How to Handle the Heat of Hot Flashes (Vasomotor Symptoms)

When menopause hits, many women experience hot flashes (vasomotor symptoms). You know, those sudden waves of heat that leave you feeling flushed and uncomfortable? Yes, they are frustrating, uncomfortable and sometimes debilitating for some women, but they don't have to take center stage in your life. Whether you're waking up drenched in sweat or fanning yourself in the middle of a meeting, these sudden heat waves can disrupt your day and your peace of mind. The good news? You don’t have to suffer in silence. From natural remedies to medical interventions, there’s a wide range of solutions to help you take back control and feel like yourself again. Let’s dive into some effective options that can cool things down and empower you to thrive during this transformative time.

I came across this quote from Dr. JoAnn V. Pinkerton, a leading expert in menopause management, emphasizes the importance of individualized treatment plans for managing hot flashes:

"Lifestyle changes, nonhormonal medication, and hormone therapy can all be very effective in treating hot flashes."

Here’s a breakdown of the latest insights and solutions for managing vasomotor symptoms, based on research reviewed by top experts at the North American Menopause Society (NAMS) – now called The Menopause Society.

Different solutions for different intensities of vasomotor symptoms (hot flashes!):

• For mild hot flashes, lifestyle changes and some non-prescription remedies may help, (be warned that results vary.)
• For moderate to severe hot flashes, estrogen therapy is the most effective, but it can come with risks. Alternatives like antidepressants and progestogens can be useful for those who can’t use estrogen.
• Consult with a healthcare provider to make the best decision based on your symptoms and health history.

Lifestyle Strategies: Your First Line of Defense

If your hot flashes are mild, start with simple lifestyle changes:

• Stay Cool: Dress in layers, use fans, and avoid triggers like spicy foods and alcohol.
• Get Active: Regular exercise can help stabilize your body temperature.
• Breathe Easy: Deep, paced breathing techniques can also reduce the intensity of hot flashes. There are plenty of great breathing meditations on apps and online.

These approaches are natural, safe, and a great place to begin and can provide relief but they are NOT a solution.

Do Nonprescription Remedies Work?

Great question! The response from the Menopause Society study on over-the-counter options like soy, red clover, black cohosh, and vitamin E showed that while these options are popular, studies have mixed results. While they’re generally safe for short-term use, there’s no strong evidence that they reliably reduce hot flashes. On the flip side, remedies like dong quai, evening primrose oil, ginseng, acupuncture, and magnet therapy have shown little to no benefit in clinical trials.

Prescription Options

For more pesky and persistent hot flashes, certain medications can help:

• Antidepressants: Venlafaxine, paroxetine, and fluoxetine have shown good results with minimal side effects.
• Gabapentin: Originally used for nerve pain, it’s proven effective for hot flashes too. I personally tried this, and it didn’t work for me but see above – ‘results vary’!
• Antihypertensives: Medications like clonidine can help, but they often come with side effects. Again, I tried this and had no luck, but I could just be that one in million person who should probably buy a lottery ticket.

If your symptoms are moderate to severe, systemic estrogen therapy is the gold standard according to the Menopause Society. Estrogen, either alone or combined with progestogen, can significantly reduce hot flash frequency and severity. However, it’s important to note the potential risks, including an increased chance of breast cancer, stroke, and blood clots.

What About Hormone-Free Options?

For women who prefer to avoid estrogen or can’t take it for medical reasons, progestogens, antidepressants, or gabapentin are excellent alternatives. Again, I have tried a few of these to no avail. The one thing that has worked well is reducing or eliminating alcohol intake. It has been said that alcohol and spicy foods can be contributing culprits. Damn!

Key Takeaways on harnessing hot flashes:

1. Start Small: Try lifestyle changes or nonprescription remedies for mild symptoms.
2. Explore Options: For moderate to severe hot flashes, prescription therapies are available.
3. Weigh the Risks: Talk with your doctor to find what’s best for you, balancing benefits with any potential risks.
4. Reassess Regularly: Menopause symptoms often fade over time, so your treatment plan may need adjustments.

Every woman is different, so menopause management is too. It’s important to work with your healthcare provider, come prepared with your questions and work with your provider to choose a plan that fits your needs and lifestyle. Remember that menopause doesn’t have to suck – relief is possible!