The People's Perspective on Medicine

How to Handle Hot Flashes

Q. When I started suffering hot flashes, my gynecologist recommended soy instead of hormones. Although adding soy to my diet did not reduce my hot flashes and night sweats, my thyroid levels got worse each time they were checked and I had to increase my dose of levothyroxine.

When I gave up on soy, I had to cut my dose of thyroid hormone to stay within the normal range. Now what can I do for my hot flashes?

A. The effects of soy isoflavones on thyroid activity are confusing. Animal research suggests that soy may interfere with thyroid function, particularly if iodine levels are low (Environmental Health Perspectives, June S-3, 2002).

In a recent study soy did not help hot flashes but actually made them worse (Archives of Internal Medicine, Aug. 8/22, 2011). To ease hot flashes without hormones, you might consider Pycnogenol (French maritime pine bark extract), black cohosh with St. John’s wort or tropical yams (Dioscorea). We are sending you our Guide to Menopause for more details on these and other options.

Some women are enthusiastic about vitamin E: “Five years ago, when I was suffering mightily from hot flashes and night sweats, I did some research and came across vitamin E as a remedy. I tried it and the flashes stopped entirely for over 10 months.”

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    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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    I am 48 and have had hot flashes for 10 yrs and they are brutal. I have been taking sage which helps but my dr coupled my antidepressant with Cymbalta and it increased my hot flashes. The side effect of Cymbalta says it may increase hot flash 2% and I got the whole 2%! Lol Lordy help me I am soo hot!!

    I had a total hysterectomy approximately 10 years ago primarily due to problematic fibroids and ovarian cysts. I started taking HRT immediately after surgery. Prior to surgery my doctor advised me that it may take some time to find the right formula to treat the hot flashes. Well that was an understatement and I had no idea how debilitating hot flashes could be! Despite taking HRT the hot flashes I experienced were severe and as disruptive as imaginable. All of a sudden my life was dominated by these terrible, uncontrollable hot flashes and I turned into a mean and surly person (so not me).
    So I’ve gone through the rigors of trying different prescription formulas including bio-identical estrogen and herbal treatments like soy and black cohosh. All in all the best treatment seemed to be the bio-identical HRT. But before I started taking the bio-formula I showed signs of dementia and I believe I had a mini-stroke which I am convinced was caused by the HRT drugs (no family history of either condition on either side).
    I decided that it would be in my best interest to try a natural remedy and deal with the flashes the best that I could. I recently learned of a new herbal formula called Oona herbal supplement for menopause which combines black cohosh and chaste tree berry (vitek) which I started taking about 45 days ago.
    Since then I’ve had a couple of severe bouts with the hot flashes and I wondered if I made the right choice. I figured it was because the HRT drugs were finally out of my system. So I continued to take Oona and ultimately I got through it. I still have hot flashes but they are mild and infrequent so I’m managing quite well and best of all I’m off the HRT for good. I know that without Oona I would be laid out because whenever I’ve changed the dosage of the HRT in the past there was always a period when I had hot flashes every 20 minutes and I would be drenched from head to toe. The days of feeling like I want to come out of my skin or that I may go out of my mind are gone. Now I’m able to focus, I eat well, exercise, think positive, breath through any periods of discomfort and yes I do pray.
    Some women claim that after taking Oona for 30 days they have no menopausal symptoms at all. In my case as mentioned before the hot flashes still exist but I’m back in control and no more HRT which I attribute to Oona!!! By the way, once the hot flashes are under control the dosage drops and as far as I know there are no negative side effects of either black cohosh or chaste tree berry.

    I am 57 and experiencing hot flashes all the time. At as night sweats and in the daytime too on and off as if someone turned a switch on and off. I also had lumpectomy for DCIS and not sure cancer related too. Googling seems to indicate that cancer also cause hot flashes??
    Peoples Pharmacy response: Certain cancers, including breast cancer, may cause hot flashes. Please check with your oncologist to see if there are other trouble signs.

    I am 57 and have hot flashes several times per day. I have fibroid tumors that are small and when I used hormone patches it caused the fibroids to bleed. My sister takes testosterone and hormones and never flashes. I asked my ob gyn about testosterone and she said it does not help. Some days I feel cheated because of hot flashes.

    I’m 61, used to be on bioidentical estrogen for hot flashes, but had to stop four years ago, because it caused severe acid reflux. I’ve tried everything on the market since and nothing has helped. If only there was a compounding pharmacy out there that could come up with an estrogen formula that did not cause acid reflux. Does anyone know if such a pharmacy exists??

