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Health Information | 01/23/2018

Keep Your Cool – Help for Hot Flashes

By  Dr. Marcie Richardson

If you’re a woman, chances are pretty good you’ve at least heard about hot flashes. Maybe you have experienced them yourself or you know someone who has them. Hot flashes are one of the more common symptoms of perimenopause and menopause – and they can be rather inconvenient. One minute you’re freezing cold, the next minute you’re burning up and stripping down to a tank top. They can happen during the day, or they can wake you up in the middle of the night. The good news is you don’t have to let hot flashes disrupt your life. In this article, I’ll share some ways you can lessen the severity of hot flashes.

First off, let’s start by explaining what happens when you have a hot flash. According to the North American Menopause Society (NAMS), the exact cause is unknown but they are thought to be a result of changes in the hypothalamus, the part of the brain that regulates the body’s temperature. When you have a hot flash, you get a sudden feeling of warmth in your upper body and face. You may get flushed, experience a rapid heartbeat and/or start sweating. Your brain thinks you are too hot and is trying to get rid of heat.

Every woman is different, so hot flashes vary in severity and frequency. The Study of Women's Health Across the Nation (SWAN) found that hot flashes last an average of 7.4 years, although the range is wide. There are some American women who never experience a hot flash, about 15%, and others who continue to have hot flashes into their 60’s or 70’s.

There are measures you can take to reduce hot flashes ranging from lifestyle changes to prescription medication. Many women have triggers or activities that set off hot flashes. If you can identify your triggers and eliminate them, you can help reduce them. Some common triggers include:

  • Hot beverages
  • Spicy/hot food
  • Alcohol
  • Caffeine
  • Smoking cigarettes
  • Stress
  • Being in a warm/hot room
If a food or activity is a trigger, a hot flash generally occurs within an hour, but that time can vary. Keeping a diary of what you eat and drink and when you have hot flashes might help you make a connection. In addition to identifying and avoiding triggers, here are some other remedies to help with hot flashes:
  • If you smoke, get help in trying to quit
  • Dress in light, breathable layers so you can remove layers when a hot flash strikes
  • Keep a fan at your desk at work
  • Running your hands under cold water when you get a hot flash can help cool you down
  • If your hot flashes happen at night, keep your room cool and try putting a cold pack under pillow and flipping your pillow throughout the night
  • Evidence has shown that diaphragmatic breathing helps to alleviate hot flashes
  • Try practicing yoga, acupuncture, massage or meditation to reduce stress levels

Many of my patients ask me about over-the-counter medications. Walk into any drug store and you’ll see dozens of non-prescription medications that claim to help with hot flashes. These products are not regulated by the government so we don’t know all about their quality or the potential risks and side effects and I don’t generally recommend them to my patients. That said, there are some non-prescription remedies that have been found to decrease hot flashes in some studies including soy (tofu, tempeh, soy milk, or roasted soy nuts), supplements containing soy isoflavones, or herbs such as black cohosh.

The most effective prescription medication for severe hot flashes is hormone therapy. Certain anti-depressants can be used to treat hot flashes and gabapentin, a medication prescribed for nerve pain and seizures, has been found especially effective in helping women who experience hot flashes at night.

If you’ve tried lifestyle changes and non-prescription options and hot flashes are still disrupting your life, talk with your primary care provider or OB/GYN about prescription options. Atrius Health offers menopause consultation services to help women understand the most current information about menopause and assist them in making informed decisions about lifestyle, self-care, and available treatments for women with ongoing issues related to menopause.

About The Author

Dr. Marcie Richardson

Dr. Marcie Richardson joined Atrius Health in 1988. She is a board certified obstetrician and gynecologist and practices at our Copley location. She is also part of our Menopause Consultation Services team and offers personal consultations for women about menopause. Dr. Richardson completed her internship at Cambridge Hospital and her residency at Beth Israel Deaconess Medical Center. Her clinical interests include menopause, breastfeeding, and women’s health education.

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