The spikes of severe heat can happen multiple times a day and night, yet treatments aren't as numerous.
Barbara Urian, like millions of menopausal women, was looking for a way to beat the heat.
"At one point I was waking 12 times a night, tearing covers off, being very uncomfortable," she recalls.
Herbal remedies like Black Cohosh didn't help her hot flashes and she chose to avoid hormone replacement therapy after reading reports of potentially severe side effects.
"I come from the school that this is part of getting older, no one ever died from it, just grin and deal with it," she says.
She didn't have to deal with it for long.
Urian was one of nearly 200 women who participated in a clinical trial testing the antidepressant escitalopram, sold under the brand name Lexapro, for hot flashes.
Dr. Ellen Freeman led the study at the University of Pennsylvania School of Medicine.
After reviewing the daily diaries participants kept, the difference was clear.
"This appears to be an option for generally healthy women who are distressed by their menopausal hot flashes," she says.
Barbara could tell she wasn't taking the placebo from the first day of the trial.
"I got halfway through the day and realized I did not have a hot flash, it was the most amazing thing I had ever seen," she says.
This isn't an FDA approved use of the drug and doctors warn there could be side effects like fatigue and nausea, but experts say having new options to treat menopausal hot flashes is a very cool thing.
Also, one out of three women in the placebo group also experienced a significant reduction in hot flashes, leading experts to believe state-of-mind also plays a role in menopause symptoms.