- Are you in your mid-to-late-40s, maybe your early 50s and noticing that your body is changing?
- What is Menopause?
- Hot Flashes and Night Sweats
- Medications are Available – But They Have Side-Effects & Risks
- Want to Learn More About Plant Medicine?
- Dr. Aviva’s Herbal Hot Flash Remedies
- Dr. A’s Cool Down Extract
- Ginseng for the Ladies!
- Not Your Grandma’s Rhubarb
- Valerian for More than Sleep
- Holy Pine Bark Bat Girl!
- First Aid for Sleep
- Additional Support
- Managing menopause
- Remedies for Hot Flashes
- Hormone replacement therapy
- Soy isoflavones
- Black cohosh
- Take some ‘you’ time
- Cool it down
- Watch what you eat
- Kick the habit
- Other medications
- The bottom line
- Natural remedies for hot flashes
Are you in your mid-to-late-40s, maybe your early 50s and noticing that your body is changing?
- You’re still having periods, but they’re not the same. They may be shorter, longer, lighter, or heavier, and you can no longer set your clock by them if you could before.
- Maybe you’re sleeping a little less well, waking up too early in the morning and having trouble falling back to sleep.
- Your libido just isn’t what it used to be.
- A few pounds seem to be creeping up around your middle.
- You’re overheated and sweating more than usual, and at inconvenient times?
What’s happening? Simple. You’re on the cusp of menopause.
What is Menopause?
Menopause is the change in our hormones, a decline in estrogen and progesterone that brings us into our “wisdom years.”
It’s a natural transition and an awesome time in life where we get to expand into speaking our truth, care less about what people think about us, and have time to nurture ourselves and our personal dreams. But some of the symptoms can be a royal pain. Many women find hot flashes, insomnia, and mood changes draining and disruptive.
It’s also a big deal time in our lives. All of this happening just as kids leave home for college, long-time marriage dynamics may be changing, and your sense of yourself may be changing as you do a midlife self-assessment – so your coping skills may feel like they are on a temporary hiatus.
The actual menopause is defined as when we’ve been period-free for a full year and for most women around the world this occurs around age 51. But there’s a big lead up for many women – often several years of symptoms heralding a change that then may persist after menopause happens. The lead up is referred to as “perimenopause” which in simple terms means the time around the menopause. Going forward in this article I refer to symptoms that occur during this time as peri/menopause to keep things simple.
This series of articles on natural approaches to menopause will start with one of the most common symptoms: hot flashes.
Hot Flashes and Night Sweats
Hot flashes occur when hormonal changes cause a sudden, temporary spike in body temperature. As many as two-thirds of American women experience them. They can occur anytime, with most women who have them reporting several flashes per day, but some women with more severe symptoms having them as often as hourly — and sometime this goes on for over a decade!
Symptoms range from a mild sensation of heat rising up in your body and face, to a seriously uncomfortable feeling of being overheated and even a drenching sweat that can be profoundly embarrassing if your face suddenly reddens or you perspire profusely at an inconvenient time, like in front of a board meeting or while giving a public speech.
Hot flashes at night – night sweats – can soak your PJ’s and sheets, wake you up in a chill, and make sleep miserable. While these symptoms usually resolve over time, for some women they persist for years and are disruptive to quality of life.
But there is help!
Medications are Available – But They Have Side-Effects & Risks
At this time in life many women, even those who previously have been “all natural” in their health choices, start considering hormonal medications to stop the symptoms: antidepressants to quell hot flashes and a sleep medication to get a better night’s rest.
For some women, hormone replacement therapy (HRT) in the form of bio-identical hormones is the right choice. And even integrative and functional medicine doctors can be all too quick to dispense them. But not every woman can or, for health reasons, should take hormones. Even natural hormone therapies are not without risks for any woman.
