Treating Hot Flashes

Hot flashes — sudden brief increases in body temperature — are the most common symptom of menopause. They may occur during the day or at night (also known as night sweats). Hot flashes usually begin before your last period and can range from mild to severe. For many women, hot flashes occur for less than two years; however, some women do experience them longer.

Treating Hot Flashes

If your hot flashes are mild or moderate, you may find relief by making some lifestyle changes. If you have severe hot flashes, you may still benefit from lifestyle changes, but may also choose to use medication, including hormones, to help manage your symptoms. Women’s health experts at El Camino Health offer extensive menopause education and support.

Lifestyle Changes

The two main lifestyle strategies that can help improve your hot flashes are to stay cool and to reduce stress.

Steps you can take to manage hot flashes include:

• Avoid warm rooms, hot drinks and foods, alcohol, caffeine, bright lights and smoking.
• Wear layers of clothing made from light, breathable fabrics. You can remove layers when you’re hot and replace them when you’re cooler.
• Try cooling products including hand fans, sprays, gels and cooling bed linens.
• Maintain a healthy weight to minimize hot flashes and improve your overall health. Women who are overweight have more hot flashes.
• Exercise regularly to reduce stress and promote more restful sleep. Make sure not to exercise too close to bedtime.
• Consider meditation, yoga, qigong, tai chi, biofeedback, acupuncture or massage to help lower your stress levels.
• Take slow, deep breaths when a hot flash is starting. Try breathing in through your nose, into your abdomen, and out through your mouth. Take five to seven breaths per minute.
• Try different strategies to stay cool while sleeping. Dress in light, breathable nightclothes, use layered bedding that can be easily removed during the night, and use a bedside fan. Keep a frozen cold pack or bag of frozen peas under your pillow and turn the pillow often so your head is always resting on a cool surface. If you wake at night, sip cool water.

Medication

Prescription medications may be a good option if you have frequent, bothersome hot flashes. Talk to your doctor about your medical history and potential risks and benefits when considering a prescription medication. In 2013, the FDA approved the first non-hormonal treatment for moderate to severe hot flashes associated with menopause.

Although these medications aren’t government approved for treating hot flashes, they’ve been shown to be more effective than placebos in scientific studies:

• Certain depression medications — including venlafaxine, escitalopram and paroxetine — have been shown to reduce hot flashes in women without depression. If you take tamoxifen for breast cancer, you shouldn’t take paroxetine.
• Gabapentin is a drug approved to treat epilepsy, migraine and nerve pain, but it can also reduce hot flashes. It can cause excessive sleepiness, so it may be an especially good option if night sweats interfere with your sleep.
• Sleeping medications (both prescription and nonprescription) won’t reduce your hot flashes, but may help you sleep through them.
• A combination estrogen-progestin birth control pill has been shown to provide relief from hot flashes. This is a good option if it hasn’t been a full year since your last period and you’re a nonsmoker.

Hormone Therapy

Prescription hormone therapy with estrogen has been used as an effective treatment for hot flashes. Although hormone treatment is associated with some risk, studies show that benefits may outweigh risks for healthy women under 60 who have moderate to severe hot flashes.

The goal is to use the lowest dose of hormone therapy that treats your symptoms for the shortest time necessary. Unless you’ve had your uterus removed, you’ll need to combine estrogen with progesterone. Your doctor can help you decide if hormone therapy is the right option for you.