2005-06-20 10:08:29
Dr. Carolyn DeMarco

What is a hot flash?
A hot flash is described as a sudden reddening of the skin over the head, neck and chest, or even the entire body, accompanied by a feeling of intense body heat. The hot flash may last from several seconds to several minutes, and rarely, up to an hour. Some women sweat profusely, others just a little or not at all. Hot flashes are usually preceded or followed by chills.

Some women experience incapacitating hot flashes that seriously interfere with their sleep or work. They wake up drenched in sweat and have to change their nightgown and sheets three to four times a night.

Treatment

Hormones
Natural hormone preparations can be very useful for women with severe nighttime hot flashes. I usually advise some type of natural progesterone preparation taken at night for 25 days each month. One of the side effects of natural progesterone is drowsiness, which is a good aid for sleep when taken at night. Natural progesterone can be taken as a cream, a lozenge or a pill. If symptoms persist, a natural estrogen preparation can be taken. You should use a preparation that is 80% estriol. Estriol is a type of estrogen that has a lower potential for causing breast cancer or other side effects than the stronger estrogens usually prescribed, such as estradiol.

Herbs
Herbal preparations can be very helpful for hot flashes. There are many combination herbal formulas designed for menopause and you may have to experiment to see which one works best for you.

Standardized black cohosh root has been well studied in Europe for over 40 years. It improves all menopausal symptoms and has a good safety record.

Dong quai root (Angelica sinensis) is famed in Chinese medicine for its affinity for the female constitution. It contains many plant estrogens that are about 1/400 as strong as prescription estrogens. Dong quai balances the amount of estrogen in the body and usually relieves hot flashes.

It is also a great idea to see a qualified Chinese acupuncturist who can do pulse diagnosis and give you acupuncture treatments specific to your constitution and symptoms. Your health practitioner can then design an herbal combination for you that may include dong quai and other herbs.

In Chinese acupuncture, the twelve energy pathways of the body are balanced with acupuncture needles and herbs. Many women have had excellent relief of hot flashes when they receive a series of acupuncture and Chinese herbal treatments from an experienced practitioner.

Red clover extracts also contain plant estrogens that have a favorable effect on hot flashes.

Soy proteins contain 75% plant estrogens known as isoflavones, which have been shown to relieve menopausal hot flashes. Two tablespoons of ground flaxseed (which has a nutty taste) or two servings of soy foods daily should help get rid of hot flashes. A new cookbook entitled Estrogen the Natural Way, Over 250 Easy and Delicious Recipes for Menopause, by Nina Chandler (Villard, 1997) provides new ways to add soy and flaxseed to your diet.

Vitamin E enhances the effect of estrogen in the body and is helpful for hot flashes. One controlled study of 94 women showed that of women who received 200 mg of vitamin C combined with 200 mg of bioflavonoids six times a day for hot flashes, 67% reported complete relief and 21% reported partial relief. Bioflavonoids have a very weak estrogenic effect.

Two food supplements, evening primrose oil and bee pollen, are safe and effective for hot flashes. It is usually wise to take calcium and magnesium at night to enhance sleep.

Tryptophan prescribed by your doctor or 5-HTP from the health food store can also be added to this regimen.