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  • Michael Frey, MD

Treating Hot Flashes



A hot flash is a sudden feeling of heat that rushes to the upper body and face. A hot flash may last from a few seconds to several minutes or longer. Some women have hot flashes a few times a month. Others have them several times a day. Hot flashes that happen at night (night sweats) may wake you up and cause you to feel tired and sluggish during the day.


​​Causes of hot flashes:

  • Menopause: decreased estrogen levels cause your body's thermostat (hypothalamus) to become more sensitive to changes in body temperature.

  • Hot bedroom: set the thermostat to 60 - 68 degrees at night.

  • Thyroid disorders.

  • Excess weight.

  • Anxiety.

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Treatment:

DIY: First steps to try at home


Cooling blankets & pillows

  • PeachSkin Sheets: Moisture-wicking sheets work by pulling moisture off the surface of the skin. This bestselling option is also stain-resistant, ultra-soft, and super breathable.

  • Brooklinen Linen Core Sheet Set: High-end linen sheets that are great for hot sleepers because they’re much lighter and more breathable compared to more common fabrics. Although linen isn’t as soft as cotton, it has a cozy, textured look and is much more durable.

  • Cariloha Classic Bamboo: There’s a reason why bamboo sheets are becoming so popular: Not only is the fabric soft and comfortable, but it’s also eco-friendly. Plus, they naturally keep odors and allergens away from your bed.

  • Tempur-Pedic TEMPUR-Cloud Breeze Dual Cooling Pillow



​​Supplements​​​

  • Equelle: a non-prescription supplement that has been clinically proven to reduce hot flashes, vaginal irritation, and insomnia.

  • Maca Root: probably the only supplement with good clinical trials behind it. Harvested from the Peruvian Andes. I like Gaia Herbs Maca root supplement.

  • Black Cohosh: is one of the most well-studied supplements for menopause. It's made from the root of the North American black cohosh plant. Several studies have found it helps -- especially with hot flashes -- when compared to placebo (a fake treatment). BUT other studies haven't found a benefit. One warning: Don't use it if you have liver problems.

  • Flaxseed and flaxseed oil: may help some women with mild menopause symptoms. It's a good source of lignans, which tend to balance female hormones. Not all studies have shown these benefits in relieving hot flashes, though.


​Medications

  • Effexor: a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). A good choice if you have associated mood swings.

  • Neurontin (Gabapentin): a medication used to treat many conditions. A good choice if you have associated sleep disturbance.

  • Clonidine: a patch typically used to treat high blood pressure.

  • Veozah: A new non-hormonal prescription medication for hot flashes.


Hormones


What is hormone therapy?

Hormone therapy can help relieve the symptoms of perimenopause and menopause. Hormone therapy means taking estrogen and, if you have never had a hysterectomy and still have a uterus, a hormone called progestin. Estrogen plus progestin sometimes is called “combined hormone therapy” or simply “hormone therapy.” Taking progestin helps reduce the risk of cancer of the uterus that occurs when estrogen is used alone. If you do not have a uterus, estrogen is given without progestin. Estrogen-only therapy sometimes is called “estrogen therapy.”

How is hormone therapy given?

Estrogen can be given in several forms. Systemic forms include pills, skin patches, and gels and sprays that are applied to the skin. If progestin is prescribed, it can be given separately or combined with estrogen in the same pill or in a patch. With systemic therapy, estrogen is released into the bloodstream and travels to the organs and tissues where it is needed. Women who only have vaginal dryness may be prescribed “local” estrogen therapy in the form of a vaginal ring, tablet, or cream. These forms release small doses of estrogen into the vaginal tissue.

What are the benefits of hormones?

Systemic estrogen therapy (with or without progestin) has been shown to be the best treatment for the relief of hot flashes and night sweats. Both systemic and local types of estrogen therapy relieve vaginal dryness. Systemic estrogen protects against the bone loss that occurs early in menopause and helps prevent hip and spine fractures. Combined estrogen and progestin therapy may reduce the risk of colon cancer.

What are the risks of hormones?

Hormone therapy may increase the risk of certain types of cancer and other conditions:

  • Estrogen-only therapy causes the lining of the uterus to grow and can increase the risk of uterine cancer.

  • Combined hormone therapy is associated with a small increased risk of heart attack. This risk may be related to age, existing medical conditions, and when a woman starts taking hormone therapy.

  • Combined hormone therapy and estrogen-only therapy are associated with a small increased risk of stroke and deep vein thrombosis (DVT). Forms of therapy not taken by mouth (patches, sprays, rings, and others) may have less risk of causing deep vein thrombosis than those taken by mouth. Combined hormone therapy is associated with a small increased risk of breast cancer.

  • There is a small increased risk of gallbladder disease associated with estrogen therapy with or without progestin. The risk is greatest with oral forms of therapy.

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Examples of hormone replacement medication:

Premarin​

Prempro

Megace

Climera

Activella

Femhrt

Click here to see a complete list of hormone replacement options



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