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Menopause: The Basics
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Hot Flashes

Hot flashes can be one of the most uncomfortable and distressing menopausal symptoms and the one that lasts the longest. Depending on how you are progressing through menopause, hot flashes may be a sudden warming a few times per day or more uncomfortable with profuse sweating 10-12 times per day. Most women fall somewhere in the middle of this range, beginning in perimenopause and continuing for some years after menstrual periods have ended.

Hot flashes can have a negative impact on a woman’s well-being and quality of life. It’s understandable that many women will look into management, hormone treatments, and a variety of supplements to get relief from their hot flashes.

What are Hot flashes?

A hot flash involves a sudden feeling of intense heat. They commonly affect the face, neck, and chest and are often accompanied by redness, sweating, and anxiety. Some women also experience a racing heart while a hot flash is in progress. Most hot flashes are short; however, can last from 30 seconds to several minutes. Hot flashes can occur at any time during the day or night, although when they occur at night they are more commonly referred to as night sweats.

Most Common Signs and Symptoms of Hot Flashes

Sudden feelings of intense heat. Commonly occur in the face, neck, arms, chest, torso, or even the whole body.
Rapid or irregular heartbeat and pulse. Feels like your heart skipping a beat.
Flushing. Reddened, warm skin most commonly in the face.
Perspiration. Sweating can range from mild to profuse.
Cold chills. Commonly follow hot flashes, although some women only have the chills.
Sleep disturbances. Night sweats can be uncomfortable and disrupt sleep leading to fatigue or insomnia.
Other symptoms include headaches, dizziness, anxiety, and nausea.

Why do hot flashes happen?

It is thought that hot flashes occur as a result of the hormonal changes that characterize menopause. Falling estrogen levels are believed to affect the part of the brain that regulates body temperature. This encourages the “random” feelings of warmth and sweating.

Common Triggers of Hot Flashes

Hot and spicy foods or drinks
Overconsumption of caffeine, alcohol, and sugar
Warm environments (i.e., hot, humid weather, saunas)
Devices that give off heat (e.g., fireplaces, hair dryers, heaters)
Stress
Anxiety
Smoking cigarettes
Diet pills

Approaches for Managing Hot Flashes

Lifestyle changes
Medications
Alternative therapies

Approaches for Managing Hot Flashes

Lifestyle Changes

When considering ways to help fight hot flashes it’s smart to start with the least risky options. Lifestyle adjustments are a great first line option for women as they are usually risk-free and cost-free. The only downside is having the self control and motivation to see these changes take effect.

There are two different approaches when it comes to making lifestyle modifications to help aid in hot flash reductions. The first area is to simply avoid triggers that are likely to bring on a hot flash and the second is to improve overall health and wellbeing.

Avoiding Triggers

Dress in layers that are easy to remove
Wear breathable fibers
Avoid constrictive clothing
Stay in an air conditioned space if its hot/humid outside
Keep the bedroom cool, use cotton bed sheets
Use a cold, wet compress
Reduce consumption of hot drinks, alcohol, sugar and caffeine
Avoid spicy or hot foods

Overall Health and Wellbeing

Practice slow, paced breathing
Eat a balanced diet
Increase soy protein intake
Exercise regularly and maintain a healthy weight
Consider meditation, yoga, visualization, or other methods of stress relief
Drink a small amount of cold water or take a cold shower before bed

While some of these tips may be easy to accomplish, like reducing the amount of hot coffee or tea you drink in a day, there are some things which may be a little more unavoidable such as family or work stress. Being aware of ways to help acknowledge and recognize these stressors can be beneficial.

Lifestyle changes alone will not be able to address the underlying hormonal imbalance that can cause symptoms of hot flashes. However, these adjustments are a good option for motivated women looking to take control and fight off their hot flashes.

Medications

Medications to manage hot flashes are often considered as a third line option behind lifestyle modifications and supplements (discussed later) as they are more likely to cause unwanted side effects and possibly cost more.

The most common medication in the treatment of hot flashes is hormone replacement therapy (HRT). This type of medication has been shown to be reliable in relief of hot flashes; however, there are significant side effects in which the pros and cons of the medication must be weighed when considering this medication.

These medications do just what the name indicates, replace hormones like estrogen and progesterone. HRT can come in many different varieties, including both estrogen and progesterone, estrogen alone, or testosterone. Most HRT is in the form of a tablet you take by mouth, but it can also be found in the form of patches, creams, and gels. Symptoms like hot flashes can potentially be avoided by replenishing the hormones being depleted during perimenopause and menopause.

Commonly Prescribed HRT Medications

Estradiol
Imvexxy
Bijuva
Duavee
Premarin

Taking HRT comes with some risks. Hormone therapy may increase the chances of getting blood clots, heart attacks, strokes, breast cancer, and gallbladder disease in some women. It is recommended to use the lowest effective dose for the shortest amount of time needed due to the risk of side effects of HRT.

Who Should Avoid Using HRT?

Women with a history of:

Uncontrolled hypertension or high blood pressure
Heart disease
Severe migraines
Blood clots
Stroke
Endometrial, ovarian, or breast cancer
Liver disease

In addition to HRT, several other classes of medications are often prescribed to women in menopause/peri-menopause. These medications include:

Selective serotonin reuptake inhibitors (SSRIs)
Blood pressure medications
Mild sedatives
Anti-seizure medications

Supplements

Many women may choose to use hormonal therapy such as estrogen, progesterone, and testosterone as a primary treatment; however, some women find hormonal treatment unappealing. Supplements or alternative treatments may be a good option for those who want to take a different approach and still target the root cause of their hot flashes. It is important to note that supplements and other treatments are not free of risk and you should consult your doctor or pharmacist before starting anything new.

