How can I control hot flashes naturally?

Dr. Afua Mintah, MD
OBGYN (Obstetrician & Gynecologist)

You may be able to control hot flashes naturally by trying the following:

  • If symptoms are mild or infrequent, dress in layers so you can easily peel away a scarf or a sweater if you start feeling warm.
  • Sit next to the door or window on your morning commute to the office.
  • Crack the window open in the bedroom if overnight symptoms are a problem.
  • Exercise, healthy diet and maintaining a normal weight can also help.
  • Adding dietary supplements like soy, black cohosh or other Chinese herbals may provide relief for some women. 

If symptoms persist despite these non-medical interventions, discuss your options with an OBGYN.

Dr. Rovenia Brock, PhD
Nutrition & Dietetics Specialist

What are natural treatments for hot flashes? Hot flashes are the external sign of internal drops in estrogen levels during menopause. The estrogen-like compounds, called phytoestrogens, found in soybeans can help offset the drop in estrogen. Studies report hot flashes can be reduced by up to 40 percent when women add soy to their diets. I suggest 15 ounces of soy milk (about 2 cups) or 2 ounces of tofu daily might be all you need to help stop hot flashes. Be aware that recent studies have found a possible link between soy and breast cancer, so if you are a breast cancer survivor or at increased risk for developing the disease because of a family history, don't increase your soy intake until you speak with your physician.

Other natural ways to combat flashes include increasing vitamin E intake and reducing consumption of caffeine, alcohol, hot beverages, and spicy foods. For a good night's sleep, you might want to add the herb sage—the same sage you use to season your Sunday chicken and stuffing. There is growing evidence that including sage in the diet may ward off night sweats, another menopausal symptom. Add 4 tablespoons of dried sage to a cup of boiling water. Cover and steep as you would a tea, but let it sit for four hours before straining. Drink it before bedtime for a restful night's sleep.

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Boston Women's Health Book Collective
Administration Specialist

Scientific research has not demonstrated alternative treatments to be as effective as hormone treatment for hot flashes, but many women have found ways that don't involve taking hormones. Some women get relief from dietary strategies. Some research shows that paced breathing can decrease the frequency of hot flashes. There is also some promising research on the effectiveness of the herb black cohosh, although it is short-term research, so the safety of using the herb for longer than six months is not known. The National Center for Complementary and Alternative Medicine at the National Institutes of Health is currently conducting research to determine the safety and efficacy of alternative treatments for menopausal symptoms.

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“Natural" therapies (usually herbal or plant based estrogens) are available from many different vendors to help control hot flushes during menopause. Unfortunately, in the United States these medications are not well regulated and not well studied. Of the studies available, most show little difference between these therapies and placebo. That said, some studies do show limited benefit in women with severe and frequent hot flushes.

If you'd like to go beyond the DIY (do-it-yourself) route to helping prevent hot flashes, your doctor may have some suggestions. Alternative therapies like vitamins, acupuncture or herbology can help. There are also other medications that can help with hot flashes, including hormone replacement therapy.

Dr. Julia Schlam Edelman
OBGYN (Obstetrician & Gynecologist)

Acupuncture has been shown to reduce the number of hot flashes a woman experiences. Although there are not a large number of studies, it is reasonable to try this technique to relieve hot flashes as long as it is performed by a licensed practitioner and the needles are sterile.

Many therapies are available to treat hot flashes. Estrogen therapy eliminates hot flashes, and it works well in even very small doses. But many women can't, or chose not to, take estrogen.

Selective Serotonin Reuptake Inhibitors (SSRIs) were serendipitously found to significantly reduce hot flashes in menopausal women years ago, but the drugs are only intended and FDA approved to be used as anti-depressants. Drugs such as Fluoxetine (Prozac), Paroxitene (Paxil), Paroxetine Mesylate (Brisdelle) and Venlafaxine (Effexor), have all been found to be helpful in reducing flashes. Effexor is the most studied and seems to do the best job.

