Key Takeaways

  • Hormone therapy, particularly estrogen supplementation, is a traditional and effective treatment for hot flashes. It’s not suitable for everyone due to potential risks and medical history considerations.
  • Various lifestyle adjustments, such as stress reduction techniques, maintaining a cool body temperature, and making mindful food choices, can help manage the frequency and severity of hot flashes during menopause.
  • Quitting smoking and considering medications like low dose antidepressants or anti-seizure drugs may alleviate hot flashes, but it’s essential to discuss these options with a healthcare team due to potential side effects and interactions.

Hot flashes may be uncomfortable and distressing for some people, but they are also a natural symptom of hormonal changes associated with menopause.

Natural strategies may help reduce the intensity and frequency of hot flashes, but if these don’t work as expected, doctors may also recommend prescription medication.

Keep reading to learn about some methods and lifestyle changes you can make to address menopause-related hot flashes.

Traditionally, the most effective management strategy for hot flashes is estrogen supplementation, often referred to as hormone replacement therapy (HRT).

Estrogen may be taken alone or in combination with progesterone. If you have had a hysterectomy, you may be able to take just estrogen safely. However, if you haven’t had a hysterectomy and are using HRT, you’ll take estrogen and progesterone together.

Estrogen isn’t recommended for everyone, especially if you have a history of breast cancer, blood clots, or certain other medical conditions. It may also increase the risk of future health problems, including heart disease, breast cancer, and blood clots.

Key Terms

Estrogen and progesterone are the main hormones that guide the menstrual cycle.

Estrogen helps regulate menstrual cycles, supports bone health, and influences mood and energy levels. Progesterone prepares the body for pregnancy and helps balance estrogen.

During menopause, levels of both hormones drop. This causes periods to stop and can trigger symptoms like hot flashes.

Hormone replacement therapy focuses on these two hormones to ease symptoms and protect long-term health outcomes, particularly for your bones and heart.

Black cohosh is a popular herb that some people report as an effective remedy for hot flashes and other menopausal symptoms.

The plant’s root is used in capsules and tea. Both forms are available in health food stores and online. Although the exact mechanism of black cohosh is unknown, researchers believe it binds to estrogen receptors or stimulates serotonin receptors.

The National Center for Complementary and Integrative Health reports that most research on black cohosh involves low-quality, older studies, and recent research is not conclusive in showing any direct benefits for menopause symptoms or hot flashes.

However, a 2017 research review did note that black cohosh extracts used in Europe appeared to reduce menopause symptoms. However, research isn’t conclusive in supporting the claim that black cohosh can help reduce hot flashes during menopause.

Minor reported side effects of black cohosh include stomachache and rash. There are some reports of liver failure, which is life threatening, in individuals using black cohosh. This herb isn’t recommended for those who are pregnant or nursing, or who have breast cancer.

As with other supplements, it’s best to consult your healthcare team before taking it. Supplements are not regulated in the United States, which may compromise their safety and effectiveness.

Although hot flashes can happen at any time, they’re more frequent during times of stress.

Reducing stress levels may help with the frequency of hot flashes.

Some of the strategies that may help you lower stress levels include:

  • gentle yoga
  • meditation and visualization exercises
  • guided breathing
  • tai chi
  • walking
  • music therapy
  • talk therapy

Some of these strategies can also improve sleep quality. Taking a few minutes alone to read a book, sing out loud, or simply sit outside can do wonders for relaxation.

Even slight increases in your core body temperature can lead to or worsen hot flashes.

Maintaining a cool temperature can help reduce the impact of hot flashes.

Strategies to regulate body temperature include lowering your room temperature (especially at night) by turning on the air conditioner, installing a fan, using a cooling gel pad to lie on, or opening a window if the outside air is cool.

Consider dressing in layers, too. When you start to feel your body temperature rise, you can remove a layer or two to help cool down. Wear cotton whenever possible, as other fabrics, such as spandex, nylon, and rayon, tend to trap body heat.

Cold showers may also help lower your body temperature and prevent hot flashes.

Certain foods and drinks may affect hot flashes during menopause.

Spicy foods, caffeinated beverages, high fat and high-sugar diets, and alcohol may all contribute to the severity and frequency of hot flashes.

Research from 2021 concluded that a low fat, vegan diet that included soybeans was linked to fewer and less severe hot flashes, as well as an improved quality of life. In addition, it noted that during the 12 weeks of treatment, most of the study participants didn’t experience moderate to severe hot flashes.

Your experience may be different, but generally, eating plant-based foods is associated with better health outcomes. Consulting with your healthcare team, including a dietitian or nutritionist, may help you understand how your food choices and potential new eating patterns can affect your menopause symptoms.

If you smoke, quitting may help reduce the severity and frequency of hot flashes.

The benefits of stopping tobacco use don’t end there, though. Quitting smoking can also help reduce the risk of heart disease, stroke, and a wide variety of cancers.

Low doses of antidepressants may improve symptoms like mild to moderate hot flashes.

Examples of potentially effective antidepressants include:

Antidepressants can also treat other menopause symptoms, such as anxiety and depression. However, these medications may also decrease libido, which is also another common symptom of menopause.

Gabapentin (Neurontin), an anti-seizure medication, may be particularly effective if you experience hot flashes at night. Possible side effects include:

  • drowsiness
  • dizziness
  • unsteadiness
  • headaches

Clonidine (Kapvay), which is typically used to lower high blood pressure, may also help reduce hot flashes in some individuals. Possible side effects include:

  • dizziness
  • drowsiness
  • constipation
  • dry mouth

Questions to ask a doctor about medications for hot flashes

You can consult a gynecologist or a menopause specialist for information on prescription medications for menopause. A primary care doctor may also guide treatment, while an endocrinologist may be consulted for tailored care.

These questions may help you make an informed decision about medications:

  1. In your professional experience, how effective are gabapentin and clonidine compared to hormone replacement therapy in reducing hot flashes?
  2. How long would I need to take these medications before noticing improvements in hot flashes?
  3. If one of these medications doesn’t work for me, what other non-hormonal options might be available?

FIND CARE: Find a gynecologist in your area today.

The symptoms of menopause, including hot flashes, can last for a few years or longer. Strategies such as hormone replacement therapy, quitting tobacco use, consuming more soy-based dishes, and managing stress levels may be beneficial.

If these don’t work, prescription medications like antidepressants and gabapentin may help some people.

Consulting a healthcare professional who understands menopause and hormonal changes is key to determining the best next steps to manage hot flashes.