    Hello, I am 45 and had a complete hysterectomy at 36 and cannot take hrt. Since the hysterectomy, I have had hot flashes. And as they have gotten better (they used to last for 30 minutes with major emotional shifts and nausea) they can still be frequent and are often accompanied with a flood of anxiety (I’ve found it fascinating to watch my thoughts during a hot flash. It’s like a part of mind searches for something to stress out about while it lasts and then when the hot flash diminishes so does the anxiety and the stress-thought it had latched onto has faded away).
    What seems to trigger the hot flashes (piggybacked with anxiety) for me, the most, is sugar. If I don’t ingest sugar, they happen FAR less. When a hot flash does occur I suggest watching your thoughts while it lasts and breathing through it; If I don’t step back and observe it and my thoughts go unchecked the hot flash will be more intense and last longer. Staying hydrated with water I’ve noticed helps a lot as well. Take care :)

    I had to have a complete hysterectomy at the age of 30 due to scar tissue and other issues. I refused HET due to high cancer rate in my family. I have tried every herbal remedy for hot flashes and insomnia, nothing works. It gets to the point I don’t want anything touching me. I am really anxious and have anxiety attacks. This is crazy. I’m 34 now and it hasn’t gotten any better. I would really appreciate any advice. Thanks for letting me vent:).

    I am 60– and went thru menopause at 57—my hot flashes are truly debilitating as they keep me up all night. I have hashimotos and my endocrinologist suggested neurontin– a seizure med- which worked great (100mg) at bedtime for a while, then flashes worse than ever. He said to try doubling the dose at bedtime, an hour apart— but unless I take some xanax as well-.25mg – and another middle of night– no sleep or very little. I am going to try more neurontin as doc says this is still a low dose. I recommend trying it as the drug has been around forever and can’t find any literature that warns of anything. Worth a try. Talk to your doctor.

    how much vitamin E did you take?

    I have been on the “hot flashes” roller coaster ride for many years. My doctor started me on low dose of Prozac and it helped.
    I also take cinnamon tablets twice daily. So, between the two I have achieved very few flash attacks. In trying to get off Prozac I found that I became moody. Not good so I went back on. Perhaps I needed it all along. Now I am a happy hot flasher.
    If you do not want to go that route try cinnamon…. no side effect if you stop taking them.

    I had to have a total hysterectomy at age 38 due to damage caused from scar tissue. My doc put me on hormone replacement which didn’t help the hot flashes. He then recommended Evening Primrose Oil (which you can get just about anywhere that sells herbs in capsules) & it has worked fantastic! I recommended to a friend who had really bad night sweats & it worked wonders for her also!

    I tried soy milk, 3 – 8oz glasses a day, after 3-4weeks I became very fuzzy mentally, seriously effecting my job. Stopped the soy and my fuzziness went away. By the way no changes in my hot flashes.

    I tried everything as my hot flashes began – acupuncture, tofu, miso, soymilk, Chinese herbs, Remifemin (red clover), black cohosh, etc. All worked for awhile and then nothing worked at all. My hot flashes were what I would call “debilitating”! I couldn’t sleep, had a very hard time working as a massage therapist since I didn’t want to touch anyone while I was flashing every 5 to 10 minutes, then freezing. I have watched what I eat for years and couldn’t believe this was happening to me.
    Long story short – I went on HRT (estrogen and progesterone patch, lowest dose) and then developed breast cancer after 5 years on HRT. Unable now to do any kind of hormone replacement and watchful of the soy intake since I’m vegetarian, I now know that sugar in any form will bring on a hot flash. I read that for survival in the cold, keep sugar nearby since it will warm your body temperature.
    Dried fruit, candy of any sort, most processed foods (anything in a package, jar, can or bottle) contain large amounts of sweeteners. Alcohol too has lots of sugar in it. I recommend limiting sweeteners of all kinds for a healthier life.
    In the throes of a hot flash, if you can get something cold on your wrists and/or neck, it shortens it. Breathe deeply in and out of your mouth and try to relax as much as possible, especially your belly. I never wear sweaters that I can’t get off quickly, and have blouses with buttons that open easily at the neck. Maybe someday I’ll “outgrow” this malady, but the 74 year old who wrote in and is having them, and my 78 year old friend who said they had never stopped for her are signs that I may have a long time to live to outgrow hot flashes!

    Soy is interesting — I’ve been confused on some of the results. What I read awhile back that seems really true is that fermented soy is dramatically different in its benefits from soy in non-fermented stated. I think a lot of results need to be looked at from this perspective.

    After trying multiple “cures” for hot flashes, I came across a side effect of Cymbalta: it helps reduce or completely eliminate hot flashes! My doctor agreed to let me try it; best thing I ever did.

    I am 74 years old, had a total hysterectomy at 50, and have had bothersome hot flashes ever since I stopped taking estratest (hormone) 5 years ago. I am too old for this! I tried prozac, which made me mellow but didn’t touch the hot flashes, so I stopped the drug.
    I can’t wear pull-over sweaters or anything warm I can’t hurriedly take off when the hot flashes come, night and day. What to do? MCG

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