Q. I am 51 years old and my doctor says I can’t take estrogen or other HRT because I am very prone to blood clots. Do you have any recommendations for natural remedies for hot flashes and insomnia?
The hot flashes for the past few weeks have been every 15 to 30 minutes, day and night. I’m not getting enough sleep and I am tired all the time. I work full time, so I need to be able to rest! Any information you can send would be greatly appreciated.

A. Although hormone replacement therapy (HRT) can be effective against hot flashes, it is not for everyone. Estrogen increases the chance of blood clots, so it is too risky for women like you. Even bio-identical hormones from natural sources could be dangerous.
There are other approaches, both natural and pharmaceutical. Antidepressants such as Effexor, Paxil or Pristiq can ease hot flashes, but they have many side effects and may be difficult to stop.
In Europe, doctors prescribe St. John’s wort together with black cohosh for hot flashes. A different herbal extract, Pycnogenol, may also be helpful for these symptoms. We are sending you our new Guide to Menopause for an in-depth discussion of ways to ease symptoms.

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  1. RB

    Dr. prescriped 1/2 starting dose (which is normally 75mg. of Effexor 37.5/day (Venflaxine) for my hot flashes. Went from having 4 severe per hour to 1 the second day. Now infrequent. I only took half of her dosage which was 37.5, so 18.75 mg. and I feel much better. Sleeping very well now and feeling quite normal again. I would recommend to anyone suffering from hot flashes that does not want to go on Estrogen or cannot.

  2. Virginia

    Where is the Guide to Menopause mentioned?

  3. Karen

    My heart goes out to you, Mary Lou. I’m 70 with a similar past & present. My husband, 80, has Myasthenia & Parkinson’s, so I know how stressful your husband’s illness is for both of you. I was on HRT also, from age 50 to 55, and I felt GREAT… right up until I was hospitalized with blood clots!
    They took me off HRT and my health took a nosedive. Hot flashes, insomnia, weight gain, depression, rapid increase in Arthritis, plus all-over pain diagnosed as Fibromyalgia. Before long, I was hospitalized with clots again. This second time, they did a DNA test and discovered that I had inherited the Factor #5 Leiden blood clotting disorder from one of my parents. They told me that I was “lucky to have survived” HRT.
    The bad news is that I still suffer from hot flashes. The GOOD news is that, otherwise, I’m much better. God bless my doctor who put me on Ambien, which cured my insomnia and helped me to cope. I finally got to the place where I committed myself to a healthier diet & some daily exercise in the community pool.
    The “all over” pain left with my major depression, and I’ve been able to help my husband more since my own health improved. (Of course, I still have arthritic knees, feet and a crippled left hand!)
    I don’t think we’ll ever “get our life back” the way it was, Mary Lou. But you CAN feel better. One step at a time. You don’t have to be “tired” of it all. Take my advice: It starts with a good night’s SLEEP.

  4. Mary Lou J.

    I am now 74-1/2 yrs. old. I was given HRT from the beginning of menopause and never knew I was in menopause. But when I was ill a few times in my late 60s and early 70s and ended up with blood clots, my doctor would not prescribe the HRT anymore. I have steadily gone downhill since then. I have Crohn’s Disease, R.A., and hypothyroidism and have hot flashes and sleepless nights everynight. The hot flashes start after dinner when we sit down to watch TV.
    I am tired of all this and want my life back. If I die of a blood clot I don’t care anymore. My husband has AML (leukemia) and it has been very stressful. Maybe we can just go together.

  5. bennie p.

    I’m taking all the comments into consideration as I’m looking for something to help me with those darn old hot-flashes !

  6. Linda M.

    To anonymous– I’ve been taking effexor xr for depression for over two years. It is NOT a temporary medication and if you only took it for a few weeks you did not give it enough time to help you. You seem to have an issue with medication that is not “natural” so perhaps this aversion contributed to the side effects you found so troubling. Effexor has been a life saver for me and I would hate to have women doing the trial and error hunt for a “natural” cure if this medication might make all the difference with significantly less hassle. If anything, women need less hassle and more support.
    Also-with hot flashes, I find that they increase during times of significant stress for me. My mother was recently diagnosed with terminal lung cancer and my hot flashes sky rocketed leaving me sleep deprived. After a bad week I called my M.D. looking for some hormonal and she increased my effexor.
    Last night I slept fairly well (maybe a placebo effect but at this point I’ll happily attribute it to a great doc and a little pill) and hope that this continues to improve. I’m no good to my mother if I’m in a fog due to the lack of sleep brought on by hot flashes.

