Hot Flashes: What Can I Do?
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Hot flashes, a common symptom of the menopausal transition, are uncomfortable and can last for many years. When they happen at night, hot flashes are called night sweats. Some women find that hot flashes interrupt their daily lives. Research has shown that there can be different patterns of when women first experience hot flashes and for how long, and that African American and Hispanic women have hot flashes for more years than white and Asian women.
You may decide you don't need to change your lifestyle or investigate treatment options because your symptoms are mild. But, if you are bothered by hot flashes, there are some steps you can take. Try to take note of what triggers your hot flashes and how much they bother you. This can help you make better decisions about managing your symptoms. You can also visit My Menoplan, an evidence-based tool developed by NIA-funded researchers, to identify treatment and coping strategies best suited for you.
Lifestyle changes to improve hot flashes
Before considering medication, first try making changes to your lifestyle. If hot flashes keep you up at night, lower the temperature in your bedroom and try drinking small amounts of cold water before bed. Layer your bedding so it can be adjusted as needed and turn on a fan. Here are some other lifestyle changes you can make:
- Dress in layers that can be removed at the start of a hot flash.
- Carry a portable fan to use when a hot flash strikes.
- Avoid alcohol, spicy foods, and caffeine. These can make menopausal symptoms worse.
- If you smoke, try to quit, not only for hot flashes, but for your overall health.
- Try to maintain a healthy weight. Women who are overweight or obese may experience more frequent and severe hot flashes.
- Explore mind-body practices. Some early-stage research has shown that hypnotherapy and mindfulness meditation could help with management of hot flashes.
Nonhormonal medications to treat hot flashes
If lifestyle changes are not enough to improve your symptoms, nonhormone options for managing hot flashes may work for you. These may be a good choice if you are unable to take hormones for health reasons or if you are worried about the potential risks.
The U.S. Food and Drug Administration (FDA) has approved the use of paroxetine, a selective serotonin reuptake inhibitor (SSRI) antidepressant, to treat hot flashes. Researchers are studying other antidepressants, which doctors may prescribe for off-label use.
Women who use an antidepressant to help manage hot flashes generally take a lower dose than people who use the medication to treat depression. As with any medication, talk with your doctor about whether this is the right medication for you and how you might manage any possible side effects.
Using hormones to treat hot flashes and night sweats
Some women may choose to take hormones to treat their hot flashes or night sweats. A hormone is a chemical substance made by an organ like the thyroid gland or ovary. During the menopausal transition, the ovaries begin to work less effectively, and the production of hormones like estrogen and progesterone declines over time. It is believed that such changes cause hot flashes and other menopausal symptoms.
Hormone therapy steadies the levels of estrogen and progesterone in the body. It is a very effective treatment for hot flashes in women who are able to use it. They can also help with vaginal dryness, sleep, and maintaining bone density.
Hormone treatments (sometimes called menopausal hormone therapy, or MHT) can take the form of pills, patches, rings, implants, gels, or creams. Patches, which stick to the skin, may be best for women with cardiac risk factors, such as a family history of heart disease.
There are risks associated with taking hormones, including increased risk of heart attack, stroke, blood clots, breast cancer, gallbladder disease, and dementia. Women are encouraged to discuss the risks with their health care provider. The risks vary by a woman's age and whether she has had a hysterectomy. Women who still have a uterus would take estrogen combined with progesterone or another therapy to protect the uterus. Progesterone is added to estrogen to protect the uterus against cancer, but it also seems to increase the risk of blood clots and stroke.
Before taking hormones to treat menopause symptoms, talk with your doctor about your medical and family history and any concerns or questions about taking hormones. If hormone therapy is right for you, it should be at the lowest dose, for the shortest period of time it remains effective, and in consultation with a doctor.
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For more information on treatments for hot flashes
National Institutes of Health Menopausal Hormone Therapy Information
National Center for Complementary and Integrative Health
North American Menopause Society
This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.
September 30, 2021