Most women are aware that hot flashes are a much-talked-about symptom of menopause. But you have to experience one (I'm told) to understand just how intense they are. "It's like you ignite from the inside out," says Dr. Robin Miller, medical director of Triune Integrative Medicine in Medford. And even younger women can find themselves dropped into menopause through medical or surgical causes like autoimmune disorders, chemotherapy or a hysterectomy that includes the ovaries.
"Surgical menopause is the worst," says Dr. Daniel Tomlinson of Medford Women's Clinic in Medford. "It's like falling off a cliff. "Whatever the reason, women battling hot flashes often face a mountain of information — and misinformation — about their options.
Many women today turn to herbal supplements to help curb the heat of their hot flashes. Some common choices include black cohosh, primrose oil, ginseng or motherwort. But it's important to remember that all herbs have their potential side effects or have not been in use long enough to establish any long-term effects. As an example, black cohosh should not be taken if you are allergic to aspirin medications and should be discontinued before any medical or dental procedure with a risk of bleeding.
It should also be kept in mind that many herbal remedies contain a plant-based estrogen, says Dr. Daniel Tomlinson, and so will not be suitable for everyone, particularly those who have had certain types of estrogen-sensitive breast cancer.
One resource Dr. Robin Miller highly recommends is www.naturalstandard.com, a database of information on various herbs. And, of course, any supplement should be discussed with your health care provider to be sure it is safe for you and will not interfere with any prescribed medications you may be taking.
Hormone replacement therapy.
"The traditional approach is estrogen," says Miller. But both Miller and Tomlinson recognize that many women (and doctors, too) are not comfortable with hormone therapy, largely due to a study released in the last decade that linked increased risk of heart disease, cancers and osteoporosis to women using hormones. The study, which Tomlinson wryly refers to as "tainted, but not forgotten," was found to have some significant flaws, but many women still struggle with the information even though recent data shows more positive results.
Some common supplements include black cohosh, primrose oil and soy. Be sure and talk to your doctor before starting supplements as they may conflict with prescription medication. If your hot flashes are accompanied by sweating, you may want to add vitamin B, C or magnesium supplements. Though helpful, it's important to remember there can be unexpected benefits and drawbacks. For example, Miller cautions that soy can interfere with thyroid function and that some soy nuts are very high in salt. And they are definitely not good for those with breast cancer. On the flip side, Tomlinson points out, "It's good for your cardiovascular health" with its fatty acid content.
If you're trying to control hot flashes, Miller recommends avoiding common "triggers" like spicy foods, caffeine, alcohol and smoking. Some also find chocolate or aged cheeses problematic. Hot weather, saunas and hot tubs can also be culprits. And as Miller acknowledges, "Nerves can do it, too," so improving your exercise routine or finding time for relaxation will reduce the hot flashes as well as the stress that can trigger them.
Some medications cause hot flashes and some have been found to alleviate them. For instance, Tomlinson says some types of antidepressants seem to reduce the severity of hot flashes due to their effect on the hypothalamus, the temperature-regulating part of the brain. Neither doctor considers this a best choice but know patients who have reported relief.
Don't forget the usual heat busters. Dress in layers that can be removed when a hot flash occurs. Stay hydrated and keep a fan or ice pack nearby, even in the bedroom. Miller jokes that many women find 3 a.m. a common time for a hot flash. It can be the difference between coping and needing help, says Tomlinson. "Nighttime is worst when it affects sleeping." Try using natural fibers like cotton or silk for clothing and bedding to move heat away from your body. And always take a deep breath and remember that this will not last forever.
Because the medical community has only begun to study menopause in the last few years, Miller reminds, "There is no hard-and-fast rule. We're new at this." But that doesn't mean that there is nothing to do but sweat it out. "Quality of life is important," says Tomlinson. So if you're finding the heat too much to take, talk with your health care provider about which option may be right for you.