One of my goals is to help women avoid unnecessary and potentially risky medication use. So while I do prescribe them sometimes, outside of severe symptoms, they are a last resort in my practice. Unless symptoms are severe and debilitating, I always suggest a natural approach to my patients first, as I am suggesting to you here.
HERBAL MEDICINE FOR WOMEN
Want to Learn More About Plant Medicine?
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Dr. Aviva’s Herbal Hot Flash Remedies
Over the past 30 years I’ve developed and used many herbal formulations that effectively relieve peri/menopausal symptoms. Here are my top herbal remedies for your hot flashes. These herbs have been shown to be effective based on clinical trials – and most have centuries of traditional herbal use behind them for safety.
You can find these herbs at major health food stores, online (i.e., Herb Pharm, Gaia Herbs, Mountain Rose Herbs), and at some pharmacies and even supermarkets.
Six to twelve weeks (6-12 weeks) is a good amount of time to try these herbs separately or in combination, to see if you get the level of symptom relief you are seeking. If you need to consider medication options, you always can, but most women find that these natural approaches relieve symptoms completely or at least enough to avoid medications, and without the side effects and risks of conventional treatments.
Dr. A’s Cool Down Extract
This blend combines several herbs that have demonstrated their effectiveness in cooling down hot flashes. I recommend getting the individual extracts from Herb Pharm, Gaia Herbs, or Mountain Rose online and mixing them yourself. You can purchase an empty 4 oz. dropper bottle from Mountain Rose, or mix these in a glass bottle and take the recommended dose daily.
I’ve put the equivalent capsule dose from scientific studies next to the herbs when relevant.
- 1 oz. chaste tree tincture (regulates hormones, reduces menopausal symptoms)
- 1 oz. lemon balm tincture (cools hot flashes, improves mood)
- 1/2 oz. motherwort tincture (relaxing, calming, cools hot flashes and menopausal symptoms)
- 1/2 oz. black cohosh tincture (80 mg twice daily, cools hot flashes, improves menopausal mood and symptoms)
- 1/2 oz. hops tincture (100-200 mcg for at least 12 weeks, cools hot flashes, relieves vaginal dryness)
- 1/2 oz. sage leaf tincture (cools hot flashes)
To prepare: Combine the different extracts in a 4 oz. dropper bottle or glass bottle.
Dose: Take 1 teaspoon in 1/4 cup hot water, 2-3 times daily. You can take this formula until hot flashes are no longer a problem.
Note: Omit sage leaf and hops extract if you have a history of estrogen receptor positive cancer as they are estrogenic.
Ginseng for the Ladies!
3 gm. per day (3-6 capsules) of Chinese ginseng (Panax ginseng) taken daily not only reduces hot flashes, but can boost your libido and lower high cholesterol! Take in the early part of the day as ginseng can be stimulating and interfere with sleep.
Not Your Grandma’s Rhubarb
Rheum rhaponticum, or Rhubarb, in the form of an extract called ER731 has been shown in a clinical trial to be very effective in the treatment of hot flashes. The proprietary extract can be found in the product Estrovera by Metagenics. This can be ordered online or obtained through an integrative medical or naturopathic physician. Take as directed on the package or try Herb Pharm’s Rhubarb Extract as directed on the bottle.
Valerian for More than Sleep
225 mg of Valerian in capsules taken 3 times daily can dramatically reduce hot flashes after just 4 weeks of use, and in most people, is also a gentle, non-addictive sleep aid that does not lead to morning grogginess.
Holy Pine Bark Bat Girl!
Pycnogenol, an extract of pine bark, is not only an excellent antioxidant, but has been shown to be effective in reducing hot flashes in a dose of 60-100 mg twice daily.
First Aid for Sleep
Since hot flashes can affect your sleep, consider adding in an extract blend for sleep. This combination has herbs for sleep that also reduce hot flashes:
• 1/2 oz. passion flower extract (or 80 mg before sleep)
• 1/2 oz. valerian extract (or 250-500 mg twice daily)
• 1/2 oz. lemon balm extract
To prepare: Combine the different extracts in a dropper bottle or glass bottle.
