Why do some women have hot flash and some don't have after menopause?

Unfair!: You point to the fact that some women have different hormonal and physiological environments during menopause. It's really not fair, right? I definitely have had patients who say they barely noticed the menopause transition, and others who curse the changes. Smoking, obesity and lack of exercise can all exacerbate hot flashes. Thus a healthy diet, exercise and good habits may lessen.