Are There Effective Treatments for Hot Flashes?

What Are Hot Flashes?

Hot flashes manifest as an unexpected rush of heat across your face and chest. They seem to be related to changes in circulation, caused when blood vessels under the skin dilate. They can be accompanied by sweating, redness in the face, a rapid heart rate, and chills. Hot flashes can occur while you sleep as well; in this case, they’re known as night sweats, and they’re likely to wake you up.

The severity and intensity of hot flashes vary from woman to woman, as does the length of time they last. Some hot flashes come and go in 30 seconds, while others can hang on for 20 minutes or more. In addition, some women experience hot flashes only for a short period during their perimenopausal years, while others see hot flashes continuing after they’ve moved past menopause. For some women, a hot flash is a momentary inconvenience, while other women find their lives are changed (not for the better) by their incessant hot flashes.

Treatment for Hot Flashes

You have a lot of options when you decide to seek treatment for your hot flashes, and your doctor can help you choose what’s right for you. By far, the most effective treatment is hormone replacement therapy, which also treats other symptoms of menopause, including vaginal dryness, weight gain, and insomnia, among others.

Other prescription medications used to treat hot flashes are approved for other purposes, but have been approved. In addition, some women turn to herbal supplements (not all of which are safe), while others attempt to handle their hot flashes through lifestyle changes that aren’t effective for all women. Take a look at your options.

Hormone Replacement Therapy

Hormone replacement therapy provides the estrogen that your body no longer produces in sufficient quantities. If you have a uterus, your therapy will also include progesterone as protection against endometrial cancer. No matter which version of hormone replacement therapy your doctor recommends, the dosage is tailored to your needs.

Hormone replacement therapy is extremely effective at preventing hot flashes during perimenopause and menopause. It also treats vaginal dryness, mood swings, and the other symptoms of menopause that result from decreased estrogen production, and it helps prevent osteoporosis and sleep disturbances. It’s the only treatment for hot flashes that also provides relief from other menopausal symptoms.

You have many options for the delivery of your hormones. Hormone replacement therapy is available in pill form, but you can also take it via skin patches, implants, and gels. While most women are able to handle hormone replacement therapy safely, women with a history of blood clotting or breast cancer may be advised to avoid it and to seek another treatment for their hot flashes.

Prescription Medications

Several prescription medications are used to treat hot flashes, but only one (paroxetine) has official approval for that purpose by the regulatory authority. Other prescription medications used to treat hot flashes are approved for other purposes by the FDA, but have also shown some efficacy at ameliorating hot flashes. Among the medications your doctor may suggest are:

• Paroxetine (Paxil). The low-dose form of this anti-depressant is approved for the treatment of hot flashes. Paroxetine is a selective serotonin reuptake inhibitor (SSRI) used in higher doses to treat depression, anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and panic attacks. It should not be taken by any woman also taking tamoxifen.
• Venlafaxine (Effexor). This serotonin and norepinephrine reuptake inhibitor (SNRI) is an antidepressant typically used to treat panic attacks, anxiety, and social anxiety.
• Citalopram (Celexa). This SSRI is also used primarily to treat depression.
• Escitalopram (Lexapro). Used as a treatment for depression and anxiety, escitalopram is also an SSRI.
• Gabapentin (Neurontin). This anti-seizure medication has been shown to be somewhat effective at treating hot flashes, and it’s an especially good choice for women who are also experiencing insomnia.
• Pregabalin (Lyrica). Another anti-seizure medication, pregabalin may result in dizziness, weight gain, and drowsiness while controlling hot flashes.
• Oxybytynin (Ditropan). This medication, used to treat overactive bladder and other urinary conditions, has proven to relieve hot flashes in some cases. It’s typically taken as a pill or applied as a patch.
• Clonidine (Catapres). Also delivered in pill or patch form, this medication is used to treat high blood pressure and provides relief for hot flashes in some women as a side effect.
• Fluoxetine (Prozac). While this well-known antidepressant is effective against hot flashes and is also used to treat premenstrual syndrome, it’s inappropriate for any woman who is taking tamoxifen.

