Can exercise help with hot flushes? Here's what the evidence says
- rosiealicestockley
- Aug 3
- 3 min read
by Rosie Stockley · Strong for Life
Hot flushes are one of the most common and disruptive symptoms of perimenopause. Around 75–80% of women experience them, ranging from mild warmth and flushing to intense heat that interrupts sleep, work, and everyday life. For many women, they can last for years.
Most of the conversation around managing hot flushes centres on HRT, which is often very effective and worth discussing with your GP. What gets far less attention is the evidence for exercise - particularly strength training - as a meaningful intervention, and the research here is more compelling than most people realise.
Why hot flushes happen
Hot flushes are classified as vasomotor symptoms, and they're caused by the hypothalamus, the part of the brain that regulates body temperature, becoming more sensitive during the hormonal fluctuations of perimenopause. As oestrogen levels become less stable, the hypothalamus starts to misread the body's temperature signals, triggering the sensation of intense heat and the sweating response that follows.
Understanding this matters for understanding why exercise helps, because the mechanism isn't simply that exercise makes you fitter and fitter people have fewer symptoms - it's considerably more specific than that.
What the research shows
A 2024 meta-analysis published in Maturitas examined the effects of resistance training on vasomotor symptoms in postmenopausal women and found it was associated with a significant reduction in both the frequency and severity of hot flushes. A separate randomised controlled trial - a 15-week resistance training programme - found that participants in the intervention group reduced moderate-to-severe vasomotor symptom frequency by almost 50% compared to the control group.
The proposed mechanism involves exercise's effects on the sympathetic nervous system and on serotonin and endorphin levels. Strength training in particular appears to help stabilise the thermoregulatory system over time, making the hypothalamus less reactive to the hormonal fluctuations that trigger flushes.
One nuance worth noting: high-intensity interval training can trigger hot flushes in some women during or immediately after a session, particularly in the earlier stages of perimenopause. This doesn't mean HIIT is harmful, but it's a reason why strength training, which raises the heart rate progressively rather than acutely, tends to be better tolerated and more consistently helpful for this particular symptom.
What this looks like in practice
The exercise dose that shows up in the research is two to three strength training sessions per week, maintained consistently over at least eight to twelve weeks. Like most interventions, the effect builds over time rather than being immediate.
This doesn't need to be intense or exhausting training. The research supports moderate, progressive resistance work - the kind that challenges you without leaving you depleted. Recovery matters too, particularly in perimenopause when the body needs more time between sessions than it used to.
The wider picture
Hot flushes are one symptom among several that exercise has been shown to support in perimenopause, alongside sleep quality, mood, bone density, and muscle maintenance. This is partly why the evidence points so consistently towards resistance training as the most broadly beneficial form of exercise at this stage, rather than any single-symptom approach.
If you're looking for structured training built around the specific needs of women in perimenopause - including manageable session lengths, built-in recovery, and a programme that progresses without overwhelming you - Strong for Life is designed exactly for this. Find out more at www.strongforlifewithrosie.com
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