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How To Treat Hot Flushes Menopause

Cynthia Managed Her Severe Night Sweats Using A Little Hot Flush Kit She Kept Beside Her Bed

How to Treat Hot Flashes and Menopause? – Dr. Shira Miller

In the early days, I had to get up physically on the hour every hour. It woke me without fail and I had to get out of bed, go into the other room, had a big fan, stand in front of it until I cooled down and then I went back to bed. You do get used to doing that and you do sleep in between. As I got better at managing them I think, I identified that I couldnt drink anything and I couldnt eat curry or Chinese food I got so that I had my little hot flush kit beside the bed. I had a towel and gel pack, sports injury gel pack that had been frozen inside of a pillow case. And Ive got dozens, dozens and dozens, and Ive still got them in a little basket of those little hand fans like youd have on holiday. And I had that beside the bed so when I woke with a hot flush starting, Id grab the towel and slip that underneath me, the gel pack behind my neck and the little fan resting on my chest and Id just lie there like a sack of potatoes until it passed. And then Id chuck it all off and go back to sleep until the next one. And I did sleep. I did get used to being tired but I did sleep in between each hot flush. But they were on the hour.

Treating Hot Flushes Without Hormones: What Works What Doesnt

Numerous products and techniques are promoted for hot flashes, but do they work, and are they safe? To answer these questions, a North American Menopause Society panel of experts weighed the evidence and made recommendations in a position statement, Nonhormonal management of menopause-associated vasomotor symptoms, published online today in the Societys journal, Menopause.

From 50 to 80 percent of women approaching menopause try nonhormonal therapies for hot flushes. US and British surveys show just how uncertain women are about these therapies, with one survey demonstrating that nearly half feel confused about their options for managing menopause symptoms and another showing that 75% dont feel fully informed about herbal products.

The NAMS panel found evidence that a few therapies do work, including two behavioral approaches and certain nonhormonal prescription medications. Other lifestyle and behavioral approaches, treatments, and a supplement under study look beneficial, but the evidence is not as strong. And the evidence for other lifestyle approaches, herbs, and supplements is insufficient, inconclusive, or just plain negative.

Evidence that isnt as strong suggests that some other approaches may be beneficial, including weight loss, stress reduction, a soy derivative under study , and stellate ganglion block , so the panel recommends these with caution.

Black Cohosh For Hot Flashes

Black cohosh is an herbal preparation that is becoming more and more popular in the U.S., and the North American Menopause Society does support the short-term use of black cohosh for treating menopausal symptoms, for a period of up to six months .

Some studies have shown that black cohosh can reduce hot flashes, but most of the studies have not been considered to be rigorous enough in their design to firmly prove any benefit. There also have not been scientific studies done to establish the long-term benefits and safety of this product. Research is ongoing to further determine the effectiveness and safety of black cohosh.

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Oestrogen And Progesterone Therapy

Oestrogen is the main hormone prescribed to relieve menopausal symptoms, and for women who have had a hysterectomy, this may be all they need.

In women who still have their uterus, oestrogen alone can overstimulate the cells lining the uterus, causing an increased risk of endometrial cancer .

To remove the risk of overstimulation, women who have not had a hysterectomy need to take progesterone, or a synthetic form known as ‘progestin’, together with the oestrogen. ‘Progestogens’ is the name used to refer to both the natural form of progesterone and the synthetic form, ‘progestin’.

Alternative Therapies Are Worth Trying

Top 5 Natural Remedies for Hot Flashes

Alternative therapies can also alleviate symptoms of menopause, like hot flashes. In particular, Cognitive Behaviour Therapy can help develop practical skills and techniques to manage hot flushes. Studies have found that CBT is widely applicable for women having problematic hot flashes and night sweats, regardless of sociodemographic or health-related factors, and that CBT works mainly by changing the cognitive appraisal of handling menopausal symptoms.For some, acupressure, acupuncture and herbal therapies can help reduce hot flashes.

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How To Treat Hot Flushes

The most effective treatment is Hormone Replacement Therapy , which stops hot flushes completely in most cases. Its available from a GP and can be prescribed in tablet, patch or gel form. As well as relieving symptoms of the menopause, HRT significantly helps to protect women against osteoporosis and heart disease as they age.

For more information about HRT, download Lizs bestselling e-book ;The Truth About HRT.;

Reduce Refined Sugar And Processed Foods

A diet high in refined carbs and sugar can cause sharp rises and dips in blood sugar, making you feel tired and irritable.

In fact, one study found that diets high in refined carbs may increase the risk of depression in postmenopausal women .

Diets high in processed foods may also affect bone health.

A large observational study found that among women aged 5059 years, diets high in processed and snack foods were associated with poor bone quality .

Bottom Line:

Diets high in processed foods and refined carbs are associated with a higher risk of depression and worse bone health in postmenopausal women.