Alternative treatments and supplements can be used to rebalance the hormone changes that contribute to hot flashes. Some women may find relief from treatments of acupuncture or massage when they know that stress may be a big contributing factor for their hot flashes. These types of treatments may require more time commitment or may not be financially feasible options. Supplements may provide a more simple and convenient method to gaining relief from hot flashes.

Herbal supplements generally fall into one of two categories: estrogen balancing supplements and hormone regulating supplements.

Estrogen Balancing Supplements

Supplements that may aid in balancing estrogen and contain natural plant estrogens, called phytoestrogens. Hot flashes are linked to low levels of estrogen, which affects body temperature control.

Increasing estrogen levels in the body can help to create a better balance, therefore reducing the intensity and severity of hot flashes [1]. Phytoestrogens are a plant-based estrogen, which may trick the body into thinking there is estrogen present. This may lead to a decrease in the body’s own production of estrogen and further lowering hormone levels. Phytoestrogens have shown promise in many studies in helping to reduce hot flashes. There is still a lot to be discovered about their long term effects.

Phytoestrogens can also be found in the foods we consume. Some foods rich in phytoestrogens include soy, tempeh, strawberries, and alfalfa sprouts. Eating meals rich in phytoestrogens could potentially help relieve some menopausal symptoms, like hot flashes. Try out some free recipes we have provided to boost your phytoestrogen consumption to fight hot flashes.

Black cohosh is supported by the North American Menopause Society for treating mild menopausal symptoms [2]*. A few studies have indicated that black cohosh can lead to a 26% improvement in symptoms, including hot flashes [3]*.

Licorice root is another phytoestrogen, which contains compounds that stimulate estrogen receptors [4]*. A 2012 study found that licorice root capsules reduced the frequency and severity of hot flashes [5]*.

Dong quai has been used as a hormone balancing phytoestrogen for centuries in Chinese medicine and as part of herbal blends associated with a reduction in hot flashes. An Israeli study found that an herbal blend containing dong quai decreased hot flashes by up to 73% [6]*.

Hormone Regulating Supplements

Other supplements aim to stimulate hormone production. If the body can be encouraged to produce more of the hormones that are depleted during perimenopause, this can also help to reduce hot flashes (and other menopausal symptoms). Hormone regulating supplements could possibly be considered a safer option considering they act more like cheerleaders for the body to start producing more of its own hormones.

These types of supplements are of great interest to many women on the basis that they work to balance the endocrine system. They don’t contain any hormones, but they may have the ability to support the endocrine system in producing hormones naturally. This can balance key hormones, i.e. estrogen and progesterone, that start to dwindle during perimenopause and are even further depleted during menopause.

There is anecdotal evidence that evening primrose oil has evening primrose oil can make hot flashes less severe, but it’s not yet fully known if the number and duration of hot flashes can be decreased or shortened [7]*. –

Ashwagandha is an herb that can have hormone balancing qualities. A 2012 study involving Ashwagandha noted that women experiencing hot flashes had an increased level of IL-8. IL-8 (Interleukin-8) is a protein which is produced by the body during stressful situations. This lead to the thought that when estrogen levels fall (or when the body is under a significant amount of stress) cells in our body respond by secreting more IL-8. The results of this study indicated that Ashwagandha can decrease the amount of IL-8 produced [8]*

Many supplements combine the above herbs to support and help women in menopause, visit our store for more information on which supplements are available.

Other Supplements For Hot Flashes

Magnesium is an important mineral during menopause, particularly for hot flashes and night sweats. The role of magnesium in breast cancer patients who were experiencing a minimum of 14 hot flashes per week found that it could reduce the number of hot flashes by 25-50% [9]*. Sweating, fatigue, and discomfort were also shown to be decreased. A significant point about this study was that the participants were breast cancer patients. This meant that they were not able to take estrogenic medications and these results can be seen favorably by women who do not want to take them either.

It’s worth being aware that taking too much magnesium can make you more likely to experience side effects. These can range from fairly mild side effects, such as diarrhea and stomach upset to more serious problems such as low blood pressure, slow heart rate or cardiac arrest. For women who are taking high blood pressure or heart medications, it is best to check with a medical professional before starting any new supplements.

Vitamin E has been shown to give some relief from hot flashes, especially for those with relatively mild occurrences. Studies have indicated that vitamin E can reduce both the intensity and severity of hot flashes for women who are not receiving hormone therapy [10]*.

In a study published in the Journal of the International Menopause Society, vitamin E was compared to gabapentin for treating hot flashes in women who had survived breast cancer. The vitamin E group saw a 10% decrease in the number of hot flashes that they experienced. [11]*

A study published in the Journal of Managed Care Pharmacy compared various natural remedies for hot flashes, including vitamin E. This study also highlighted vitamin E as a potential treatment option for mild hot flashes [12]*. Clinical studies tend to use higher amounts of vitamin E compared to the recommended daily amount, which can lead to side effects such as nausea, diarrhea, headaches, skin rashes and fatigue.

Which Is Right for You?

Each of these approaches to relief from hot flashes are not mutually exclusive. It is important to consider many things when deciding what is right for you. Some women may find that a combination of these options, such as a healthier lifestyle along with alternative therapy is the best and most effective option to manage their hot flashes.

Disclaimers:

You should always consult your health care provider before starting any herbal supplements or products. *These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.