Hot flashes are one of the most common symptoms that women experience during perimenopause or menopause. As I discussed in my previous article on perimenopause, it can begin as early as 12 years before menopause (which is defined as going a full 12 months without a menstrual period). It is estimated that approximately 85% of women will experience hot flashes at some point in their life. That’s a huge number! For the majority of women these may last for a few years, but for some women they can last for 5-7 years! (1)
Hot flashes are believed to be rooted in abnormal signalling from the hypothalamus (which regulates temperature in the body). This abnormal signalling causes vasodilation in the periphery, resulting in increased temperature and sweating. Hot flashes have been linked to changes in estrogen levels and neurotransmitters like serotonin and noradrenaline.
The conventional treatment for hot flashes that are severe enough to affect quality of life is hormone replacement therapy, and sometimes SSRI’s. While these treatments can be effective, they are not free from risk. Accordingly, it is worthwhile to explore more natural and gentle treatments. In fact, dietary, lifestyle, and herbal treatments can be effective in treating the symptoms of perimenopause.
From a dietary perspective, reducing your consumption of spicy foods, alcohol, and caffeine may help, as these are common triggers of hot flashes. Lowering the temperature of your room, especially when you are sleeping, and wearing lighter layers of clothes, can also help.
Stress can be a trigger for hot flashes by affecting the signaling of hormones and neurotransmitters from the hypothalamus. While managing stress levels is important for overall health, mind-body techniques have been found to help reduce hot flashes and other symptoms of menopause (2). I often talk about activating the parasympathetic or ‘rest and digest’ part of our nervous system by taking 3 deep belly breaths. You can try counting to 4 on the inhale and then exhaling to a count of 6. Doing this a few times a day (before meals and before bed!) can really help. Breathing is incredibly important for signaling to your body that you are in a calm and relaxed state, but it is also important to remember our mindset around stress. This is a bigger topic, but as a starting point, maybe you can ask yourself these questions – How full is your schedule on a day to day basis? Are there things you need to say no to? How can you take better care of yourself?
And finally – herbs! There are quite a few herbs that have been studied in the treatment of hot flashes. While I always look to the evidence in my practice, I also acknowledge there are limitations to research and often we can find conflicting results for the same treatments. I also look to the traditional uses of herbs in herbal and naturopathic medicine. Here I will highlight a few herbal treatment options, while also mentioning some of the conflicting results found in the research.
Rhubarb was found to be effective at reducing the severity and frequency of hot flashes in 4 weeks compared with placebo (3). Black Cohosh has been studied quite a bit with respect to hot flashes and climacteric symptoms of menopause, and while the research is mixed, one study found it to significantly positively impact the severity and frequency of hot flashes in both a 4 and 8 week period (4). Maca has also been studied, and while this systematic review explains that there have been limited studies of a high quality done, the studies it looked at did find it to be effective at decreasing hot flashes in women in perimenopause and menopause (5). These are a few of the herbal options when it comes to treating hot flashes and as a gentle treatment option, may be worth looking into with your health care practitioner.
Bioidentical hormone replacement therapy (BHRT) can also be an effective treatment for hot flashes and other symptoms associated with perimenopause and menopause (6). See here for my article on BHRT to learn more about this treatment.
I always recommend working with a health care practitioner who is well versed on hormones to determine what is the best treatment for you, as we are all unique! I offer a free 15 minute consultation to help you feel confident that naturopathic medicine is right for you!
1. Bansal R, Aggarwal N. Menopausal Hot Flashes: A Concise Review. J -Life Health. 2019;10(1):6–13.
2. Innes KE, Selfe TK, Vishnu A. Mind-body therapies for menopausal symptoms: a systematic review. Maturitas. 2010 Jun;66(2):135–49.
3. Heger M, Ventskovskiy BM, Borzenko I, Kneis KC, Rettenberger R, Kaszkin-Bettag M, et al. Efficacy and safety of a special extract of Rheum rhaponticum (ERr 731) in perimenopausal women with climacteric complaints: a 12-week randomized, double-blind, placebo-controlled trial. Menopause N Y N. 2006 Oct;13(5):744–59.
4. Shahnazi M, Nahaee J, Mohammad-Alizadeh-Charandabi S, Bayatipayan S. Effect of Black Cohosh (Cimicifuga Racemosa) on Vasomotor Symptoms in Postmenopausal Women: A Randomized Clinical Trial. J Caring Sci. 2013 Jun 1;2(2):105–13.
5. Lee MS, Shin B-C, Yang EJ, Lim H-J, Ernst E. Maca (Lepidium meyenii) for treatment of menopausal symptoms: A systematic review. Maturitas. 2011 Nov;70(3):227–33. 6. Bitzer J. Progesterone, progestogens and psychosomatic health of the climacteric woman. Maturitas. 2009 Apr 20;62(4):330–3.