Anyone suffering through hot flashes–or hot flushes, technically–knows just how uncomfortable and distracting they can be. Millions of women are going through menopause and looking for ways to manage the symptoms of hot flashes, night sweats, poor sleep and vaginal dryness.
Is Premarin the Answer?
In years past, doctors prescribed Premarin at the first hint of a flush, and women stayed on the drug for years. The idea was that the supplemental estrogen in this old-fashioned product was good for women’s health overall. But that assumption was shattered more than ten years ago when data from the Women’s Health Study demonstrated that hormone replacement therapy (HRT) did not protect women from heart attacks or strokes. In fact, Prempro slightly increased the risk for these dangers, along with the risk for breast cancer (JAMA, July 17, 2002).
It is no wonder that women are eager to find alternatives that can help. (Many also have ethical qualms about Premarin, which is derived from pregnant mares’ urine.) As we have discussed previously, a comparative trial from Group Health Cooperative suggested that oral estradiol would be as effective but less dangerous than the conjugated estrogens in Premarin (JAMA Internal Medicine, online Sept 23, 2013).
Herbal Medicines to Cool Hot Flashes
Readers have also been on the lookout for herbal products that may be helpful. Extracts of black cohosh seem to be helpful, at least for some women (Springerplus, Feb. 10, 2015). A systematic review concluded that we don’t yet have adequate data to conclude once and for all whether black cohosh is effective or not (Cochrane Database of Systematic Reviews, Sep. 12, 2012).
French Maritime Pine Extract
Some readers are enthusiastic about another plant extract, Pycnogenol:
Q. One of your readers recently shared her success with pine bark extract for hot flashes. I was not looking forward to the hot, humid Houston summer so I started taking Pycnogenol.
My hot flashes ceased immediately. Why is this not better known?
A. A review of herbal preparations reports that Mediterranean pine bark extract (Pycnogenol) eases “vasomotor symptoms,” doctor-speak for hot flashes (Maturitas, Feb. 2014). A randomized double-blind placebo-controlled trial found that Pycnogenol significantly improved such menopausal symptoms (Journal of Reproductive Medicine, Jan-Feb., 2013).
We are not sure why this has not been well publicized, but we suggest that women struggling with menopausal symptoms give this product a try. You can learn about other approaches to hot flashes in our Guide to Menopause.
When it is convenient, an ice pack or a cold towel applied to the back of the neck can often soothe a hot flash quickly.