Dose: Take 1/2 teaspoon every 30 minutes for 90 minutes before going to bed. If necessary, take an additional 1/2-teaspoon during the night if you wake and have trouble going back to sleep.
Alternatively, try Herb Pharm’s Relaxing Sleep blend:
This contains Valerian, Passion flower, Hops, Chamomile flower, and Catnip leaf (nope, not just for the kitties!) and is an excellent blend that contains herbs for both sleep and hot flashes.
Caution: Do not take sleep herbs with prescription sedatives without your physician’s guidance.
In addition to the above herbal options, I recommend the following dietary and lifestyle strategies to prevent and ease hot flashes:
- Emphasize a plant-based diet rich in phytoestrogens including cupfuls of cooked green leafies like kale, collard greens, broccoli, and Napa cabbage daily, as well as legumes such as garbanzo beans and lentils.
- Add Flax seed, 1 TBS fresh ground daily, to your daily diet
- “Fatten up”: Ample good quality dietary fat, including olive oil, coconut oil, butter or ghee, and walnut oil, as well as fresh avocado is necessary for maintaining hormone synthesis. In fact, if you are underweight you have a higher risk of having hot flashes – and there is no connection between good quality dietary fat and a higher risk of high cholesterol – with olive oil it’s just the opposite!
- Dress in layers so if you feel yourself heating up, you can cool down in a flash.
- Keep the clothing layer closest to your skin breathable – 100% cotton is light and absorbent.
- Carry a shirt change with you – if you do work up a major sweat, you don’t have to go throughout your day feeling clammy or sporting pit stains.
For Night Sweats
- Wear cotton pajamas (or sleep in the buff) so you don’t have to change clothes at night. Keep an extra sheet next to the bed so you can quickly strip down the bed and toss a fresh sheet on with the least possible sleep disruption.
- Sleep with the bedroom no warmer than 68 degrees F to keep cool under covers.
- Layer your bed covers so you can cool down and warm up easily
Going through major changes in our phase of life, particularly in a culture that values youth over wisdom, is not a psychological breeze. Add to it symptoms that feel anything like a breeze – in fact, they feel more like an inferno – and it’s not a picnic. The recommendations in this article have helped literally thousands of women sail more easily through and past hot flashes.
I wish the same for you!
Almost all women experience symptoms at menopause. Most women find these symptoms manageable and choose not to have treatment. When symptoms are particularly severe or prolonged, there are a range of ways to manage them.
Hot flushes and night sweats
These are the symptoms most commonly associated with menopause.
You can reduce the impact of hot flushes if you can identify and avoid anything that may trigger them, for example, hot drinks, hot weather, stressful circumstances, spicy foods. Some women find it helpful to dress in layers to help them cool down more quickly. Some find a fan helpful. Stress reduction techniques such as mindfulness or meditation might also help ease this symptom.
Night sweats that disturb sleep are one of the most troublesome symptoms of menopause. Wearing light breathable bed clothes or sleeping naked might help ease this symptom. Some women use separate bed covers from their partners to avoid over-heating at night. A bedroom fan may also help.
Treatments for menopausal symptoms
Non-pharmacological (drug-free) treatments
There are several drug-free ways to reduce the impact of hot flushes and night sweats. These include:
- Counselling and psychological treatment such as cognitive behaviour therapy (CBT).
- Hypnosis may also be helpful.
- Some women also benefit from acupuncture.
Whilst paced breathing, exercise and relaxation programs (such as mindfulness) may be helpful for your general physical and emotional health, they do not significantly reduce menopausal symptoms.