  7. anonymous

    How do you define a hot flash? My head becomes hot, around the hairline, on the ears (but not the earlobe) and on my face. The heat is so had on my ears that my skin peels off. But I don’t have sweats and the rest of my body is not hot.
    I can’t believe anyone would prescribe effexor for hot flashes. Effexor is a medication for severe depression. I once needed it for a few weeks. It is only supposed to be a short term medication for very severe depression. I had severe side effects from it: it gave me psychedelic symptoms such as the feeling of a colors in a fountain from the bottom of the back of my brain, and I have never taken any psychedelic drugs and I do not take marijuana.
    Effexor put a very weird expression on my face. It helped stop the crying, but it was only a temporary drug. Effexor had permanent effects on my brain. These have given more mental health, prevention of depression, but I can’t imagine taking effexor for something that is not severe depression. I have nothing good to say about paxil and I can’t believe anyone would prescribe it at all.
    The one time I was prescribed it one tablet put me on such a roller coaster of extreme thoughts swinging from one mood to another that it was the worst experience of my life. I had the maturity to know it was the medicine so I just stayed in bed and waited for it to wear off. I do not think depression medication and dangerous substances like Paxil should be used for hot flashes, i.e. symptoms that are not depression.
    I take fish oil and eat canned salmon and sardines and will see if taking fish oil more often helps.

  8. BL

    Red Raspberry Leaves (supplement) work for me. I have rarely had hot flashes during the past 5 years I have been in menopause. I purchase the supplements in a local health food store.

  9. mj

    Black Cohosh worked for me. One in the AM and one in the PM.
    I forgot to pick some up and was off for three days, hot flashes started again….got back on the, no hot flashes. I also take milk thistle.

  10. EM

    Black Cohosh and soy milk work for me. I used to suffer with night sweats and hot flashes and was determined to go the natural route instead of with hormone replacement therapy. Over the years (about 4 years now) I’ve had to increase the dosage of Black Cohosh (to 1 pill morning and evening) to control the symptoms of Menopause but it has worked well for me.

  11. Bobbir

    My OB/GYN prescribed 2,000 mg Omega 3 along with 1500 mg Omega 6 (Evening Primrose) for my hot flashes….within 3 days the hot flashes were gone. That was over a year ago and as long as I continue with the fish oil/evening primrose I am not bothered by them at all.

  12. Noemi from St. Louis

    I have had hot flashes since the onset of menopause. Cannot take HRT because I had breast cancer (7 year survivor). I do take Effexor (so now I’m a happy hot flasher) but seriously, I read about cinnamon to reduce HF and it seems to be working fine for
    me. They come in capsule form and I take one in the a.m. and one in the evening. No harm in trying it and see if it works for you. Good luck.

  13. EC

    I’m 65 and still having problems with hot flashes. HRT is out of the question for me. After trying every remedy and alternative therapy in the book, I’ve gotten relief with Red Clover Blossom.
    I get absolutely no help from medical doctors with this problem – they just look at me and shrug and tell me “You should be over this by now”. So I did my own investigating and reading up on hot flashes and found the Red Clover Blossom.

  14. Sandy C

    Going through menopause, I never had a hot flash. It could be that I wouldn’t have suffered anyway, but since I had every “woman” problem possible when young, I doubt it. I used Emerita, a natural progesterone cream made from yams that I bought (and still buy) from a health food store. I also used vitamin E. I got night sweats starting in my mid 40s and a friend told me to try it. It worked for many years then the sweats came back. The same friend told me to increase the dose, I did and never had another night sweat. Good luck!

  15. CM

    Try using soy for hot flashes…..I had the same problem and purchased Revival soy shakes by mail, these are high potency, designer soy foods that worked wonders for me…..

  16. Katherine H.

    After reading a recommendation by a nurse to take Vitamin E for hot flashes, I started doing so. After one month I was down to 2 or 3 hot flashes a month. Later, I would have one every month or so. They were not severe.

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