Hot flushes: what works

By Roger Dobson , Tuesday 4 March 2014

Learn more about the symptoms of menopause and the treatments available to help you cope with them.
Herbs and drugsHerbs and drugs - what works for hot flushes?

Research at the University of Exeter shows that 50.5% of women now use one or more complementary or alternative medicines to ease menopausal symptoms.
 

Menopause symptoms



  • Hot flushes – suffered by seven out of ten women
  • Night sweats
  • Loss of libido
  • Vaginal dryness and pain, itching or discomfort during sex
  • Palpitations
  • Headaches
  • Mood changes
  • Insomnia
  • Urinary tract infections

Their analysis of surveys found that six out of ten women rated their treatment as successful, and the five most popular therapies were herbal medicine, followed by soy, evening primrose oil, relaxation and yoga.

The rise in the popularity of complementary and alternative medicine has followed a decline in HRT use after reports of links between hormone therapy and increased risk of breast and endometrial cancer, heart disease and stroke although, for many women, the real increase is slight.

Personal factors such as age, weight, family and medical history will affect the level of risk, as will the duration of the treatment.

Nevertheless, research suggests that many women are attracted to alternative treatments in the belief that they are natural and safe – which may not always be the case – as well as being effective.

The challenge for women searching for a natural remedy is finding one that works. Relatively little research has been carried out, and sometimes the evidence is wanting or negative. According to a Yale University School of Medicine report, phytoestrogens (derived from plants), black cohosh and vitamin E may be no better than a placebo in reducing hot flushes, while the Exeter team says the same about evening primrose.

However, a survey of 2,500 German gynaecologists who were asked to rate the effectiveness of each therapy based on observations of their patients found that most of the doctors believed in the effectiveness of at least one alternative therapy. Straightforward lifestyle changes were rated the best, with 54.4% saying that they were effective, while 35.7% reported that they worked sometimes. And alternative treatments that were rated as effective by the doctors were St John’s wort (25%) and black cohosh (21%).

The best bets for managing menopause symptoms



Simple lifestyle changes have been shown to ease hot flushes, including maintaining a healthy weight and stopping smoking, as well as more obvious adjustments such as creating a cooler environment, wearing light and layered clothing and using fans when needed, according to one Yale University study.

Relaxation

Group relaxation therapy can work, according to a 2012 study by gynaecologists at Linköping University, Sweden. Postmenopausal women with seven or more moderate-to-severe hot flushes a day had either relaxation therapy or no treatment at all. In those who had the therapy, the number of hot flushes dropped by five a day compared with 1.9 in the other group after 12 weeks.

Exercise

Aerobic exercise three times a week for three months can have a significant beneficial effect on some menopausal symptoms. One trial at Minnesota University showed improvements in sleep quality, insomnia and depression, but not in hot flushes.

Yoga

A study at the University of California San Francisco showed that eight weekly 90-minute sessions of yoga led to an average drop in hot flushes each week of 30.8%. The researchers say bigger trials are now needed.

Pine bark

According to one study at Keiju Medical Centre in Namao City, Japan, a supplement based on pine bark was particularly effective against hot flushes, night sweats and insomnia. The study involved 170 women taking either Pycnogenol French maritime pine bark extract or a placebo a day, and found significant improvements after four weeks in the women on the supplement.

St John’s wort

Better known for its use as an antidepressant, it has been shown to improve quality of life in women around the time of the menopause. The study, at the University Hospital of Quebec, found that after three months of taking St John’s wort, women had significantly better quality of life and fewer sleep problems than those who were taking a placebo.

The jury is still out on these menopause remedies



Black cohosh

Some studies have found black cohosh effective, while others have not. A study funded by the US National Institutes of Health found it to be no better than a placebo for relieving hot flushes. However, a Swiss study based on more than 400 women showed that it was effective: ‘Treatment in patients with hot flushes and night sweats resulted in a significant improvement of symptoms,’ say the researchers. One in four German gynaecologists also considered black cohosh to be effective.

Acupuncture

This ancient Chinese therapy can reduce the severity of symptoms of hot flushes according to a study at Stanford University in California, where postmenopausal women with moderate to severe hot flushes were given nine sessions of acupuncture or placebo needles. Acupuncture resulted in a significantly greater decrease in the severity, but not the frequency, of hot flushes. Other studies have found no effects.

Evening primrose oil

Some research shows that the third most popular natural remedy used by menopausal women is effective, but a report in the British Medical Journal found that gamolenic acid – a major compound in primrose oil – offered no benefit over a placebo in treating hot flushes. However, a study at Shahid Beheshti University in Iran involving the same number of women found primrose oil to be superior to a placebo, with a 42% improvement in the severity of symptoms.

