10 Ways To Ease Hot Flashes

Photo: Jorg Greul/Getty Images

When it comes to managing hot flashes, here’s what might work and what might waste your time—or money.

Waiting for you hot flashes to subside? These sweaty sessions can stay in your life for up to a decade or longer. There is relief, but not all remedies are equally effective.

“There are lots of muddied ideas out there, and you have to be careful,” says Dr. Jennifer Pearlman, a women’s health and wellness physician in Toronto. “Women are best served by a medical expert who can direct them to the most suitable options for them regarding safety and effectiveness.”

Here’s what might work and what might waste your time—or money.

1. Hormone therapy

Because hot flashes are triggered by falling estrogen levels, taking estrogen is the most effective way to alleviate them. Pearlman often recommends a combination of bioidentical estradiol (a type of estrogen) patch and progesterone taken as a capsule (for preventive health benefits). Prescribed hormones are produced in a lab using plant sources and pregnant mares’ urine. Bioidentical hormones, synthesized from yams or soy, are identical on a molecular level to those your own body would make. Speak with your health-care professional about the right dose, and use with other approaches instead of relying solely on hormone therapy.

“To flood a woman with estrogen to solve a myriad of menopause-related problems is never going to be as safe as taking a more integrative approach,” Pearlman says.

That may especially apply if you have certain health risks like blood clots or cancers associated with estrogen including breast and uterine.

2. Herbal supplements

Although the evidence isn’t overwhelming, some botanical products—black cohosh, red clover, rhubarb extract—may take the edge off your hot flashes. Other menopause supplements you’ll find on health-store shelves, including dong quai, kava and evening primrose oil, don’t appear to make a difference. Supplements can have side effects—black cohosh can cause liver problems—so chat with your health-care provider first.

3. Non-hormone drugs

Gabapentin, a prescription drug for neurological disorders, lessens hot flashes in some women. “Gabapentin is sedating so, for my sleepless patients, I might get them to try it at night,” says Pearlman. The blood pressure drug clonidine may help, and many antidepressants appear to relieve hot flashes as well. Again, these medications can have unwanted side effects.

4. Soy

Is it effective or only soy-soy? (We couldn’t resist.) Research is limited and mixed. Soy contains plant estrogens, and Asian women who eat it regularly often experience fewer hot flashes. But most scientific studies have not found strong evidence for taking soy. A 2012 research review concluded that two daily servings may make a small difference. Worried soy can cause breast cancer? When eaten in moderate amounts (two daily servings), it won’t. Soy compounds may in fact play a protective role against cancer.

5. Hypnosis

Research is promising, especially since a 2013 randomized controlled trial showed that hypnotic relaxation therapy improved hot flashes by up to 80 per cent. The women in the study also learned self-hypnosis. One of the keys: cool imagery, such as a snowy scene.

Next: Avoiding caffeine and alcohol

6. Avoiding caffeine, alcohol and smoking

Although it’s not fully understood why, coffee, tea and other caffeine drinks can actually bring on hot flashes (not to mention interfering with shut eye). Alcohol has been shown to aggravate menopause symptoms such as insomnia and mood changes. Smokers are at greater risk of hot flashes—again, for yet-to-be-determined reasons—but what’s less certain is whether quitting reduces that risk. Last year, an epidemiologist at the University of Illinois found that women tend to have less frequent and less severe hot flashes after they quit smoking. The effect was weaker, though, in women who’d quit only within the past five years.

7. Weight management

Do heavy women have more hot flashes or fewer? Fat cells make an enzyme that converts sex hormones into estrogen, so if you’re overweight, you produce more estrogen. “That actually mitigates the hot flashes a bit,” says Pearlman. But many experts suggest weight loss can ease hot flashes. It may depend on your age. A study in Journal of Clinical Endocrinology & Metabolism found that fat is helpful after about age 60, when your ovaries have stopped making estrogen. Before that, heavier women have more hot flashes than their slimmer pals. These links were strongest among Caucasian women.

8. Giving up sitting

We know a sedentary lifestyle means big trouble for cardiovascular health. Now, sitting has been linked to worsened hot flashes and other menopausal symptoms after a study of more than 6,000 mid-life ladies.

9. Acupuncture

A group of women at Wake Forest Baptist Medical Center in North Carolina who were given acupuncture treatments saw hot flashes and night sweats reduced by more than a third. Since emerging research shows a direct association between stress level and hot-flash severity, anything that lessens anxiety stands a good chance of relieving hot flashes. “We recommend engaging in stress management interventions like mindfulness, breathing and yoga,” Pearlman says.

10. Cognitive behaviour therapy

CBT may not get rid of your hot flashes, but it can lessen their impact on sleep and daily activities. CBT works by helping women replace negative thoughts (“These hot flashes are driving me up the wall!”) with adaptive ones (“This will be over in a few minutes”), modify behaviours that trigger hot flashes, like diet choices, and learn behaviours that mediate them, such as relaxation techniques. CBT is most effective when used in combination with other solutions. “The reality is you would never leave my clinic with just yoga.” says Pearlman. “I spend time talking about lifestyle: dress in layers, lower bedroom temperature, avoid triggers like caffeine and alcohol.”

A version of this article appeared on the November 2016 issue with the headline, “10 Ways To Ease Hot Flashes,” p. 28-30.