How to Treat Hot Flashes

Prescription and Over the Counter Remedies for Hot Flashes

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Every menopausal woman knows what they are…sweating, facial flushing, overwhelming waves of warmth. You got it…hot flashes! Hot flashes are one of the most common symptoms experienced by menopausal women and they can be bothersome, affect a woman’s quality of life and sleep, and they can be embarrassing. Hot flashes can be present only occasionally, occurring once or twice per day to up to one an hour and may be present for up to 5 years after menopause. In some instances, hot flashes are a lifelong nuisance.

While the cause of hot flashes is not known, it is thought that it is a response to a change in hormones and/or circulation. Some women are at a higher risk than others to have menopausal hot flashes; this includes those who smoke, are obese, lack exercise and are African American.

Hot flash symptoms often include:

  • Warm sensation especially in the face, neck and chest
  • Night sweats
  • Tingling fingers
  • Rapid heart rate
  • Facial redness/flushing
  • Sweating followed by chills

Hot flashes may not just be a simple annoyance, as the sleep disturbances caused by night sweats can lead to chronic insomnia triggering memory problems, anxiety and depression.

Many women wonder if they can in some way prevent hot flashes and the answer is maybe. There are definitely ways to reduce their frequency. Some avoidable triggers which are known to cause hot flashes and include alcohol, caffeine, spicy foods, stress, tight clothing, heat exposure and/or cigarette smoking. Additionally, there are lifestyle modifications which can be made to decrease the occurrence and severity of flashes.

Lifestyle modifications include:

  • Stay cool by dressing in layers, have a cold drink when a flash is coming on, use a fan or air conditioner to lower the room temperature and keep the bedroom temperature cool
  • Dress in layers preferably in cotton clothing
  • Drink at least 8 glasses of water daily
  • Keep an ice pack on your nightstand for nighttime flashes
  • Avoid hot flash triggers –spicy foods, aged cheeses, caffeine and alcohol are common ones but you may have others
  • Relax and avoid stress; try abdominal deep breathing
  • Exercise every day
  • Lose weight
  • Chill pillows

Whether you're considering either alternative approaches or traditional medicinal treatments, it is important to speak with your healthcare provider to see what is appropriate for you. Certain techniques may not be suitable with certain medical conditions and/or medications and may also carry certain risks and side effects. The good news is that there are a number of treatment options that can be used.

  • Alternative approaches include acupuncture, hypnosis and relaxation techniques such as yoga or meditation. Another approach that is quite successful for some is cognitive behavioral therapy or CBT. It's a form of hypnotic relaxation and focuses on using behavioral medicine and mind control techniques and can be very effective. I particularly recommend a book by Dr. Gary Elkins called Relief from Hot Flashes. At times, herbal supplements can be considered and include the use of soy based foods, black cohosh, evening primrose oil and flaxseed. Other over-the-counter treatments including vitamin B complex, ibuprofen and/or vitamin E with varying degrees of benefit.

For certain women, medication may be required to control menopausal symptoms. I discuss all of these in great detail in my new book The Estrogen Window coming out in April 2016. Here is a short summary of those medications:

  • Prescription medications:
    • Hormone replacement therapy such as treatment with estrogen and progesterone in women with a uterus. Women who have had a hysterectomy can take estrogen therapy alone. It is recommended that women take hormone replacement therapy at the lowest dose for the shortest amount of time. In The Estrogen Window, you'll discover why hormone therapy is in fact a very safe treatment if taken during your estrogen window.
    • Antidepressants such as Venlafaxine (Effexor XR, Pristiq), Pexeva) or Fluoxetine (Prozac, Sarafem), Paroxetine (Paxil). Brisdelle is a lower dose prescription of paroxetine developed just to treat hot flashes
    • Gabapentin (Neurontin, Gralise)
    • Clonadine (Catapress, Kapvay, etc)
    • Duavee (combined estrogen and bazedoxifene – a selective estrogen receptor modulator or SERM that is used instead of a progestogen for women who have a uterus.

You are not alone and you don’t have to suffer! If you are experiencing troubling hot flashes as a result of peri-menopause or menopause, speak with your healthcare team to see what approach will work best for you.

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