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What Are Some Common Triggers

Each womans hormones have a delicate balance of their own, which is why triggers vary from one woman to the next. However, some common triggers for hot flashes are:

  • Stress or Anxiety
  • Eating spicy foods
  • Bending over suddenly

Its a good idea to identify your triggers, as this can help make hot flashes less frequent and/or severe. While it is not possible to prevent hot flashes completely during menopause, avoiding or controlling your triggers will go a long way towards improving your quality of life.

How Can You Deal With Hot Flushes

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There are some things you can do to help manage hot flushes yourself. Try these tips to stay cool, calm and collected.

Avoid triggers. Although hot flushes can be unpredictable, you might find theyre worse after drinking alcohol or caffeine, after eating spicy food or when youre stressed, for example. Try keeping a diary for a few weeks to see whether you notice a link or trigger.

Dress lightly. Wearing lighter clothing made of natural, breathable fabrics, such as cotton, silk or soft wool, might help you to keep cool. Go for looser styles rather than tighter ones. During the colder months, wear a few light layers so you can easily take clothes off when you feel a hot flush coming on.

Layer your bed linen. The same principle applies at bedtime. Try to keep your room cool. Rather than using one heavy duvet, try layering a few light blankets and sheets made from natural fabrics. Sheets made with 100% cotton are usually cool and comfortable.

Use a fan. Keep a fan in your bedroom and on your desk for times when you need to cool down. You can also carry a battery-powered mini-fan in your bag, or go for vintage glamour with a traditional hand-held fan.

Carry a cooling spray. Keep a small spray bottle in your bag, on your desk or close to hand when youre at home. Fill it with water and give yourself a little spritz to cool down during a hot flush.

Take a lukewarm shower. When you take a shower, aim for a temperature thats a happy medium rather than too hot.

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How Long Does It Last

The average hot flash lasts from 30 seconds to 10 minutes. Everyone gets them with a different frequency and intensity.

In most people experiencing it during menopause, hot flashes last between 6 months and 2 years. Often this symptom will stop once youve completed the menopause transition.

Up to half of women report continued hot flashes for a few years after menopause. Some keep getting them for 10 years or more well into their 70s or 80s. Things like your genes and hormone levels will dictate when this symptom stops.

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How Long Will I Be Having Hot Flushes For

Each woman is different and therefore their symptoms, severity and duration of symptoms will be different. According to a recent study carried out in the United States called the Study of Womenâs Health Across the Nation , vasomotor symptoms such as hot flushes and night sweats will last between 7 to 11 years.

One factor determining the duration of these symptoms is the timing of the onset of hot flushes and night sweats. If a woman begins to experience these symptoms prior to cessation of menstruation or during the peri-menopause stage then the symptoms average more than 11 years while women who are already post menopausal at the onset of symptoms averaged 3.4 years.

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Eat Lots Of Fruit And Vegetables

A diet rich in fruits and vegetables can help prevent a number of menopause symptoms.

Fruits and veggies are low in calories and can help you feel full, so theyre great for weight loss and weight maintenance.

They may also help prevent a number of diseases, including heart disease .

This is important, since heart disease risk tends to increase after menopause. This could be due to factors such as age, weight gain or possibly reduced estrogen levels.

Finally, fruits and vegetables may also help prevent bone loss.

One observational study of 3,236 women aged 5059 found that diets high in fruit and vegetables may lead to less bone breakdown .

Bottom Line:

A diet rich in fruit and vegetables may help keep bones healthy, and can help prevent weight gain and certain diseases.

Menopause And Excessive Sweating: When Medication Is In Order


Some women find relief with lifestyle changes, but others need more. The most important thing to remember: talk to your doctor and think about all of the possibilities for treatment, says Mary Lake Polan, MD, PhD, adjunct professor of obstetrics and gynecology at Columbia University School of Medicine in New York City.

Finding a treatment that works for you is a highly individual thing. âI tell patients to keep trying,â Polan says. Sooner or later youâll find relief from hot flashes and night sweats.

Hormone therapy. Hormone therapy is the most effective way to treat hot flashes, but the Women’s Health Initiative study found an increased risk for heart disease, blood clots, and stroke, and an increase in breast cancer when women took oral estrogen and progestin long-term, Omicioli says. The increased heart disease risk was in older women who were 10 or more years postmenopausal, she says.

But thereâs emerging evidence that non-oral forms of estrogen — a cream, gel, patch, or ring — may have safety advantages in reducing risk of blood clots and stroke, Omicioli says.

The WHI study didnât find an increased risk of breast cancer in women who took estrogen alone, Omicioli says. The study also looked at one dose of oral estrogen and synthetic progestin. âThere may be a lower risk with progesterone vs. synthetic progestin,â she says.

The supplement black cohosh may also help some women reduce hot flashes, although the results of scientific studies have been mixed.

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Why Was This Study Needed

Menopause usually occurs in women between 45 and 55 years old, with an average age of 51. About 1 in 100 women experience premature menopause before turning 40.

