Treating Hot Flashes

As the days grow longer and the temperatures start to soar, I always see an uptick in the number of women who come with complaints of hot flashes. Unfortunately for most, it’s not the rising temperature of spring and summer that is causing their discomfort. Hot flashes are a common symptom of menopause. Understanding the causes, symptoms, and treatments for hot flashes can help many women deal with this common symptom of menopause.

In North America, hot flashes are common with 3 out of 4 women experiencing some degree of symptoms with perimenopause, menopause, or surgically induced menopause.  For some women, hot flashes are a minor annoyance that is well tolerated. Other women may experience more severe symptoms and may find them to adversely affect their quality of life. The exact cause of hot flashes is not completely understood, but it is believed that during menopause, fluctuating estrogen levels interfere with the hypothalamus. The hypothalamus is the part of the brain that regulates body temperature.

Hot flashes are usually experienced as a temporary feeling of heat that is centered on the upper chest and face and last 2 to 4 minutes. Sweating, sometimes a rapid heart rate, and an anxious feeling accompany hot flashes. Afterwards the hot flash is often followed by chills and shivering. Many women will experience these symptoms during sleep, which are referred to as night sweats. The duration of symptoms can last from a few minutes up to a half an hour. Some women may only experience hot flashes a few times a week, while others may have them repeatedly throughout the day. Women can be awakened by night sweats, and some women may have trouble getting back to sleep. For some, hot flashes and night sweats may be severe enough to disrupt a woman’s quality of life.

If you feel that hot flashes are problematic, you should seek the advice of your health care provider. Depending on the symptoms and your medical history, he or she may offer a myriad of options for treating hot flashes. Women with mild symptoms may benefit best from simple modifications to their habits. For instance, simply dressing in layers can let a woman quickly remove clothing if she becomes too hot. Some women find that certain foods or drinks like spicy foods or hot beverages or alcohol bring on their hot flashes. Limiting or avoiding these items can help to minimize hot flashes. Woman who smoke experience more severe hot flashes. So add hot flashes to the already long list of reasons to not smoke.

Additionally, obesity is often associated with higher incidences of hot flashes. Shedding excess weight can help to minimize the number of hot flashes. Many women find that exercise and relaxation routines help to reduce the number of hot flashes. Yoga, deep breathing, and walking are great ways to reduce stress, lose weight, and control hot flashes. Exercise can also help to reduce insomnia often associated with night sweats.

When preventive measures and life style changes don’t seem to mitigate hot flashes, your health care provider may recommend hormone replacement therapy, which can be a very effective treatment particularly if your symptoms are bad. Depending on your personal and family history, including your risks for certain cancers or cardiovascular disease, a regime of estrogen, progesterone, or a combination of both might be effective.

Your health care provider is the best source of information when deciding which therapy might work best for you. Estrogen works well for women who have had a hysterectomy. A combination of estrogen and progesterone may work better for other women to reduce the risk of uterine cancer. Still other women may be recommended to take only progesterone therapy because of increased risks of breast cancer or blood clots. Any recommendation for hormone replacement will come after a complete physical and history to establish your personal health risks. Your health care provider can explain the benefits and risks associated with all treatments and help you decide if hormone replacement is right for you.

Women who have not had success with preventative measures and choose to skip the hormone replacement route may find relief from symptoms with several other medications or dietary supplements. While the efficacy of HRT has been well studied, there are fewer studies of supplements and medications that are used “off label.”  For instances, some women find that low doses of antidepressants like Paxil, Prozac, or Effexor help relieve some hot flash symptoms. Likewise, a medication called clonidine, which is traditionally used to treat hypertension, may also work to lessen symptoms. Neurontin is another medication designed to treat other conditions but which has shown signs of helping some women with hot flashes.

When taking any prescribed medication, a woman should confer with her health care provider to discuss possible side effects and decide whether it may be a good option for her. While most dietary supplements do not require a prescription from your doctor, it is still vital that you share information about any you might be taking. Many over the counter products can still have side effects and interact with any prescription medications you might be taking. Currently, there is limited information about the effects of supplements like black cohosh or soy-rich products for helping with hot flashes, but some women seem to experience a diminishment of symptoms.

Hot flashes eventually subside as your body readjusts to the hormone levels established in menopause. However, there’s no need to suffer. Your health care provider can partner with you to find a solution, particularly if your symptoms are severe. Whether it’s limiting triggers, getting more exercise or relaxation, taking medication or supplements, hot flashes are treatable and don’t have to make you lose your cool. 

Dr. Hardy practices obstetrics and gynecology at Atlantic Ob/Gyn located in Va. Beach and Chesapeake. Please visit www.atlanticobgyn.com

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Timothy J. Hardy, M.D.

Dr. Timothy Hardy, M.D. has been practicing medicine in the community for many years. He received his medical degree from Eastern Virginia Medical School and founded his own practice, Atlantic OB-GYN, in 1990, where he has been providing women with exceptional care ever since. Website: www.atlanticobgyn.com
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