Non-hormonal drug treatments
Several prescription medications have been shown to reduce hot flushes and night sweats. Unfortunately, these do not improve vaginal dryness. Prescription medications for hot flushes and sweats include:
- certain antidepressants (e.g. venlafaxine, escitalopram, citalopram, paroxetine)
- a drug called gabapentin (which is sometimes used to treat chronic pain)
- a blood pressure medication called clonidine.
These drugs may reduce hot flushes and nights sweats from around 40-60 per cent (when compared to a placebo or ‘sugar pill’ treatment). Using antidepressants and using treatments that improve sleep may also improve mood.
For more information see the fact sheet Treating hot flushes: An alternative to menopausal hormone therapy
Menopausal Hormone Therapy (MHT)
Menopausal hormone therapy (MHT) contains oestrogen to treat menopausal symptoms and may contain a progestogen to protect the lining of the uterus (womb) from cancer in women who have not had a hysterectomy. Menopausal hormone therapy is also known as hormone replacement therapy (HRT) or hormone therapy (HT).
MHT reduces hot flushes and night sweats by around 80 per cent, making it the most effective treatment currently available. MHT also protects bone by reducing osteoporosis and fracture. Most women tolerate MHT very well, but some experience uterine bleeding or breast tenderness. These may need investigation by a gynaecologist to rule out other causes
Most healthy women around the age of natural menopause can safely take MHT for up to 5 years or at around age 60. Beyond 5 years there is an increased risk of breast cancer with combined (oestrogen plus progestogen) MHT. Stopping MHT may lead to a resurgence of menopausal symptoms.
See the fact sheet Menopausal Hormone Therapy for more information on:
- what symptoms it can treat and how
- how it is taken
- who can safely take MHT
- the benefits and health risk of MHT.
Compounded or bioidentical hormone therapy
These products are sometimes sold by pharmacists or over the internet. They may contain hormones but the dose and safety of the hormone content have not been checked in these products, therefore should be taken with caution. For more information on compounded hormones visit Jean Hailes website.
Soy extracts and soy foods
Soy foods, foods enriched in isoflavones (plant-derived oestrogen-like substances such as red clover) and isoflavone supplements have not been consistently shown to reduce hot flushes. These compounds may have oestrogen-like effects, so discuss with your doctor whether they are safe for you.
- Black cohosh – may have a mild benefit for hot flushes in some women.
- St John’s wort – may improve depression but has not been shown to improve menopausal symptoms. St John’s wort may interact with other medications so check with your doctor before taking it.
- Evening primrose oil, dong quai, ginseng, licorice and sage do not reduce menopausal symptoms.
Unfortunately, no over the counter or herbal medicines have been shown to significantly reduce menopausal symptoms.
Talk to you doctor for more information and advice on treatment options.
- Australasian Menopause Society For more information on treatments for menopause
- Jean Hailes For more information on compound hormones and other ways to manage menopause symptoms
- Provide feedback about the information on this page.
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Remedies for Hot Flashes
Hot flashes are one of the most common symptoms of menopause. They’re characterized by sudden body heat, flushing, and sweating. Other unpleasant symptoms often coincide with hot flashes, including:
- weight gain
- mood swings
- loss of libido
- sexual dysfunction
Luckily, there are several treatment options for hot flashes. Your choices range from medications and herbal supplements to lifestyle changes. Keep reading to learn about remedies you can use to help stay cool.
Hormone replacement therapy
Traditionally, the most effective treatment for hot flashes has been estrogen supplementation. It’s often referred to as hormone replacement therapy (HRT). Estrogen may be taken alone or in combination with progesterone. Women who’ve had a hysterectomy may be able to safely take estrogen alone, while all other women using HRT should take estrogen and progesterone together.
Estrogen isn’t recommended for everyone, especially women with a history of breast cancer, blood clots, or certain other medical conditions. Also, estrogen is believed to increase the risk of future health problems, including heart disease, breast cancer, and blood clots.
Soy contains large quantities of phytoestrogens, chemicals that act like estrogen in the body. Soy is particularly high in isoflavones, which bind to estrogen receptors. This can help reduce hot flashes.