In 2016, a UK survey showed that women aged 45 to 65 years who had experienced menopause in the previous ten years experienced on average seven different symptoms, with 42% saying that symptoms were worse than expected. Despite the impact on home and work life, half of women reported not consulting a healthcare professional for management of symptoms.

It is important to identify the best treatment to manage menopause in order to decrease the impact it has on womens lives. This systematic review and meta-analysis aimed to compare different interventions used to treat the most common vasomotor symptoms of menopause, hot flushes and night-sweats.

What About Alternative Therapies

Some alternative remedies are often suggested for hot flushes and night sweats. There is little information about the safety of these alternatives, especially when used long-term.

Some alternative remedies include:

  • Black cohosh is a herb available from herbalists, health food shops and some pharmacies. Some small studies have shown that black cohosh is effective at reducing hot flushes and night sweats, but a recent Cochrane review of all the research has found that black cohosh is no more effective for flushes than a placebo
  • Phytoestrogens are plant hormones found in some foods and in supplements. Phytoestrogens are like oestrogens and they are not necessarily safe just because they come from plants. There is some evidence that foods containing phytoestrogens or phytoestrogen supplements may help with hot flushes, though not all studies show this effect. Long-term safety has not been studied
  • natural progesterone cream is widely advertised for menopausal symptoms, but there are only a few studies looking at the effect for hot flushes. Some studies show it helps with hot flushes but others do not. It can only be obtained on a doctors prescription.

Some people report relief from using the following alternative therapies, and some studies have shown they can be helpful.

  • St Johns Wort for mild depression and mood swings .
  • Ginkgo Biloba – for short-term memory loss, slow reaction time, energy levels and concentration.
  • Acupuncture – can help with hot flushes.

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Eat Foods Rich In Calcium And Vitamin D

Hormonal changes during menopause can cause bones to weaken, increasing the risk of osteoporosis.

Calcium and vitamin D are linked to good bone health, so its important to get enough of these nutrients in your diet.

Adequate vitamin D intake in postmenopausal women is also associated with a lower risk of hip fractures due to weak bones (

Many foods are calcium-rich, including dairy products like yogurt, milk and cheese.

Green, leafy vegetables such as kale, collard greens and spinach have lots of calcium too. Its also plentiful in tofu, beans, sardines and other foods.

Additionally, calcium-fortified foods are also good sources, including certain cereals, fruit juice or milk alternatives.

Sunlight is your main source of vitamin D, since your skin produces it when exposed to the sun. However, as you get older, your skin gets less efficient at making it.

If you arent out in the sun much or if you cover up your skin, either taking a supplement or increasing food sources of vitamin D may be important.

Rich dietary sources include oily fish, eggs, cod liver oil and foods fortified with vitamin D.

Bottom Line:

A diet rich in calcium and vitamin D is important to prevent the bone loss that can occur during menopause.

Are There Medications That Help Reduce Hot Flashes

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If youre having a hard time managing your hot flashes at home, you may want to ask your doctor about medications. If your hot flashes are a result of your body being put into medical menopause, your care team may treat you with some form of hormone therapy, because estrogen is the main hormone given to manage symptoms of menopause. However, not everyone can take estrogen replacements. Some cancers, like receptor-positive breast cancer, are sensitive to estrogen, so the replacement drugs may worsen the disease. In some people, estrogen therapy may actually increase the risk of breast cancer.

If you dont want to, or cant, take hormones, other medications may be effective. The antidepressant paroxetine is approved by the U.S. Food and Drug Administration to treat hot flashes. Patients typically receive a lower dose for hot flashes than for treating depression. Some blood pressure medications and Gabapentin®, which is used to control seizures, have been shown to help, too.


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The Benefits Of Progesterone

It turns out that estrogen withdrawal leads to hot flashes and night sweats. In other words, the brain gets used to higher estrogen levels and reacts to the decrease by releasing the stress hormone norepinephrine, which causes altered temperature responses.

Progesterone can ease this response. It treats hot flashes and night sweats, causes no rebound when stopped and, importantly, it significantly helps menopausal women with sleep problems.

Although progesterone has not been tested in a large controlled trial, progesterone also doesnt seem to cause the blood clots, heart disease or breast cancer associated with estrogen or estrogen-progestin menopausal hormone therapy.

In our randomized trial of progesterone or placebo for the treatment of vasomotor symptoms we also measured changes in weight, blood pressure, waist size, fasting glucose, blood lipids, a marker of inflammation and one of blood-clot risks. The changes with progesterone did not differ from changes on placebo, meaning that it had neither positive or negative effects on these factors.

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Causes Of Hot Flushes

Hot flushes usually affect women who are approaching the menopause and are thought to be caused by changes in your hormone levels affecting your body’s temperature control.

They can happen without warning throughout the day and night, but can also be triggered by:

  • eating spicy foods
  • some health conditions, such as an overactive thyroid, diabetes and tuberculosis

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