Hops

A number of symptoms, including hot flushes, were eased among women taking an extract of hop flowers daily compared with those who had a placebo preparation. The research at Ghent University Hospital in Belgium found that the reduction in hot flushes was significant after six weeks.

Soy

Some trials show it is helpful, while others have found it ineffective. Its use is based on the idea that soy contains compounds called isoflavones, which have some small oestrogen-like effect. A study at the University of Minnesota concluded, ‘Consumption of 30mg/day of soy isoflavones reduces hot flushes by up to 50%’.

Folic acid


The supplement widely used in pregnancy to lower the risk of birth defects may also be a way to treat hot flushes. Improvement in hot flushes was reported by 65% of the women taking the active treatment (but also by 16% of the placebo group!) in a study at the University of Alexandria. Two weeks after stopping the tablets, hot flushes recurred in all women who had shown an improvement. Folic acid may have an effect on the brain chemical serototin, which has been implicated in hot flushes.

Can you delay the menopause?


Fish

Regular fish-eaters are up to 40% less likely to go through an early menopause, according to research at Demirel University Medical School, Turkey. In a group of women with an average age of 52, fish-eating delayed menopause the most, while lifelong sun exposure increased the risk of early menopause the most.

Red wine

Women who drink red wine have a lower risk of an early start to the perimenopause, the two to eight years leading up to the menopause itself, according to Harvard University research based on around 500 women aged 36 to 45, who were monitored for more than five years. One theory is that it is down to a non-alcoholic compound in red wine, resveratrol, which has oestrogen-like actions.

Milk

Results of a 20-year study of 46,000 women show that the more low-fat dairy products a woman consumed the later her menopause. The Harvard University researchers say that cow’s milk contains compounds that appear to increase the amount of oestrogen and progesterone in a woman’s body, which might cause the delaying effects. Low-fat dairy products contain more of these compounds, which may explain why the same effects were not seen for full-fat dairy items.

Health warning

Talk to your doctor before using complementary and alternative medicines. Some herbal therapies can be dangerous, and can interact adversely with prescription medications, yet in a study of users by Exeter University researchers, more than half of the women had not told their doctors about their use of complementary and alternative medicine.

Before you decide which menopause treatment to try



Before ruling out conventional treatments, it’s worth discussing HRT as well as other prescription medications with your doctor so you can weigh up the relative pros and cons of the different treatments and decide what’s best for you.

Medical treatments for menopause


HRT

Hormone replacement therapy is effective in treating a number of the most common menopausal symptoms, including hot flushes and night sweats, vaginal symptoms and urinary tract infections, such as cystitis.

In the long-term, it can also reduce the risk of osteoporosis. It works by replacing oestrogen whose levels drop as the menopause approaches. It’s available as a cream or gel, a tablet, a skin patch or an implant.

A number of side effects can be associated with HRT, including weight gain, tender breasts, nausea, headaches and mood changes.

According to NHS Choices, HRT slightly increases the risk of developing breast cancer, endometrial cancer, ovarian cancer and stroke.

The balance of benefits and possible risks will be different for each individual woman, so it's worth having a full discussion of the pros and cons with your GP before making a decision about treatment.

Testosterone gel

Research at the Karolinska Hospital in Sweden shows that a gel rubbed on the skin boosts libido in post menopausal women. "Testosterone gel of 10 mg had positive effects on several aspects of sexual life such as frequency of sexual activity, orgasm, arousal, fantasies and sexual interest in postmenopausal women on HRT," say the researchers.

Antidepressants

One study, based on more than 2,000 women, showed that compared with placebo, selective serotonin reuptake inhibitors (or SSRIs) such as Prozac were associated with a significant drop in frequency of hot flushes, and in their intensity. A second study showed that symptoms rapidly returned in more than a third of women after therapy was stopped.


Tibolone

A man-made hormone that works in the same way as HRT, it is effective in treating hot flushes and night sweats and it can also help prevent fractures of the spine. It may also improve sexual problems, such as a decreased sex drive. It has some risks, however, including a small increased risk of breast cancer, cancer of the womb and stroke. It is not suitable for women over 60.


Clonidine

A drug originally developed to treat high blood pressure,  it has been found to reduce hot flushes and night sweats in some menopausal women.


Gabapentin

An anti-convulsant, used for treating seizures and pain associated with shingles, it has been shown to reduce symptoms according to a Wayne State University School of Medicine report, but it is not known how. A study involving 59 women found a reduction of hot flush frequency of 45 per cent compared to 29 per cent for placebo treatment.


