Vasomotor symptoms, or hot flashes and night sweats, are the most common symptoms of perimenopause and menopause.
Perimenopause is the period before menopause when these symptoms begin and peak. This period lasts on average for 4 years but can last for much longer.
Menopause is the time in a woman's life when she has not had a period for at least a year. She may continue to experience hot flashes and night sweats, but they will probably occur less often.
The details of exactly how hot flashes work are still not fully understood. However, most research suggests that a lack of estrogen interferes with the body's ability to control temperature.
While hormone replacement medications can help treat severe cases, natural remedies may lessen the intensity and frequency of hot flashes.
There are many ways that women experiencing hot flashes can get some relief from symptoms.
Recommended lifestyle tips that may help reduce hot flashes include:
Identifying trigger points and avoiding them
The factors that increase the frequency and severity of hot flashes vary from woman to woman. Common triggers include:
- warm weather
- spicy or hot foods and beverages
Most women do not need to avoid trigger points entirely, but knowing which specific factors worsen hot flashes allows women to deal with them when they occur.
Smoking may speed up the onset of menopause and increase the severity of symptoms, especially hot flashes.
Carrying cool water at all times
Drinking cold water or splashing it over the face and wrists can help quickly cool the body during hot flashes. Having a cold shower or running the face and wrists under cold water helps lower body temperature even quicker.
Staying hydrated may also help steady body temperatures.
Keeping a fan close by
The breeze generated by fans can help keep bedroom temperatures cool and steady throughout the night. Handheld fans can also provide instant cooling relief.
Relaxation techniques and exercises
Stress causes the release of a substance called epinephrine, which increases body temperature and sweating. Relaxing activities may help reduce the severity and frequency of hot flashes.
Recommended relaxation exercises include:
- guided thought
- Tai chi and qi gong
- talk therapy or counselor services
- breathing exercises
The intensity of hot flashes can cause a sense of panic, intensifying symptoms. Rushing to find relief, such as a damp towel or rapidly fanning oneself may increase body temperature.
Eating a healthful diet
Nutrients, in particular proteins and fats, help guide healthy hormone and nerve signaling.
A well-balanced diet can also reduce blood sugar changes that cause similar symptoms to hot flashes. Women should eat foods high in omega-3 fatty acids, such as cold-water fish or ground flax seed, or consider a fish oil supplement.
Traditionally, a variety of plant products has been used to treat hot flashes. Although there is little scientific evidence that many of these alternative therapies are effective, many women still use herbal supplements.
The United States Food and Drug Administration (FDA) do not regulate the quality, strength, or composition of herbal and plant products. As a result, dosing, purity, and safety recommendations depend on the particular supplement, brand, and product.
Many plants contain compounds called phytoestrogens or "dietary estrogens," which are capable of binding to human estrogen receptors. Plant-based estrogens are thought to help women experiencing reduced estrogen levels by increasing the effect of the hormone on the body.
There are different types of phytoestrogens found in legumes, seeds, and whole grains. Legume and bean products, such as soy, contain phytoestrogens called isoflavones, the most studied plant estrogen.
In North America, lignans, found in seeds, such as flax and sesame, are the most commonly consumed form of phytoestrogen.
A 2012 study found that menopausal women who took 330 milligrams (mg) of licorice extract three times daily for 8 weeks reduced the severity and frequency of hot flashes.
Benefits typically lasted for 2 weeks after women stopped using the supplement. Licorice root contains phytoestrogens.
Several studies have supported the use of Valerian root for the management of menopause symptoms.
In a 2013 study where menopausal women took 255 mg of Valerian three times daily for 8 weeks, the number and severity of hot flashes were reduced. Valerian also helps enhance sleep, which is known to improve these symptoms.
Valerian contains phytoestrogens and may also influence serotonin activity and improve sleep.
Black cohosh is a herb that has been used by Native American cultures for centuries to relieve menopause symptoms. Though black cohosh supplements are commonly used to treat hot flashes, the efficacy of the herb remains controversial.
Several studies have been carried out, which involved daily dosages of 6.5 to 160 mg of black cohosh for up to 1 year to treat menopausal symptoms.
Black cohosh may not be recommended for women with estrogen-affecting conditions, such as breast, ovarian, or uterine cancer.
While rare, use of the herb has been linked to severe health complications, the most common complication being liver injury or damage. Black cohosh interacts with many prescribed medications and should not be used at the same time as other herbs. People should speak with their doctor before using black cohosh.
Women taking the herb should be aware of the signs of liver failure or jaundice. Jaundice may be life-threatening and requires immediate medical attention.
Common signs of jaundice include:
- yellowing of the skin and eyes
- loss of appetite
- upper stomach pain or cramping
- dark urine
- nausea or vomiting
- extreme tiredness not related to exercise or lack of sleep
Traditional hormone replacement therapies use synthetically produced versions of human hormones.
Although they are not identical, bio-identical hormone medications use plant hormones that mimic human hormones, such as estrogen, estriol, estradiol, and progesterone. Many FDA-approved bio-identical hormone therapy options exist, and doctors can help women decide if this is an option for them.
The National Women's Health Network suggest using the lowest effective dose for the shortest period possible. Custom-prepared mixtures of different bio-identical hormones are not regulated by the FDA, however, and are not considered safe.
There are many more potential alternative therapies that may help manage hot flashes, but there is even less evidence to support them.
All plant-based or herbal products should be taken with caution because the FDA do not regulate them. Some herbs and supplements also interfere with blood pressure and blood clotting.
Other remedies for hot flashes that have less evidence to support their use include:
- red clover
- dong quai
- wild yam
- evening primrose oil
- yellow dock
Hot flashes are a sudden, exaggerated response from the body to overheating.
Nerve centers in the brain normally keep internal body temperature within a strict range. When body temperatures go above or below this range, the nerves trigger sweating or chills to restore balance.
In response to overheating, the body also increases the rate of blood flow to the surface of the skin, causing it to redden or flush.
Although the specific causes of hot flashes are unclear, sex hormones play a clear role in the condition.
Studies in rats have shown that when estrogen levels drop off, the nerve centers that regulate internal temperature and hormone signaling become deformed. These mutated nerve centers appear to narrow the body's acceptable temperature range, making it far easier to become overheated or too cold.
Altered nerve centers may also produce an exaggerated response to temperature imbalances and trigger false responses.
It has also been shown that reduced estrogen levels may potentially damage the nerve receptors for other temperature-regulating hormones.
During hot flashes, most people experience excessive sweating, rapid heartbeat, and an intense feeling of radiating heat. For some people, hot spells occur regardless of actual body temperature.
Information from the Penn Ovarian Aging Study shows that an estimated 80 percent of American women experience moderate to severe hot flashes. Roughly 17 percent of menopausal women in the United States report experiencing mild hot flashes.
There is no average age when hot flashes develop but the risk is likely highest during the end of menstruation. One study found that 46 percent of American women experience moderate to severe hot flashes in the 2-year period following their last period.
Many women live with hot flashes for around 3 years before menopause begins and symptoms lessen and eventually go away. However, a 2014 study found that 33 percent of women continue to report hot flashes 10 years or more after menopause ends.
Although they are a hallmark of menopause, any condition that reduces sex hormones in men or women is thought to cause hot flashes.