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Menopause Health Center

Tools & Resources

• Upsides of Menopause and Sex
• Manage Your Hot Flashes
• Menopause and Your Skin
• Questions About HRT?
• Sex and Menopause
• Menopause and Weight Gain

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Menopause: Managing Hot Flashes

Most women have hot flashes at some point before or after menopause. Hot flashes happen when estrogen levels drop. While some women have few to no hot flashes, others have them many times each day.

Hot flashes can be uncomfortable and upsetting. They can lower the quality of your sleep and daily life. But they aren't a sign of a medical problem. They are a normalresponse to natural changes in your body.

Hot flashes usually get better or go awayafter the first or second year after menopause. At that point, estrogen levelsusually stay at a low level.

You can make some lifestyle changes to reduce your hot flashes. And if those don't help, you may want to try medical treatment.

• Avoid using tobacco or drinking a lot of alcohol. They tend to make hotflashes worse.
• Manage stress. Stress can make hot flashes worse.
• Exercise regularly, and eat a healthy diet.
• Try rhythmic breathing exercises. This is called paced respiration. It can help you meditate andrelax, and it may reduce your hot flashes.

You also can talk to your doctor about treatments that may eitherreduce or stop your hot flashes. These include taking low-doseestrogen (hormone therapy) for a short time, taking certain medicines, and taking the herb black cohosh.

 How can I manage hot flashes?

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How can I manage hot flashes?

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You can manage hot flashes by making certain lifestyle choices. You can also take daily medicine. Some measures help prevent or reduce hot flashes. Others can make you more comfortable when you're having a hot flash.

Lifestyle choices

Eat and drink well, and avoid smoking

• Limit alcohol.
• Drink cold liquids rather thanhot ones.
• Eat smaller, more frequent meals. Digesting a lot of food can make you feel hotter.
• Eat healthy foods.
• Do not smoke oruse other forms of tobacco.

Stay cool

• Keep your area cool. Use afan.
• Dress in layers. Then you can remove clothes asneeded.
• Wear natural fabrics, such as cotton andsilk.
• Sleep with fewer blankets.

Reduce stress

• Get regular exercise.
• Use relaxation techniques, such asbreathing exercises,yoga, orbiofeedback. A breathing exercisecalled paced respiration may reduce hot flashes and emotional symptoms.

Medical treatment

• Short-term, low-dosehormone therapy (HT) can reduce or stophot flashes and other menopause symptoms. It raises your estrogenlevel. Use the lowest dose needed for the shortest possible time, and haveregular checkups. This is because HT may increase the risk of problems in a small number of women. These problems include blood clots, stroke, heart disease, breast cancer, ovarian cancer, and dementia. Risk varies based on when you start HT in menopause and how long you take it. Using HT for a short time in early menopause has less risk than when it is started later in menopause.¹If you have a history of heart disease or breastcancer, avoid using estrogen for hot flashes. There are other options.
• Estrogen-progestin birth control pills (beforemenopause) can reduce or stop hot flashes and other symptoms. They can keep your hormones from going up and down. Don't use estrogen ifyou are older than 35 and smoke; havediabetes, heart disease, or breast cancer; orhave afamily history of breast cancer.
• Antidepressant medicine can reduce the number of hot flashes and how bad they are. It improves the brain's use of serotonin, which helpscontrol body temperature. Side effects are possible.This type of medicine is a good choice if your only menopause symptoms are having hot flashes and mood swings and feeling irritable.²
• Clonidine may relieve hot flashes for some women. But studies have not shown that it makes hot flashes less severe or less frequent.³This type of medicine is a good choice ifhot flashes are your only symptom, especially if you have highblood pressure.
• Gabapentin, an antiseizure medicine, may lower the number of hot flashes each day. It also may make hot flashes less severe.²
• Black cohosh may reduce or prevent hot flashes,depression, and anxiety. As with HT, have regular checkups when you takeblack cohosh.
• Some women eat anddrink a lot of soy to even out hot flashes and other symptoms.So far, studies have used many different soy sources and different measures of how well they work. So this makes it hard to compare them. Soy isoflavone (rather than soy protein) has shown the most promise to treat hot flashes.⁴

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Citations

1. 
   North American Menopause Society (2012). The 2012 hormone therapy position statement ofthe North American Menopause Society. Menopause, 19(3): 257–271. Alsoavailable online: http://www.menopause.org/PSht12.pdf.
   
2. 
   Shifren JL, et al. (2010). Role of hormone therapy in the management of menopause. Obstetrics and Gynecology, 115(4): 839–855.
   
3. 
   Burbos N, Morris EP (2011). Menopausal symptoms, search date June 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
   
4. 
   North American Menopause Society (2011). The role of soy isoflavones in menopausal health: Report of the North American Menopause Society. Menopause, 18(7): 732–753.
   

Other Works Consulted

• 
  U.S. Preventive Services Task Force 2012. Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: U.S. Preventive Services Task Force Recommendation Statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf12/menohrt/menohrtfinalrs.pdf.
  

ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerCarla J. Herman, MD, MPH - Geriatric Medicine

Current as ofAugust 7, 2014