DEAR DOCTOR K: I’m having menopausal hot flashes, but I don’t want to take hormone therapy. Can you tell me about natural remedies?
DEAR READER: Natural remedies can help for hot flashes, but hormone therapy is helpful more often. For that reason, I’ll come back to the pluses and minuses of hormone therapy after answering your question.
There are traditional medicines other than hormone therapy that can help with hot flashes. These include drugs that relax blood vessels as well as certain antidepressants.
Several herbal remedies claim to help prevent or treat hot flashes, but most have not been well studied. There is some evidence that the herb black cohosh may be effective.
You can take steps to help make hot flashes less severe or less frequent – steps that don’t require either traditional medicines or “natural remedies”:
• Drink a glass of cool water at the beginning of a hot flash.
• Plunge your hands in cold water and pat it on your face, neck and chest when a hot flash starts.
• Begin deep-breathing exercises at the beginning of a hot flash to help nip it in the bud.
• Avoid caffeine and alcohol, which make hot flashes more uncomfortable.
• Cut down on red wine, chocolate and aged cheeses. They contain a chemical that can trigger hot flashes.
• Don’t smoke. Smoking can make hot flashes worse.
• Engage in regular vigorous exercise.
Regarding hormone therapy, here’s the bottom line – at least for me – of a complicated story. The most effective medication for hot flashes is the hormone estrogen. If you’re 60 or over, or are 10 years past entering menopause, I would stay away from hormone therapy. I think it does increase your risk of heart disease and stroke.
However, if you are entering menopause – which typically occurs in a woman’s late 40s or early 50s – I think the evidence does not show an increased risk of heart disease. Indeed, hormone therapy taken at that age to relieve hot flashes may actually protect you from heart disease.