Also, an article published in JAMA shows that Escitalopram (commonly known as Lexipro), another of the SSRI antidepressants, also reduces the frequency of flashes.

Black cohosh is one of the most widely used alternative therapies for treatment of hot flashes despite research questioning its effectiveness. Black cohosh is an extract of dried underground roots derived from a plant used by native North American Indians.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Most hot flashes will resolve in three to five years. While I don't think you necessarily have to "deal with it," I also know that if the symptoms are minor enough, you can use non-hormone therapy techniques to try to help control them.

Estrogen is about 90 percent effective in reducing hot flashes, but other methods may also help. Why? If you can control your central thermostat and relax your arteries, you'll avoid that roller coaster of vascular contraction and dilation that causes the sweats.

That's why things like meditation and relaxation techniques may be helpful for reducing the red heat. Deep breathing, which helps counteract a lack of nitric oxide, is more effective than any other therapy except estrogen. Yoga incorporates belly breathing and also offers poses that could help to lower blood pressure and heart rate. Vitamin E is anecdotally helpful, and if you are desperate, why not?

One big item that's often overlooked: the amount of saturated fat in your diet. Saturated fats cause constriction of arteries after a meal. The fluctuation between dilation and constriction causes the flash. Fewer saturated fats equal fewer symptoms.

Also, it may be worth experimenting to see if exercise, paced respiration, black cohosh, or evening primrose oil could help you reduce hot flashes.

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Hot flashes can be very irritating because they disrupt sleep. They occur as estrogen levels change in the body, not because of a deficiency of estrogen, a common misconception. What you need to consider as possible treatments are anything that will help support a constant level of estrogen in your body.

  • Pour on the flaxseeds. Add two to three tablespoons of flaxseeds to protein smoothies, salads, cereals, yogurt and oatmeal each day. They should be purchased ground, in a sealed container and kept in the freezer for freshness. You could also purchase whole flaxseeds and grind them yourself at home.
  • Include one serving of (non-GMO) soy in your diet each day. Sources of soy include soy milk, soy nuts, tofu, tempeh or edamame. Flaxseeds and soy are phytoestrogens, which means they can assist with the symptoms of menopause.
  • Try taking evening primrose oil. Take 1000 mg twice per day with 400 IU of vitamin E. This combination has been found useful for some women with hot flashes.
  • Consider taking herbs that support estrogen levels such as black cohosh and angelica or herbs that support progesterone levels such as vitex and wild yam. You may also want to look into a mixed herbal combination for menopausal support. Another herb, sage, has been found to be useful for treatment of sweating and hot flashes.
  • Consider having your hormones tested via a saliva hormone analysis conducted by a medical doctor or a naturopathic doctor in your area. There are many hormonal changes involved in menopause including three types of estrogen, progesterone, testosterone and DHEAs and all of these changes affect your symptoms. It is important to identify an unhealthy balance of the three types of estrogen, which if left unaddressed, can increase your risk of cancer. Bio-identical hormone replacement is a viable option for many women. I use this in my practice to great results, but it is essential to have proper analysis and follow-up testing. You never want to have hormones in too high or too low quantities.
  • Take relora to help with hot flashes and sleep disruption associated with menopause (two in the evening, one upon waking). 
  • As I recommend for everyone, be sure you are covering your basic nutritional needs and requirements for bone health by taking a high-potency multivitamin, fish oil supplements, antioxidants and calcium/magnesium.

For menopausal women who cannot or would prefer not to use estrogen-based hormone replacement therapy (HRT), there are several alternative treatments. Clonidine, a medication used to lower blood pressure, also has been found useful for hot flashes. There is some evidence that both Propranolol, another blood pressure medication, and the antidepressant medication venlafaxine may help alleviate hot flashes. There is less evidence of help from herbal medications like black cohash, red clover, flaxseed, or soy. However, some relief has been reported for studies of clinical hypnosis and acupuncture. And of course there are practical tips like using a handheld fan, keeping cold water close by, practice deep breathing when a flash starts, and losing weight if you are overweight.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.