None of these medications are as effective against hot flashes as hormone replacement therapy, but they may be useful to women who aren’t able to pursue hormone therapy. Researchers are currently studying some of the antidepressants on the list, hoping to have them officially classified as treatments for hot flashes. Most of these medications carry with them significant side effects, often including dizziness, drowsiness, and headaches.

Lifestyle Remedies

Women whose hot flashes are relatively mild and infrequent may be able to control or tolerate them by adopting these lifestyle changes:

• Exercising. Women who are sedentary experience more hot flashes than women who follow a regular exercise program.
• Avoiding alcohol and caffeine. For many women, these are triggers that bring on hot flashes.
• Avoiding spicy foods. Some women also find that the level of spicy heat in their foods also correlates with the frequency of their hot flashes.
• Dressing in layers. If your body temperature is varying wildly through the day, being able to take off an outer layer in public can help you cool off and regulate your internal thermostat. Wearing breathable fabrics, such as cotton, linen, and bamboo, can also help.
  
• Carrying a fan. A portable fan can help you get through a hot flash with minimal embarrassment and maximum comfort. Many women also like to have fans on their desks or other places of work.
• Losing weight. Women who are obese or overweight tend to experience more severe hot flashes.
• Drinking cool beverages. That iced drink can help regulate your internal body temperature to keep you cool through the day.
• Cooling your bedroom. If you’re experiencing night sweats, lower the temperature in your bedroom and opt for breathable bed linens, nightclothes, and pillows.
• Quitting smoking. Smoking has been linked to an increase in the severity and duration of hot flashes — and quitting is a good idea for your health in just about every other way.

In addition, your diet can have an effect on your hot flashes. Some plants contain estrogens, which may help reduce hot flashes when you ingest them. These plant estrogens, known as isoflavones, can be found in:

• Soybeans and other forms of soy
• Flaxseed
• Chickpeas
• Beans
• Lentils
• Red clover

Soy appears to be particularly effective against hot flashes, especially when you take it in via foods (rather than supplements). Look for edamame, soy milk, tempeh, and tofu as strong sources of natural soy.

Mindfulness Approaches

Some women are able to manage their hot flashes through hypnosis. In addition, while meditation doesn’t lessen or relieve the hot flashes themselves, some women find they are less bothered by them when they meditate and practice mindfulness. Cognitive behavioral therapy has similarly been found to reduce, not the hot flashes themselves, but the extent to which women find them discomforting.

Acupuncture

Research indicates that acupuncture may be effective at reducing the severity and frequency of hot flashes, though studies aren’t yet conclusive.

Supplements

Many women turn to various supplements seeking relief from hot flashes and other menopausal symptoms. Some of these may have some efficacy, but it’s important to look for the potential dangers of these unregulated substances. Among the most popular herbal supplements used to treat hot flashes are:

• Vitamin E. This necessary vitamin offers some relief, decreasing the number of hot flashes that women experience each day. However, it can be dangerous in high doses.
• Evening primrose oil. Early studies on this supplement show that it’s not especially effective against hot flashes, and it can cause diarrhea and nausea.
• Black cohosh. Studies are inconclusive regarding this supplement, with some showing some benefits against hot flashes and others showing none. If it works, it may be because it stimulates serotonin receptors or possibly binds to estrogen receptors. It can be taken in tea and capsule form. However, in some people, black cohosh can severely damage the liver.
• Ginseng. This herbal supplement has proven effective in dealing with insomnia and mood swings often associated with menopause, but it doesn’t appear to be effective against hot flashes.

Once hot flashes begin, they can last for years. You have ways to alleviate the discomfort they cause, though. At Hormonally Balanced, we are ready to discuss all your options with you and help you choose the best possible option for making your way through your perimenopause and menopause with a minimum of symptoms.