Neck cooler

A handheld device with a small metal cold plate has been designed to stop hot flushes before they really start. It is held against the back of the neck at the first sign of symptoms, and is designed to re-set the body's natural heat controls whose malfunctioning is thought to be involved in hot flushes. The Menopod, which is being used in a clinical trial, is designed to be effective within one minute. A trial of the device at Queen’s University in Canada comes in the wake of anecdotal reports of women having immediate easing of hot flush symptoms when they place something cold on their neck, like a chilled soft drink can.


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The opinions expressed are those of the author and are not held by Saga unless specifically stated.

The material is for general information only and does not constitute investment, tax, legal, medical or other form of advice. You should not rely on this information to make (or refrain from making) any decisions. Always obtain independent, professional advice for your own particular situation.

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  • Rachel

    Posted: Thursday 17 July 2014

    Hello to all sufferers!!
    I read all your comments and first off I'm relieved to know I am not alone in this dark world of embarrassing hot flushes! As I read though, I start to cry again, I feel I have tried everything going but nothing seems to stop this awful hot flush! Sometimes it is so embarrassing it feel like never going out again;what's the point I ask myself, your makeup runs down with the heaviest of droplets of sweat, your hair , looks like I just got out of shower!! Please help x

  • Eve

    Posted: Wednesday 16 July 2014

    Started the hot flushes 10 years ago (now 69)was on HRT at 50 it was great but they took me off it. Tried all the health shop remedies, nothing worked, Doctor gave me Chlonidine, didn't work, went to see a Prof who was doing a paper on all of this told me it can continue until I am 80. That for me was just about the last straw, have been offered sleeping pills but do not want to go down that road, so if anyone has a solution let me know, I am going try acupuncture next week, wish me luck.

  • Jill

    Posted: Wednesday 16 July 2014

    I am 49, I had two heart attacks at the age of 42 ! Unreal, size 10 lo. Anyway I can not take HRT but I wish I could, I have hot sweats every hour day and night accompanied by feeling unwell. Sometimes I feel sick other times just horrid. I have looked at alternatives but they only appear to delay it, so my thoughts are try and get through it. The hardest for me is disturbed nights sleep and a feeling of "low" but I have never been so happy in regard to my home and work life so that's annoying.

  • Maggie B

    Posted: Monday 14 July 2014

    I am 65 years old and now notice the times when I am cool as opposed to burning up. This has been going on for over 20 years. HRT helped a little but I cannot take it now as I had breast cancer. I have been down the natural route but short of a miracle, I think this is it. Once in a while, I just conk out on the sofa and go in and out of sleep for a few hours which recharges my battery. By this point I am so exhausted I can't even manage to be boiling hot!

  • christine

    Posted: Sunday 13 July 2014

    i am 73yrs old and having more sevire sweats than befor dr offered me a tablet that could be for incontenent people he said it would dry up the sweats but i would get a dry throat so i never take the tablets and ime not incontenent yet, so i am not going to add more problems than already got i would like a remedy with no side efects if there is one , thankyou

  • Sue Pearson

    Posted: Sunday 22 June 2014

    I am 47 an have been suffering on and of with hot flushes for about the last 2 and a half years. I am currently taking Sage which I,m not sure is helping as I still have between 5 and 10 a day, some good days and bad days and I do get them at night as well. One thing I,ve found is that I always carry a fan or something to fan myself with when I have an attack, which does work, but I have to do it quite vigorously. I also seem to know when one is coming as I get an odd moment of feeling unwell.

  • Varsha

    Posted: Friday 20 June 2014

    I was 41 when I started early menapause. It took the doctors 6 months to confirm from blood tests that this was the case, in which time I had hot flushes. Then I started taking an Aloe Vera Gel Drink for something else and quite by accident realised I wasn't having any hot flushes. Unfortunately after 12 months of being hot flush free, they have come back along with the night sweats and insomnia. I don't know why I bother trying to sleep as I spend more time adjusting the fan and duvet.

  • Peggy

    Posted: Monday 16 June 2014

    I had a mastectomy 9 years ago I was told I could no longer take HRT. I started having hot flushes straight away and have have them ever since. I have been on Dixarit and am now on Chlonidine but still get them, more severely during the night which means I never sleep for long without having a sweat. I am 66 and have been told by my doctor that they may go on until I am well into my seventies. Please help if you have found a cure! Here's hoping.

  • Lesley

    Posted: Tuesday 10 June 2014

    53 and have been in the menopause since I was 42 - I run, aerobics, cycle etc. tried HRT, great with the hot flushes and sweats, but made me bleed, having not bled since 42, now prescribed Dixarit, day 7 and still flushing ugh!

