Managing Hot Flashes

Health Writer

It's one of those dreaded symptoms of mid-life change for women - hot flashes.   Often accompanied by flushed skin and sweats, it is a hallmark of menopause for many women.   But how many hot flashes you have in a day, how intense they are and how long they persist is somewhat unpredictable.   Experts do say that your experience with menopause is often quite similar to your mom's, so if she is alive and does remember, definitely find out what symptoms she had and the duration  of those symptoms.

Three out of four menopausal women should expect to have some hot flashes.   It's important to assess the hot flashes, especially if you feel they are disruptive or affecting your quality of life-

  • How many do you have?
  • Do they occur throughout the day, just during daytime, just at night?
  • Do you have significant flushing?
  • Do you experience sweats as well?
  • Are you also experiencing weakness, fatigue, faintness or dizziness?

An occasional flash or sweat is one thing, but persistent hot flashes and sweating on and off throughout the day may be difficult to tolerate, especially if it goes on for a couple of years.   If your hot flashes last for up to 30 minutes, that may also be unbearable over time.   It's important to note that the sudden withdrawal of naturally occurring estrogen (not just lower levels) seems to  instigate hot flashes.   Smoking, obesity, physical inactivity and being African-American are all possible risk factors for hot flashes during menopause.   Insomnia is also a complication of hot flashes and night sweats.   So what's a woman to do?

If you are tolerating mild or occasional hot flashes/sweats then you don't need treatment. If you feel a strong need to ease  your  unrelenting  symptoms then you should discuss the risks/benefits of HT (hormone therapy). In some cases hormone therapy is not an option (if you have family history of breast cancer or if you don't want the risk associated with HT). Low doses of certain anti-depressants including Prozac, Celexa, Effexor, Paxil and Pristiq have been shown to help with moderate hot flashes, but again, there are side effects. Clonidine, a pill that is used to treat hypertension may provide hot flash relief. Certain alternative options like black cohosh helps some women; soy foods and selected isoflavones and red clover might help some women, due to the estrogen-like effect that they have. Some experts suggest supplements like vitamin B complex and vitamin E, while others suggest trying ibuprofen (watch your maximum daily dose due to liver toxicity).

Lifestyle choices like avoiding spicy foods, caffeinated beverages and alcohol, using relaxation techniques like meditation and yoga, may help. Keeping your bedroom cool, keeping ice water handy, wearing easy-to-remove layers of clothing, keeping a hand-held fan close by can also help to intercept a hot flash. Remember that for most women this is simply another life stage, a bit uncomfortable at times, but mostly bearable.