Hot flashes: What can I do?

African American and Hispanic women get hot flashes for more years than white and Asian women.

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Hot flashes, a common symptom of the menopausal transition, are uncomfortable and can last for many years. When they happen at night, hot flashes are called night sweats. Some women find that hot flashes interrupt their daily lives. The earlier in life hot flashes begin, the longer you may experience them. Research has found that African American and Hispanic women get hot flashes for more years than white and Asian women.

Symptoms like hot flashes during menopause transition. Symbolic photo.

You may decide you don’t need to change your lifestyle or investigate treatment options because your symptoms are mild. But, if you are bothered by hot flashes, there are some steps you can take. Try to take note of what triggers your hot flashes and how much they bother you. This can help you make better decisions about managing your symptoms.

Change you lifestyle

Before considering medication, first try making changes to your lifestyle. Doctors recommend women make changes like these for at least 3 months before starting any medication.

If hot flashes are keeping you up at night, keep your bedroom cooler and try drinking small amounts of cold water before bed. Layer your bedding so it can be adjusted as needed. Some women find a device called a bed fan helpful. Here are some other lifestyle changes you can make:

  • Dress in layers, which can be removed at the start of a hot flash.
  • Carry a portable fan to use when a hot flash strikes.
  • Avoid alcohol, spicy foods, and caffeine. These can make menopausal symptoms worse.
  • If you smoke, try to quit, not only for menopausal symptoms, but for your overall health.
  • Try to maintain a healthy weight. Women who are overweight or obese may experience more frequent and severe hot flashes.
  • Try mind-body practices like yoga or other self-calming techniques. Early-stage research has shown that mindfulness meditation, yoga, and tai chi may help improve menopausal symptoms.

Deep breathing, relaxation breathing and paced respiration all refer to a method used to reduce stress.

Non-hormone medication

If lifestyle changes are not enough to improve your symptoms, non-hormone options for managing hot flashes may work for you. They may be a good choice if you are unable to take hormones or if you are worried about their potential risks.

The U.S. Food and Drug Administration (FDA) has approved the use of paroxetine, a low-dose selective serotonin reuptake inhibitor (SSRI) antidepressant, to treat hot flashes. Researchers are studying the effectiveness of other antidepressants in this class.

Women who use an antidepressant to help manage hot flashes generally take a lower dose than people who use the medication to treat depression. Side effects depend on the type of antidepressant you take and can include dizziness, headache, nausea, jitteriness, or drowsiness. As with any medication, talk with your doctor about whether this is the right medication for you and how you can manage any possible side effects.

Hormone treatment

Some women may choose to take hormones to treat their hot flashes. A hormone is a chemical substance made by an organ like the thyroid gland or ovary. During the menopausal transition, the ovaries begin to work less and less well, and the production of hormones like estrogen and progesterone declines over time. It is believed that such changes cause hot flashes and other menopausal symptoms.

Is it hot in here, or is it just me?read here the SWAN’s [Study of Women’s Health Across the Nation -SWAN] investigation of Hot Flashes and Night Sweats (vasomotor symptoms).
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Hormone therapy steadies the levels of estrogen and progesterone in the body. It is a very effective treatment for hot flashes in women who are able to use it. There are risks associated with taking hormones, including increased risk of heart attack, stroke, blood clots, breast cancer, gallbladder disease, and dementia. The risks vary by a woman’s age and whether she has had a hysterectomy. Women are encouraged to discuss the risks with their healthcare provider.

Women who still have a uterus should take estrogen combined with progesterone or another therapy to protect the uterus. Progesterone is added to estrogen to protect the uterus against cancer, but it also seems to increase the risk of blood clots and stroke. Hormones should be used at the lowest dose that is effective for the shortest period of time possible. (See What Are the Risks of Using Hormones for Hot Flashes?)

Some women should not use hormones for their hot flashes. You should not take hormones for menopausal symptoms if:

  • You have had certain kinds of cancers, like breast cancer or uterine cancer
  • You have had a stroke or heart attack, or you have a strong family history of stroke or heart disease
  • You have had blood clots
  • You have had problems with vaginal bleeding or have a bleeding disorder
  • You have liver disease
  • You think you are pregnant or may become pregnant
  • You have had allergic reactions to hormone medications

Talk with your doctor to find out if taking hormones to treat your symptoms is right for you.

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