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Manage Hot Flashes — Without Medication

Find out which simple lifestyle changes can help you manage this common symptom of menopause. Plus, get the scoop on supplements that can also help, from The Hormone Decision by award-winning health writer Tara Parker-Pope.

Research shows that lifestyle changes really do make a difference in helping to curb hot flashes. Because hot flashes likely are the result of changes in the way the body regulates its temperature, keeping cool and comfortable is a good way to reduce their frequency. Dress in light clothing, use fans and air conditioners, and drink lots of cold ice water (which is good for you anyway).

Also, pay attention to what you’re doing when a hot flash occurs. Some women notice that certain actions trigger a hot flash — such as consuming a hot beverage, caffeine, or alcohol or having an emotional outburst. Spicy foods, hot tubs, and even hot showers can cause trouble.

Some studies have shown that stress management — either through therapy or activities like yoga — can lower the number of hot flashes a woman experiences each day.

Several herbs and supplements are touted for curbing hot flashes. Unfortunately, the data are limited, though there is some evidence that some alternative remedies may make a modest difference. If you remain wary of menopause hormones or certain prescription drugs, it may make sense for you to try an herb or supplement along with lifestyle changes.

If you go this route, take some time to check out the various supplements sold in drugstores and health food stores. As mentioned earlier, herbs and supplements aren’t subjected to the same strict regulations as prescription drugs. There have been numerous reports of adulterated products or products containing only trace amounts of the ingredients identified on the label.

One excellent Web site for checking out various supplement brands is, an independent firm that tests supplements to determine if they contain the promised ingredients. Detailed reports are available for a fee. Products that pass ConsumerLab’s testing may carry the CL seal on their labels. The nonprofit US Pharmacopeia offers its USP seal to products that pass its testing program. Be sure to look for bottles that contain the USP or CL safety seals.

While supplement manufacturers are required to adhere to the government’s food-processing standards, some voluntarily adhere to the higher manufacturing standards imposed on drugs. The product labels may reflect that. The bottom line: If you choose an herbal or nutritional supplement, do your homework to make sure you’re getting a quality product. Among the supplements you might want to consider:

Black cohosh. Black cohosh appears to be one of the most promising nonprescription treatments for hot flashes. Compared with other non-hormonal treatments, black cohosh has been relatively well researched, although the data so far are mixed. One study showed that black cohosh reduced hot flashes by 84 percent.1 In another, the herb worked just as well as estrogen in reducing hot flashes.2 Still others have found black cohosh to have little if any benefit.

It’s not clear how black cohosh might work. It may act like an estrogen in the body, or it may be more like a selective estrogen receptor modulator, or SERM. A SERM is a drug that acts like estrogen on some tissues but blocks the effects of estrogen on other tissues. Black cohosh may also decrease luteinizing hormone, a hormone secreted by the pituitary gland that may play a role in hot flashes.

There are no obvious adverse effects from black cohosh. As with other supplements, long-term risks and benefits aren’t known.

Soy. Soy contains large quantities of isoflavones, plant compounds that are similar to estrogens. In the body, they compete with estrogen for the same receptors and have estrogen-like effects. But they don’t appear to be nearly as effective as estrogens in curbing hot flashes. One small study of 39 women showed a 20 percent improvement in hot flashes.3 Another study found that women who used soy had just as many hot flashes, but they were less severe than in women who didn’t use soy. In a study of 75 women, soy users experienced a 61 percent drop in hot flashes compared with a 21 percent decline among placebo users. Several other studies have not found any benefit from soy use.

Although the data are mixed, it does appear that soy isoflavones may help some women cope with hot flashes. It’s important to remember that soy acts like an estrogen, albeit a mild one, in the body. In one study that looked at the impact of soy isoflavones on the uterus, soy users didn’t experience any more changes in the uterine lining than non-soy users. However, the effects of long-term use aren’t known.

Red clover. Despite anecdotal reports that red clover helps with hot flashes, there’s little evidence to support this. One study of just 30 women did show that red clover users had 44 percent fewer hot flashes than placebo users. However, two small studies did not show any benefit from red clover. None of the studies reported any adverse effects from the herb, but longterm risks and benefits aren’t known.

Other agents. Dong quai, vitamin E, evening primrose oil, ginseng, melatonin, and wild yam are all talked about as potentially effective against hot flashes. Unfortunately, there’s no solid scientific evidence to back up such claims.

Tara Parker-Pope, author of The Hormone Decision (Copyright © 2008 by Tara Parker-Pope), a professional reporter for twenty years, writes a weekly consumer health column and daily health blog for The New York Times, and prior to that was the health columnist for The Wall Street Journal. Her special Wall Street Journal report on the findings of the Women’s Health Initiative earned her the Media Award from the North American Menopause Society, as well as the Second Century Award for Excellence in Health Care from the Columbia University School of Nursing.



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