserve body heat. These automatic responses help keep the body's core temperature within a safe and healthy range.
Around 80% of women experience hot flashes during the menopausal transition. These are sudden, intense sensations of heat that may be accompanied by night sweats and are among the most common vasomotor symptoms of menopause.
Hot flashes often begin during the perimenopausal stage and, for many women, can continue for years after menopause. Their frequency and intensity vary widely, with some women experiencing only occasional episodes while others have frequent or severe symptoms that affect daily life and sleep.
In addition to the sudden feeling of heat, hot flashes may be accompanied by flushing or reddening of the upper body and face, changes in heart rate and breathing, and sensations of pressure or discomfort in the head and chest.
Although a direct link between estrogen levels and the occurrence of vasomotor symptoms (VMS) has not been fully established, fluctuations in this key reproductive hormone are known to play an important role in triggering these symptoms. As estrogen levels rise and fall during the menopausal transition, the body's temperature regulation can become more sensitive, increasing the likelihood of hot flashes and night sweats.
Women who experience a sudden onset of menopause following surgical removal of the ovaries (oophorectomy) often report more frequent and severe vasomotor symptoms than those who go through natural menopause.
Due to the significant impact of these symptoms on the quality of life of women, women seek out diverse treatment options for relief. While some women prefer hormone therapy, it is not advised for women with current or a history of breast or endometrial cancer, coronary heart disease, or thromboembolic diseases.
As an alternative, neurokinin-targeted therapy using NK1 and NK3 receptor antagonists has been approved by the FDA for the treatment of hot flashes. These hormone-free oral drugs include Fezolinetant (an NK3 antagonist) and Elinzanetant (a dual NK1/NK3 antagonist), which block their respective receptors and calm overactive brain cells without altering estrogen levels. Fezolinetant has been in use since 2023, while Elinzanetant, approved more recently in October 2025, has shown strong efficacy in clinical trials, with some studies reporting reductions of over 70% in hot flash frequency and severity.
A recent review published in Women's Health summarises findings from the OASIS 1–4 clinical trials, which evaluated elinzanetant for the treatment of vasomotor symptoms (VMS) in women. These four trials were conducted across multiple countries: OASIS 1-3 enrolled women aged 40-65 undergoing natural menopause, while OASIS 4 enrolled women aged 18-70 experiencing VMS related to endocrine therapy for hormone receptor-positive breast cancer.
Using daily hot flash diaries and sleep disturbance questionnaires, elinzanetant treatment rapidly and significantly reduced both the frequency and severity of hot flashes compared with placebo. Sleep quality also improved, contributing to an overall improvement in quality of life. While some women experienced mild side effects-including fatigue, headache, and somnolence- these remained mild overall, with no significant safety concerns identified.
Vasomotor symptoms during perimenopause and menopause can be deeply disruptive, affecting nearly every aspect of daily life. But thanks to recent advances in research, women no longer have to endure them. With both hormonal and non-hormonal treatment options available, women have the power to choose what works best for their bodies and finally reclaim their comfort, sleep, and quality of life.
Disclaimer: This article is for educational purposes only and does not constitute medical advice. Fezolinetant (Veozah) is marketed by Astellas Pharma, and Elinzanetant (Lynkuet) is marketed by Bayer. Neither company has sponsored or endorsed this content. Please consult your healthcare professional before starting, stopping, or changing any treatment.
Reference
JoAnn V. Pinkerton, et al. Elinzanetant for the Treatment of Menopausal Hot Flashes: A Plain Language Review of the OASIS-1–4 Clinical Trial Results. 2026. Women's Health.
Deecher DC, Dorries K. Understanding the pathophysiology of vasomotor symptoms (hot flushes and night sweats) that occur in perimenopause, menopause, and postmenopause life stages. 2007. Arch Womens Ment Health.
