Managing Hot Flashes: How Can I Manage Hot Flashes

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How can I manage hot flashes?

You can manage hot flashes by making certain lifestyle choices. You can also take daily medication. Some measures help prevent or reduce hot flashes, and others can make you more comfortable when you're having a hot flash. If you are looking for additional treatment measures, you have a few options to choose from.

Lifestyle choices for preventing or reducing hot flashes

Eat and drink well, and avoid smoking.

• Limit your intake of alcohol.
• Drink cold beverages rather than hot ones.
• Eat smaller, more frequent meals to avoid the heat generated by digesting large amounts of food.
• Eat plenty of low-fat, high-fiber foods.
• Do not smoke or use other forms of tobacco.

Stay cool.

• Keep your environment cool, or use a fan.
• Dress in layers, so you can remove clothes as needed.
• Wear natural fabrics, such as cotton and silk.
• Sleep with fewer blankets.

Reduce stress.

• Get regular physical exercise.
• Use relaxation techniques, such as breathing exercises, yoga, or biofeedback. Using a breathing-for-relaxation exercise called paced respiration has been shown to significantly reduce hot flashes and emotional symptoms.^{1, 2}

Medical treatment options for hot flashes

• Short-term, low-dose hormone replacement therapy (HRT) can reduce or stop hot flashes and other perimenopausal symptoms by raising your body's estrogen level. Use the lowest dose needed for the shortest possible time and have checkups every 6 months. This is because HRT causes breast cancer, ovarian cancer, blood clots, stroke, and dementia in a small number of women.^{3, 4} And HRT users who are 10 or more years past menopause are also at higher risk for heart disease⁵ If you have a history of cardiovascular disease or breast cancer, avoid using estrogen for hot-flash relief—other options are available.
• Estrogen-progestin birth control pills (before menopause) can reduce or stop hot flashes and other perimenopausal symptoms by evening out fluctuating hormones. If you are older than 35 and smoke, have diabetes, or have a personal or family history of cardiovascular disease or breast cancer, avoid using estrogen for hot-flash relief—other options are available.
• Selective serotonin reuptake inhibitor (SSRI) antidepressant medication can reduce the number and severity of hot flashes by improving the brain's use of serotonin, which helps regulate body temperature.⁶ Side effects are possible. This type of medication is a good choice if hot flashes, irritability, or mood swings are your only perimenopausal symptom.
• Clonidine, a high blood pressure medication, can reduce the number and severity of hot flashes by lowering blood pressure. Lowering blood pressure is safe for some women and not for others.⁷ This type of medication is a good choice if hot flashes are your only perimenopausal symptom, especially if you have high blood pressure.
• Black cohosh may reduce or prevent hot flashes, depression, and anxiety as well as low-dose estrogen does.^{8, 9} As with HRT, have a checkup every 6 months when taking black cohosh. Research on human cells and on animals suggests that black cohosh doesn't cause the same cancer changes that estrogen does. But it's best to be cautious until long-term studies are done.⁹
• Some women eat and drink a lot of soy to even out hot flashes and other perimenopausal symptoms. However, studies show mixed results about whether soy phytoestrogens are clearly effective, particularly when taken as a pill. This may be because the active ingredients in soy are not well understood.¹⁰

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Last updated:	May 26, 2006
Author:	Kathe Gallagher, MSW
Reviewed By:	Joy Melnikow, MD, MPH - Family Medicine, Carla J. Herman, MD, MPH - Internal Medicine
Editors:	Kathleen M. Ariss, MS, Terrina Vail