Going through menopause? You may be lucky enough not to experience hot flushes and their evil twin, night sweats. However around 75-80% of woman do experience these vasomotor symptoms at some point during the menopause so it’s a good idea to have some coping strategies up your sleeve for when they strike.
How does a hot flush feel? Typically a feeling of sudden intense heat starts in the face and upper chest then spreads over your body. This may be accompanied by sweating, skin reddening, anxiety, palpitations and chills. Not only can these cause a great deal of discomfort and embarrassment but also if they occur at night, they can disrupt sleep, further reducing quality of life.
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Cool down with gadgets for hot flushes
What do you do when there’s a heatwave? Put those same tools to use when you experience hot flushes. So dig out the electric fan, or a handheld version, wear loose fitting layers that you can remove when the heat strikes and, if necessary, keep a small cool pack with you containing a cold gel pack. You can also buy Magicool or other similar cooling sprays to help cool you down.
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Slow down your breathing
One very small study (only 33 women) published in the American Journal of Obstetrics and Gynecology found that controlled breathing for 15 minutes twice a day helped reduce hot flushes by half, compared to biofeedback treatment (in simple terms, this is where your brain activity is monitored, with the aim of training your brain to calm down). Controlled breathing involves inhaling for a count of five, then exhaling for a count of five, repeating this over the 15-minute period.
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Tune into relaxing music
A 2015 US randomized controlled trial published in the journal Obstetrics and Gynecology, meanwhile, found that using RESPeRATE a portable electronic device that promotes slow, deep breathing confirmed the benefits of slow breathing bringing about modest improvements in the frequency and severity of flushes. Intriguingly, however, it was significantly less effective than listening to three non-rhythmic, relaxing melodies delivered via the device. There was a a 21% decrease in the frequency of any hot flushes in the RESPeRATE group, compared to a 35% decrease in frequency associated with listening to music.
Use ice to cool hot flushes
Cooling yourself fully just as you feel a hot flush coming on can sometimes be enough to stop it in its tracks. With this in mind, one manufacturer has come up with the Menopod. This is a small device about the size of a computer mouse that activates copper pads which then can be used to cool your skin. You hold it against your neck when you feel a hot flush coming on and so, in theory, the hot flush will dissipate before it has even started properly. Of course, there are other ways you can do the same if you’re at home – ice, a cool pack, a bag of peas, all will help.
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How yoga helps hot flushes
Like progressive muscle relaxation, which involves tensing up each group of muscles, then relaxing them, yoga and meditation may help reduce the frequency and severity of symptoms.
Learn more about yoga
Exercise to control menopause sweats
It might feel like the last thing you want to do when you’re breaking out in hot sweats but regular exercise is an excellent way to ward them off. A study from Penn State University, US, found that exercise helped prevent the onset of hot flushes in the 24 hours after physical activity. A more recent Swedish study meanwhile found that a 15-week resistance-training programme decreased the frequency of moderate and severe hot flushes.
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Herbal helpers for menopause symptoms
A variety of herbs have been suggested as helpful for hot flushes including black cohosh (Cimicifuga racemosa), Dong Quai (Angelica sinensis), Wild Yam (Diascorea), Maca (Lepidium meyenii), Maca (Lepidium meyenii) However results have been inconsistent and contradictory and some may interact with exisiting medicines or have a question mark over safety. If you do decide to try one of these speak to your doctor or pharmacist first to check for safety.
Learn more about black cohosh
One study from Stanford University found that acupuncture was effective in decreasing the severity of women’s experiences with hot flushes, but didn’t reduce the frequency. A 2019 six week Danish randomized controlled trial however found that acupuncture significantly decreased hot flushes as well as day-and-night sweats leading the researchers to conclude that the standardised and brief acupuncture treatment produced a fast and clinically relevant reduction in moderate-to-severe menopausal symptoms.
Evening primrose oil
Evening primrose oil (Oenothera biennis) contains omega-6 fatty acids, which increase levels of a hormone-like substance (prostaglandin E2) that has anti-inflammatory effects. Studies have produced contradictory results with some finding an improvement in hot flush symptoms, others finding it worked no better than a placebo. A review published in 2019 concluded that there is currently insufficient evidence to support its use for menopausal symptoms. As it can have side effects in some people, including inflammation and problems with blood clotting always speak to your doctor about taking evening primrose oil before you do so.
Learn more about evening primrose oil
Get plant power
Plant oestrogens (phytoestrogens) compounds derived from soy and red clover (isoflavones) , flaxseed (lignans), and hops (Humulus lupulus), which are thought to act like oestrogen in the body, are often recommended for hot flushes although results have been inconsistent and contradictory. A review published in 2019 concluded that phytoestrogens appear to be safe for 12 months of continuous use but that more randomized controlled trials are need to draw any definitive conclusions as to their efficacy.
Try cognitive behavioural therapy (CBT)
CBT a talking therapy which involves changing the way you think and behave has been found to be effective in some studies. A review published in 2019 concluded that direct (one-to-one face-to-face) CBT was most effective reducing the frequency of hot flushes by 59%. Group CBT decreased frequency by up to 40% while ‘self-help’ CBT involving reading booklets and telephone guided CBT decreased frequency by up to 48%.
Hormone replacement therapy (HRT) is the most effective treatment for relieving hot flushes and night sweats. However it’s not for everyone. Have a discussion with your doctor and weigh up your personal needs before you make a decision.
After HRT selective serotonin reuptake inhibitors (SSRIs) and selective noradrenaline (norepinephrine US) reuptake inhibitors (SNRIs) are the most effective medications, useful if you either can’t take or don’t want to take HRT. There is a 50% decrease in levels of serotonin (sometimes called the happiness hormone) after menopause which results in an increase in levels of noradrenaline. This in turn disturbs the body’s inbuilt thermostat. Other studies suggest that gabapentin (an anticonvulsant also used for epilepsy, nerve pain, and restless legs syndrome) can help. As it can make you drowsy it may be more suitable for you if you mainly have night sweats as it can help you avoid the sleep disruption that so often accompanies these.
Which type of HRT is right for you?
|More advice from Dr Mark Porter...
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