No matter how disruptive and frustrating they may be, hot flashes are not a sign of a medical problem. They are a normal response to natural hormonal changes in your body. Most women experience hot flashes at some point before or after menopause, when their estrogen levels are declining. While some women have few to no hot flashes, others have them numerous times each day. If hot flashes are disrupting your sleep or daily life, you are no doubt looking for relief. Fortunately, you have a number of self-care and medical treatment options that can help you manage your symptoms.
Luckily, you may not have to “treat” hot flashes to prevent them or get them under control. Making healthy lifestyle choices is your best and first choice for hot flashes and can make a big difference in how your body handles the transition to menopause. For instance, tobacco use, heavy alcohol use, and stress tend to make hot flashes worse. By avoiding these risk factors, exercising regularly, and eating well, you can prevent or reduce hot flashes:
- Eat and drink well, and avoid smoking.
- Limit your intake of alcohol.
- Drink cold beverages rather than hot ones.
- Eat smaller, more frequent meals to avoid the heat generated by digesting large amounts of food.
- Eat plenty of low-fat, high-fiber foods.
- Do not smoke or use other forms of tobacco.
- Stay cool.
- Keep your environment cool, or use a fan.
- Dress in layers, so you can remove clothes as needed.
- Wear natural fabrics, such as cotton and silk.
- Sleep with fewer blankets.
- Reduce stress.
- Get regular physical exercise.
- Use relaxation techniques, such as breathing exercises, yoga, or biofeedback. Using a breathing-for-relaxation exercise called paced respiration may reduce hot flashes and emotional symptoms.
The body-mind connection is a powerful element of hot flashes and emotional symptoms. Rhythmic breathing exercises (paced respiration), which help you meditate and relax, may reduce your hot flashes.
But if hot flashes are frequent and powerful, additional treatment may be needed to help you get enough sleep or lead a predictable daily life. Medical treatments that may either reduce or stop moderate to severe hot flashes include:
- Short-term, low-dose hormone replacement therapy.
(HRT) can reduce or stop hot flashes and other perimenopausal symptoms by raising your body’s estrogen level. Use the lowest dose needed for the shortest possible time and have regular checkups. This is because HRT may increase the risk of blood clots, stroke, heart disease, breast cancer, ovarian cancer, and dementia in a small number of women.1, 2 And HRT users who are 10 or more years past menopause are also at higher risk for heart disease.3
- If you have a history of cardiovascular disease or breast cancer, avoid using estrogen for hot-flash relief—other options are available.
- Estrogen-progestin birth control pills
Before menopause these pills can reduce or stop hot flashes and other perimenopausal symptoms by evening out fluctuating hormones. Don’t use estrogen for hot-flash relief if you are older than 35 and smoke; have diabetes, cardiovascular disease, or breast cancer; or have a family history of these conditions. Other options are available.
- Antidepressant medicine
This medication can reduce the number and severity of hot flashes by improving the brain’s use of serotonin, which helps regulate body temperature.4 Side effects are possible. This type of medicine is a good choice if hot flashes, irritability, or mood swings are your only perimenopausal symptom.
Clonidine may relieve hot flashes for some women. But studies have not shown that clonidine makes hot flashes less severe or less frequent.5 This type of medicine is a good choice if hot flashes are your only perimenopausal symptom, especially if you have high blood pressure.
Some women eat and drink a lot of soy to even out hot flashes and other perimenopausal symptoms. So far, studies have used many different soy sources and different measures of success, which are hard for experts to compare. Soy isoflavone (rather than soy protein) studies have shown the most promise for hot flash treatment.
If you are having problems with hot flashes, discuss them with your doctor at your next regularly scheduled appointment. If your hot flashes are so severe that they are disrupting your sleep or affecting another area of your life, call your doctor to discuss your hot flashes.