  • Carole Barlow

    Posted: Tuesday 03 June 2014

    I am 68 years old and after being on HRT for many years my doctor advise me that I could no longer have it. I have now been suffering for months with hot flushes, night sweats and all the other horrible things that go with the menopause. Two weeks ago I visited Holland & Barrett looking for a natural product. Sage was recommended in capsule form. Already my hot flushes, night sweats etc have reduced. I am crossing my fingers that this will continue.

  • Liliane

    Posted: Thursday 15 May 2014

    Hi all
    Have had awful symptoms for the last 8 years, now take HRT but haven't had that much relief. I'm sick of getting colds all the time because i get hot and sweat and then because i am wet i get cold and am more vulnerable to catching a cold. Now i have these annoying symptoms of being hot but feeling frosty/shivery and then feeling cold, it takes a few hours to feel warm again. Also headaches everyday, muscle aches too.
    I would like my old life back if it was possible.

  • Ally

    Posted: Wednesday 14 May 2014

    Im 34 - sigh...No period in over a year, all bloodwork shoots to menopause..I have had beyond severe hot flashes all day, non stop, if I am lucky and that is a BIG if - I will sweat from 8:00 am to 1:00 pm ish 90 % of the time it is all day. I really feel for all of you, I cannot imagine being 20 + years and going thru this. I hope you are all able to fiind something that suits you all good. I am on HRT I take estrogen and progesterin (*spelling) and so far nothing has helped.

  • El

    Posted: Thursday 27 March 2014

    First, I just want to say how strong and beautiful you all are.
    Ms.Eleanor I have not slep, in 3 months but 2-3 hours a nite, I thought I could
    handle this all on my own. I am trying so hard not to loose it.
    I wish some one could just hold my hand, and go with me to the Doctor,
    that is how bad it is...I am so tired.. and hot., Pray for me.....

  • Eleanor

    Posted: Tuesday 04 March 2014

    Hi Ladies. I am 56 experiencing horrendous night sweats which wake me and disrupts my sleep. If I get 3-4 hrs a night I am lucky. I have tried everything HRT didn't agree with me stopped the sweats but gained weight, sore breasts and starting bleeding. Herbal remedies you name it I have tried them. Sage tablets. Menapause plus. If I could get a good nights sleep I could cope with anything!!!!

  • Jill Atkinson

    Posted: Tuesday 25 February 2014

    Don't just assume the symptoms are always menopausal. Get your iron levels thyroid & testosterone levels checked. Look at the symptoms separately so you don't miss anything. Best thing is talking it through with someone in the same situation .If you have a spouse /partner keep them up to speed with how you feel. We've never experienced this before so we are anxious and out of sorts. Make time for yourself to appreciate this. We can't do what we always have done so lighten up a bit. I could go on

  • Jean Watts

    Posted: Sunday 16 February 2014

    I just want to say to anyone who who is thinking about going on HRT if it suits you I would definetly recomend it the positive sides for me outwayed the negatives but i would not recommend staying on it as long as I did I have just come off it aged 67 and now at this age have to go through everything i Perhaps might have been finished now I will never know

  • Pam

    Posted: Thursday 06 February 2014

    Have been having hot flushes since age 45 am now 73yrs old have found that Remifemin from chemist helps but still get flushes not so many of them tho just might help others that are suffering this debilitating pest of a thing. Thank you cheers Pam.

  • SORAYA

    Posted: Wednesday 05 February 2014

    LADIES I HAVE HOT FLUSHES AFTER A HYSTORECTOMY LAST YEAR AND HAVE TRIED EVERYTHING, I HAVE 30 PLUS EVERY DAY AND NIGHT, ITS AWFUL. THEN I READ THAT YOU SHOULD RUN YOUR WRISTS INDER THE COLD TAP WHEN YOU ARE HAVING A HOT FLUSH. IT WORKS!!!!!!! IT STOPS THE HOT FLUSH IN ITS TRACKS!!!!!! PLEASES TRY XX

  • Sofia

    Posted: Wednesday 08 January 2014

    After trying everything like all herbs, magnet & flaxseed, I found out by searching that the apple cider vinegar is working good for hot flashes. I couldnt find organic one but over the counter is helping so much. You have to take 2 table spoon with a glass of water morning and before bed. Its good also overall to your health. It might help u too.

  • joan

    Posted: Friday 03 January 2014

    I was having hot flushes 24/7 and feeling so tired all the time .I researched a lot of remedies and even made the cake,which was awful.Eventually I found that changing my diet to non dairy,and less red meats,plus the supplement Menopace,helped a great deal.Also eating 1 pear a day and drinking more water and less hot drinks.Just one more thing for hot flushes in the daytime,a small fan to have with you at all times.

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