Soy continues to be studied in terms of menopausal relief. According to the National Institute on Aging, research is unclear as to whether soy is as effective as, or even safer than, conventional medications.
Marji McCullough, ScD, RD, writing for the American Cancer Society, suggests if using soy, choose soy sources from food rather than supplements. The amount of isoflavones in supplements is much higher than those occurring naturally in food. Good sources of soy foods are soy milk, tofu, tempeh, and edamame.
Black cohosh is among the most popular herbs for treating hot flashes and other menopausal symptoms. The root of the plant is used in capsules and, less commonly, tea. Both forms are found in most health food stores and available online. Although the exact mechanism of black cohosh is unknown, researchers believe it binds to estrogen receptors or stimulates serotonin receptors.
The National Center for Complementary and Integrative Health reports that studies lasting up to 12 months didn’t show any harmful effects of the herb. However, there are currently no long-term studies.
Minor side effects reported include stomachache and rash. There are reports of liver failure, which is life-threatening, in individuals using black cohosh. It isn’t recommended for those who are pregnant or breastfeeding, or have breast cancer.
As with other supplements, talk to your doctor before taking it.
Take some ‘you’ time
It’s true that hot flashes can strike at any time of day, but they’re also more frequent during times of stress. Stress reduction techniques may decrease the frequency of hot flashes. Consider taking some time for:
- meditation and visualization
- guided breathing
- tai chi
Some of these techniques also have the benefit of improving sleep quality. Even taking a few minutes alone to read a book, sing out loud, or simply sit outside can do wonders in terms of relaxation.
Cool it down
Even slight increases in your core body temperature can trigger hot flashes. Lower your room temperature by turning down the thermostat, turning on the air conditioner, installing a fan, purchasing a cooling gel pad to lie on, or opening a window.
If the temperature of the room is out of your control, dress in layers. When you start to feel your body temperature rise, you can remove a layer or two to cool your body down. Wear cotton whenever possible, as other fabrics, such as spandex, nylon, and rayon, tend to trap body heat.
Watch what you eat
Certain foods and drinks that naturally increase body temperature can worsen hot flashes. Spicy foods, caffeinated beverages, high-fat and high-sugar diets, and alcohol have all been implicated in increasing the severity and frequency of hot flashes.
One study that reviewed women’s experiences over several years indicated that the Mediterranean diet, which features fresh vegetables, fruits, and whole grains, reduced hot flashes. Your experience might be different, but eating plant-based foods is associated with better health outcomes for virtually everyone, so it can’t hurt to try.
Learn what foods and drinks trigger your hot flashes and limit or completely avoid them if you can. Regularly sipping on cool beverages throughout the day may help keep your body temperature down and thereby reduce hot flashes.
Kick the habit
There’s one more thing to add to the list of negative health effects of smoking: hot flashes. In fact, smoking may trigger and even increase the severity of hot flashes.
Quitting may help reduce the severity and frequency of hot flashes. The benefits don’t end there, though. Smoking cessation also helps reduce the risk of heart disease, stroke, and a wide variety of cancers.
Low doses of antidepressants may improve symptoms in women with mild to moderate hot flashes. Examples of effective antidepressants include venlafaxine (Effexor XR), paroxetine (Paxil), and fluoxetine (Prozac). Antidepressants can also treat other menopause symptoms, such as mood swings, anxiety, and depression. The downside to these medications is the risk for decreased libido, which is also a common symptom of menopause.
Gabapentin (Neurontin), an anti-seizure medication, may be particularly effective for women who experience hot flashes at night. Possible side effects include:
Clonidine (Kapvay), which is generally used to lower high blood pressure, may also reduce hot flashes in some women. Possible side effects include:
- dry mouth
Once your body begins menopausal changes, the symptoms can last for a few years or longer. Still, this doesn’t mean you have to suffer through the discomfort of hot flashes. By making simple lifestyle changes, you can reduce the heat before it creeps up on you.
