I use fans...they only happen during the day for me, and unless they start to affect my sleep, I don't want to take any medications. I know to dress in layers...if needed, only cardigans, not pullovers for outer layers....always a t-shirt/something short sleeve on for lower layer. I can have hot flashes in winter when my house is at 64 degrees, and in summer with air conditioner on...have learned to just turn on the fan the minute I start to feel one coming on and that helps.