The 6 Best Ways to Manage Hot Flashes
Though 85% of women experience hot flashes during menopause, that sisterhood is no solace when “you’re sitting in a meeting at work or standing in front of a group of people and you get that sudden sensation of heat in your face, chest, and upper torso, like you’ve just walked outside during a heat wave,” says Octavia Cannon, D.O., an ob/gyn in Charlotte, North Carolina. Nothing can completely cure hot flashes, but some treatments and techniques may bring relief. Of course, talk to your doctor before starting anything.
But first: What the heck is going on?
How a scientist would describe hot flashes: the physiologic result of abnormal hypothalamic thermoregulatory control, causing minor elevations of core body temperature yet leading to abnormal vasodilatory response. How you would describe hot flashes: like being trapped on an amusement park ride called Dante’s Fun House Inferno. You’re both right. Hot flashes are sparked by decreasing hormone levels—mostly estrogen, but also progesterone—which, in turn, impact the body’s temperature-regulating mechanisms. “Your brain then tells your body, ‘You’re too hot; you need to cool down,’ and you start sweating,” explains Dr. Cannon, past president of the American College of Osteopathic Obstetricians and Gynecologists.
Talk to your doctor about hormone therapy
Prescription hormone therapy (HT) “remains the most effective treatment for [menopausal hot flashes]," says Stephanie S. Faubion, M.D., medical director of the North American Menopause Society (NAMS) and a professor of medicine at the Mayo Clinic. The two types include estrogen-progestogen therapy (EPT) and systemic estrogen therapy (ET). The former is for women who still have their uterus; the latter is for those who have had their uterus removed (taking estrogen without progesterone can increase the risk of endometrial cancer, so it’s only recommended in people with no endometrial lining).
Consider low-dose antidepressants
One of estrogen’s many functions is stimulating the production of serotonin, a neurochemical that may help regulate temperature, per a 2019 study published in the Journal of Midlife Health. The theory, then, is that as serotonin drops, hot flashes increase. Taken daily, a class of antidepressants called SSRIs (Selective Serotonin Reuptake Inhibitors) may improve hot flashes. A 2017 literature review found Paxil (paroxetine), Lexapro (escitolapram), and Celexa (citalopram) to be most effective. (Women who are on the breast cancer drug tamoxifen should avoid SSRIs, as they interfere with the way the body metabolizes tamoxifen.)
A new Danish study tested acupuncture as a treatment for hot flashes, and while the study was small, it showed promise: Eighty percent of women who received one 15-minute session of acupuncture once a week for five weeks said that the sessions had improved their hot flash symptoms. For many of them, benefits were noticed after just three weeks. It’s not proof-positive that acupuncture works, but if you’ve been searching in vain for an “I’m so toasty” solution, this could be your needle in a haystack.
Besides helping to counteract the loss of muscle and bone mass that occurs during menopause, pumping iron may ease your temp surges, per a new Swedish study. Women with daily moderate-to-severe hot flashes were put into two groups: The intervention group embarked on 15 weeks of a strength training program (three 45-minute sessions a week, incorporating moves like chest presses, leg curls and extensions, lat pull-downs, crunches, and back raises); the control group was told not to change their physical activity habits, which may or may not have included strength training, and to avoid other hot flash treatments. What happened? Next slide!
Lifting weights has impressive payoffs!
For the intervention group, hot flashes (and night sweats) were cut nearly in half. Women in the control group saw no change. “Strength training helps increase metabolism and blood flow, not just to muscles but to the brain as well,” says certified nurse midwife Alyson Lippman, R.N., an adjunct professor of Nursing Care of Women and Infants at the University of Wisconsin–Milwaukee College of Nursing. “That, along with the paced breathing and mindfulness required for weight lifting, could help ease hot flashes.” The stress relief exercise offers may also reduce the number and intensity of hot flashes.
You are getting chilly...very chilly.
Hypnosis has been shown to reduce the frequency and severity of hot flashes on par with the antidepressant Effexor XR (venlafaxine), per a 2017 study (though about 70 percent less than with estrogen therapy). In this calm yet focused state of consciousness, people become more receptive to suggestion—in this case, such as imagining yourself lying on a patio lounge chair, a refreshing breeze washing over your skin. The theory: This state triggers the body’s natural relaxation response, with the cooling imagery helping reduce core body temperature. Find a reputable hypnotist through the American Society for Clinical Hypnosis.
Menopause Symptoms: BMJ Open. (2019). "Efficacy of a Standardised Acupuncture Approach for Women With Bothersome Menopausal Symptoms: A Pragmatic Randomised Study in Primary Care (The ACOM Study)." ncbi.nlm.nih.gov/pubmed/30782712
SSRIs and Hot Flashes: Oklahoma State Medical Association. (2017). "Do SSRIs and SNRIs Reduce the Frequency and/or Severity of Hot Flashes in Menopausal Women?"ncbi.nlm.nih.gov/pubmed/28649145
Hot Flashes and Depression: Menopause. (2020). "Monthly variation of hot flashes, night sweats, and trouble sleeping." journals.lww.com/menopausejournal/Fulltext/2020/01000/Monthly_variation_of_hot_flashes,_night_sweats,.3.aspx
Acupuncture and Hot Flashes: Oklahoma State Medical Association. (2017). "Do SSRIs and SNRIs Reduce the Frequency and/or Severity of Hot Flashes in Menopausal Women?" ncbi.nlm.nih.gov/pubmed/28649145
Resistance Training and Hot Flashes: Maturitas. (2019). "Resistance training for hot flushes in postmenopausal women: A randomised controlled trial." maturitas.org/article/S0378-5122(18)30761-8/fulltext
Hypnosis and Hot Flashes: Menopause. (2017). "Efficacy of a Biobehavioral Intervention for Hot Flashes: A Randomized Controlled Pilot Study." ncbi.nlm.nih.gov/pmc/articles/PMC5747247/