Up to 80 percent of women suffer from menopause-related hot flashes—sudden feelings of intense heat, often accompanied by profuse sweating and flushing. Even if you experience them for just a couple of months (lucky you) or a couple of years (still relatively lucky), they can be quite bothersome. Some women get them more than 20 times a day, with episodes lasting from a minute or two to as long as an hour.
Here are some strategies for managing hot flashes that don’t involve drugs (which are often effective but have undesirable side effects) or dietary supplements (of questionable value and possibly risky). Though the evidence is mixed or inconclusive for many of them—in part due to methodological problems in the studies—they may be worth trying as a first step toward staying cool and dry when a flash hits.
1. Relaxation techniques
It’s thought that the decrease in estrogen that occurs in menopause leads to increased activation of the sympathetic nervous system, which is involved in the body’s regulation of core temperature. Various relaxation techniques, such as guided imagery and progressive muscle relaxation, may thus help reduce hot flashes by tamping down sympathetic activity (often referred to as the “relaxation response”). Though the literature on such techniques as a whole has been inconsistent, a 2012 review article in the journal Maturitas concluded that “relax- ation techniques may hold promise in [the] treatment of hot flashes.”
2. Paced breathing
Recommended by the North American Menopause Society, this [ultra-slow deep breathing technique] has been shown in preliminary studies to reduce hot flashes, with some research suggesting that it is the key component of relaxation-based interventions. In a 2013 pilot study in Menopause, women who practiced slow breathing (6 breaths a minute) reported fewer hot flashes, with better results seen in those who did it twice a day for 15 minutes at a time, versus once a day. Those in a control group (14 breaths a minute) also showed reductions but, as the authors explained, that could be because they similarly focused on their breathing and this may have had unanticipated benefits. An earlier study found paced breathing to be superior to progressive muscle relaxation in reducing hot flashes.
3. Mind-body techniques
In a 2011 study in Menopause, a mindfulness-based stress reduction program—which involves bringing awareness to your body sensations without judgment through such actions as stretching and breathing—reduced the “bother,” stress, and anxiety associated with hot flashes, plus improved sleep and quality of life, even though it didn’t affect hot flash frequency or intensity. Some studies have found that yoga similarly helps relieve psychological symptoms associated with hot flashes—and sometimes the hot flashes themselves—while a large 2013 study, also in Menopause, found that hypnosis reduced hot flash frequency and intensity.
4. Cognitive-behavioral therapy (CBT)
By increasing understanding of what is happening when hot flashes occur and providing coping strategies, CBT aims to help counter the negative thoughts and behaviors associated with hot flashes and increase acceptance of and sense of control over them.
In a 2014 study in Menopause, both group CBT (four weekly sessions with a psychologist) and self-help CBT (the same information provided in a manual) improved the ability to cope with hot flashes and lessened the impact they had on daily life.
Many cultures use acupuncture to treat hot flashes, but the science to back it has been mixed and inconclusive. A 2013 review by the Cochrane Collaboration found insufficient evidence for the use of acupuncture for hot flashes, with no significant dif- ference seen between sham and real treatment. And an analysis of studies, published this year in Menopause, concluded that though acupuncture seems to have some benefit on hot flash frequency and severity, sham acupuncture also shows benefits. This suggests a placebo effect—which may not matter, as long as symptoms subside.
According to a review paper in Maturitas in 2012, there’s not enough evidence to conclude whether exercise is effective in reducing hot flashes. Its effect on hot flashes may depend on the amount of body fat a woman has, along with her fitness level, hormonal status, and psychological factors. Still, many women find it helps, and it’s worth trying since exercise has other proven health benefits.