Be sure to discuss any remedies, concerns, or unusual symptoms with your doctor, especially if you’re taking any medications.
Want to learn more? Get the facts in our guide to menopause.
Some women can wait out hot flashes with no treatment.
If they’re bothersome or causing trouble for you, talk to your doctor about taking hormone replacement therapy, or HRT, for a limited time, typically less than 5 years. This prevents hot flashes for many women. Plus, it can help other symptoms of menopause, including vaginal dryness and mood disorders.
When you stop taking HRT, the hot flashes may come back. Some short-term HRT can make you more likely to have blood clots, breast and endometrial cancers, and gallbladder inflammation.
If HRT isn’t right for you, other treatments may offer relief. Prescription treatments include:
- Low-dose depression drugs like fluoxetine (Prozac, Rapiflux), paroxetine (Paxil, Pexeva), or venlafaxine (Effexor)
- Clonidine, a blood pressure medication
- Gabapentin, an anti-seizure drug
- Brisdelle, a paroxetine formula specifically for hot flashes
- Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashes
B complex vitamins, vitamin E, and ibuprofen may help, too.
It’s important to talk to your doctor before you take any new medication or supplements, including over-the-counter products.
Natural remedies for hot flashes
Traditionally, a variety of plant products has been used to treat hot flashes. Although there is little scientific evidence that many of these alternative therapies are effective, many women still use herbal supplements.
The United States Food and Drug Administration (FDA) do not regulate the quality, strength, or composition of herbal and plant products. As a result, dosing, purity, and safety recommendations depend on the particular supplement, brand, and product.
Many plants contain compounds called phytoestrogens or “dietary estrogens,” which are capable of binding to human estrogen receptors. Plant-based estrogens are thought to help women experiencing reduced estrogen levels by increasing the effect of the hormone on the body.
There are different types of phytoestrogens found in legumes, seeds, and whole grains. Legume and bean products, such as soy, contain phytoestrogens called isoflavones, the most studied plant estrogen.
In North America, lignans, found in seeds, such as flax and sesame, are the most commonly consumed form of phytoestrogen.
A 2012 study found that menopausal women who took 330 milligrams (mg) of licorice extract three times daily for 8 weeks reduced the severity and frequency of hot flashes.
Benefits typically lasted for 2 weeks after women stopped using the supplement. Licorice root contains phytoestrogens.
Share on PinterestValerian root may help reduce the intensity of hot flashes.
Several studies have supported the use of Valerian root for the management of menopause symptoms.
In a 2013 study where menopausal women took 255 mg of Valerian three times daily for 8 weeks, the number and severity of hot flashes were reduced. Valerian also helps enhance sleep, which is known to improve these symptoms.
Valerian contains phytoestrogens and may also influence serotonin activity and improve sleep.
Black cohosh is a herb that has been used by Native American cultures for centuries to relieve menopause symptoms. Though black cohosh supplements are commonly used to treat hot flashes, the efficacy of the herb remains controversial.
Several studies have been carried out, which involved daily dosages of 6.5 to 160 mg of black cohosh for up to 1 year to treat menopausal symptoms.
Black cohosh may not be recommended for women with estrogen-affecting conditions, such as breast, ovarian, or uterine cancer.
While rare, use of the herb has been linked to severe health complications, the most common complication being liver injury or damage. Black cohosh interacts with many prescribed medications and should not be used at the same time as other herbs. People should speak with their doctor before using black cohosh.
Women taking the herb should be aware of the signs of liver failure or jaundice. Jaundice may be life-threatening and requires immediate medical attention.
Common signs of jaundice include:
- yellowing of the skin and eyes
- loss of appetite
- upper stomach pain or cramping
- dark urine
- nausea or vomiting
- extreme tiredness not related to exercise or lack of sleep