The Natural Treatment of Hot Flashes
Dealing with a Common Symptom of Menopause
Menopause is the time after a woman’s menstrual cycle stops. It is a normal part of aging. It is
not a disease or disorder. Officially, it is diagnosed after 12 months without a menstrual period
(exclusive of a specific medical cause such as hysterectomy or chemotherapy). This is when fertility ends. The average age for menopause is 51, but it can happen naturally in the early 40s. In the years leading up to menopause, women often have changes in their monthly cycles, hot flashes, or other symptoms. These years and changes are called the menopausal transition, or
Menopause is a natural biological process. Women no longer have to worry about painful
periods, cramps, or getting pregnant. But the physical symptoms (such as hot flashes), and
emotional symptoms of menopause, may disrupt sleep, lower energy levels, cause irritability
and moodiness, cause pain during sex, lead to depression or affect emotional health.
So why do women go through menopause? What biological purpose does it serve?
Researchers looked for answers in humans and in the only other species that experience
menopause - toothed whales (belugas, narwhals, killer whales and short-finned pilot whales).
The prevailing theory is the “grandmother hypothesis”, which states that older females play a
vital role in helping to feed, raise, and teach their children and grandchildren. In doing so, they
ensure the success of their genetic legacy. Researchers found that “older women” are
better off if they stop reproducing and focus on helping their progeny. This gives them the best
shot at a good genetic legacy because if they kept reproducing there would be too much
competition amongst the descendants, and this competition for physical resources and mom’s
time would hamper rather than improve the chances of a good genetic legacy.
True menopause occurs one year after cessation of the menstrual cycle. Physiologically there
are 3 distinct stages - perimenopause, menopause and postmenopause. These stages are
part of a natural biological process and as such can’t be avoided, delayed or stopped
prematurely without requiring serious medical intervention and having repercussions.
Perimenopause most often begins between ages 45 and 55. It usually lasts about 7 years but
can last as long as 14. During the transition, the body’s production of estrogen and
progesterone, two hormones made by ovaries, slowly declines. Women may experience spotty
menstrual cycles, hot flashes and sleep disruptions. Bones become less dense, making women
more vulnerable to fractures. During this period the body begins to use energy differently, fat
cells change, and women may gain weight more easily.
In the last 1 to 2 years of perimenopause, the rate of estrogen decline increases and many women begin to have the symptoms of menopause. Some women incorrectly believe they are experiencing menopause. Just to be sure, women who don’t want to get pregnant should continue to use birth control for at least a full 12 months after their last period.
During menopause estrogen levels decrease dramatically and the body stops producing
progesterone. These hormonal changes result in continuation of the symptoms that started
during perimenopause and can additionally cause memory issues, fatigue, bladder infections,
incontinence, change in libido and vaginal dryness.
After menopause, women enter post-menopause. At this stage hot flashes tend to subside. Due
to the reduction in estrogen and progesterone, post-menopausal women are more vulnerable to
heart disease and osteoporosis as these hormones in part help protect women from these
Hot flashes (also called hot flushes) are the most common symptom of menopause and
perimenopause. Over two-thirds of women who are heading into menopause have hot flashes.
They range in frequency and severity from the mildly annoying to completely debilitating, putting
a serious dent in a woman’s quality of life.
Hot flashes cause a sudden feeling of heat and sometimes a red face or neck and sweating.
They start when blood vessels near the skin’s surface widen to cool off, making you break out in
a sweat. Some women also experience rapid heart rate or chills. If a hot flush happens while sleeping, it is called a night sweat. A night sweat can wake you up and may make it hard to get enough rest. There is no telling how long a woman will experience hot flashes. A few lucky women will never experience even a single hot flash. Others will have hot flashes for only a short period of time. The unlucky ones will have them for over 11 years. On average, however, women get hot flashes or night sweats for about 7 years.
A common question about hot flashes and night sweats is - Can they be avoided?. The answer
is no. If a woman is going to get them, she is going to get them. However it is possible to reduce their frequency, duration and severity by eliminating hot flash triggers. Common triggers include stress, restrictive (or tight) clothing, caffeine, alcohol, spicy food, smoke (cigarette /vape/cigar), heat and inactivity.
Those suffering from hot flashes should try to stay cool . At night, a “chill pillow” filled with cooling memory foam, water or other cooling material might help. Use fans during the day. Wear lightweight, looser-fitting clothes made with natural fibers such as cotton. Try multiple layers that can be increased / decreased easily.
Exercise daily. No need to go as hard as Arnold. Walking, swimming, cycling, anything that
keeps you moving and gets the blood pumping is good. Practice yoga and deep breathing twice
a day – in the morning and evening. It can be part of your daily exercise regimen as well as help
to deal with stress.
There are some supplements that can help with hot flashes. Common ones are Sage, EPA and
Black Cohosh. Sage (Salvia officinalis) is a traditional remedy for hot flashes and night sweats. Researchers found an over 60% reduction in hot flash frequency using highly concentrated sage extract. EPA (eicosapentaenoic acid) is a long chain omega-3 fatty acid found in fish oil and algae. In studies, researchers found a 50% reduction in hot flashes in women taking EPA.
Black Cohosh has traditionally been used for many conditions including hot flashes. The clinical
evidence is contradictory but many women swear by this herb. There is one big caution with
black cohosh. Some experts say not to take black cohosh for more than six months at a
time because of the risk of liver problems.
Fact: Women go through menopause. But they don’t need to sit back and take the issues that
come with it sitting down. With some lifestyle changes, the journey can be made easier. A little
bit of avoidance, some exercise and some supplements can work together to reduce frequency,
duration and severity of hot flashes.
Joel Thuna, MH, is a master herbalist with over 30 years of experience.