How to manage hot flushes during menopause

Image of a menopausal women experiencing a hot flush

Hot flushes are common symptoms of menopause, with up to 80% of women experiencing them. If you haven't experienced one before, they can feel like a sudden feeling of warmth that spreads over the face, neck and chest. 

When women go through menopause, oestrogen and progesterone fluctuate and this leads to a temporary change in the way in which the body regulates temperature. Experiencing a hot flush can often be one of the first signs of menopause and can often take women by surprise. Perimenopause can start a number of years before the last menstrual period, with symptoms of menopause lasting for a number of years until our hormones level out again. 

Because they can happen at any time and without prior warning, hot flushes can impact our day-to-day life, such as disrupting work-life or sleep. Knowing that there are ways to practically manage a hot flush, as well as steps that can be taken to help reduce their intensity or how often they happen, can help to reduce any worry or anxiety that may come alongside the emergence of these symptoms. 

So now we know what they are and what effect they can have, let's get to the most important part - what we can do about them!

Medications, diet and supplements for hot flushes

1. Hormone replacement therapy

Hormone replacement therapy (HRT) is a way of replacing the hormones that are lost during menopause. It is considered the gold standard for treating menopausal symptoms, including hot flushes. This treatment can be very effective for women who are able to use it. 

There are different types of HRT, such as oestrogen only HRT or combined HRT which contains both oestrogen and progesterone. There are also different ways in which you can take HRT including tablets, skin patches or gels that you rub on your skin. With so many options available it is important to discuss them with your doctor to find out what the right choice is for you.   

2. An ashwagandha supplement 

Ashwagandha is a medicinal herb made from the evergreen shrub Withania Somnifera that grows in Asia and Africa. Research tells us that supplements containing ashwagandha can relieve symptoms of hot flushes in perimenopausal women. This study found that ashwagandha increased levels of estradiol, the major form of oestrogen found in the body which is thought to exerts its beneficial effect. Ashwagandha has been suggested as a safe and effective option.

3. Consider your phytoestrogen intake 

In countries where soy foods (tofu, soymilk, edamame beans, tempeh, miso) are regularly consumed such as Japan, China, Singapore and Hong Kong, women report having less hot flushes than in countries where these foods aren't consumed as regularly. 

It is thought this is because soy foods contain phytoestrogens. Phytoestrogens can have a weak effect on oestrogen receptors, in doing so they may be able to help to reduce the effects of low oestrogen levels which is what ultimately leads to hot flushes. 

While we can increase our intake of phytoestrogens through eating more soy based foods, research has suggested that phytoestrogen supplements may actually be more effective than food sources. 

4. Give pine bark extract a go

Pine bark extract is a herbal supplement that is extracted from the bark of the French maritime pine tree. It contains high levels of antioxidants and has anti-inflammatory effects. 

Research has shown that taking this in supplement form can benefit perimenopausal women who have recently started experiencing menopausal symptoms, in particular by reducing symptoms of hot flashes.

5. Incorporate omega-3 fatty acids into your diet

Omega-3 fatty acids are a type of healthy fat that possess anti-inflammatory properties and consuming rich sources of these, such as salmon, mackerel and sardines, can help reduce how often hot flushes are experienced.  

It's not just in food form that they can be beneficial, taking an omega-3 supplement may reduce the intensity of hot flushes.

Just to note, some complementary and alternative therapies can interact with other medicines leading to side effects so it is recommended to ask your GP or pharmacist for advice before taking any supplements.

Lifestyle advice for hot flushes

You may start to notice that there are certain things that trigger your hot flushes such as caffeinated drinks, drinking alcohol, smoking, eating spicy food, and feeling stressed. Working out what triggers your hot flushes and finding ways to avoid or reduce these can be a simple but powerful practical step you can take to lessen the impact of hot flushes on daily life - you could try keeping a journal or a diary so that you can identify patterns.  

It may sound simple but making yourself as comfortable as possible can help you get through a hot flush more easily. Try dressing lightly in layers or carrying a fan with you. Similarly, layering bed linen can be helpful so that you can make yourself comfortable at night whatever your temperature. 

Some women also find that acupuncture can be helpful to lessen the severity of hot flushes.

The bottom line 

Hot flushes can be an uncomfortable and inconvenient part of the menopausal transition but they don’t have to take over your life. As we have seen, there are ways in which you can take control of your symptoms which can have a profound difference, helping you to have a smoother and more positive journey through menopause. 

One thing to remember is that hot flushes are very common, meaning you are not alone. As well as these practical steps you can take, try talking to other women, friends or family who have been through this stage of life, they may also be able to offer advice and support. 

If you have tried these options and hot flushes are still significantly impacting your day to day life it is important to discuss your concerns with your healthcare professional and seek further help.