2/5/2013 1:59:00 PM Dr. K for February 5, 2013 Natural remedies for hot flashes have not been well studied
DEAR DOCTOR K: I'm having menopausal hot flashes, but I don't want to take hormone therapy. Can you tell me about natural remedies?
DEAR READER: Natural remedies can help for hot flashes, but hormone therapy is helpful more often. For that reason, I'll come back to the pluses and minuses of hormone therapy after answering your question.
You don't need this explanation, but some readers who have not experienced them may not be sure what hot flashes are. They're brief but intensely uncomfortable feelings of warmth followed by drenching perspiration. They're common during menopause, but not all women get them. They can be accompanied by heart palpitations, dizziness or weakness, and they can cause sleepless nights followed by irritability and exhaustion during the day. At their worst, they can really interfere with a woman's life.
There are traditional medicines other than hormone therapy that can help with hot flashes. These include drugs that relax blood vessels as well as certain antidepressants.
Several herbal remedies claim to help prevent or treat hot flashes, but most have not been well studied. There is some evidence that the herb black cohosh may be effective.
You can take steps to help make hot flashes less severe or less frequent -- steps that don't require either traditional medicines or "natural remedies":
-- Drink a glass of cool water at the beginning of a hot flash.
-- Drink six to eight glasses of water per day.
-- Plunge your hands in cold water and pat it on your face, neck and chest when a hot flash starts.
-- Begin deep-breathing exercises at the beginning of a hot flash to help nip it in the bud.
-- Avoid caffeine and alcohol, which make hot flashes more uncomfortable.
-- Cut down on red wine, chocolate and aged cheeses. They contain a chemical that can trigger hot flashes.
-- Don't smoke. Smoking can make hot flashes worse.
-- Wear loose, comfortable cotton clothing.
-- Dress in layers. Remove some clothing if you suddenly feel hot.
-- Keep your house cool. At work, open a window or use a small portable fan.
-- At night, use lightweight blankets that can be removed.
-- Engage in regular vigorous exercise.
Now let's come back to hormone therapy. Here's the bottom line -- at least for me -- of a complicated story. The most effective medication for hot flashes is the hormone estrogen. If you're 60 or over, or are 10 years past entering menopause, I would stay away from hormone therapy. I think it does increase your risk of heart disease and stroke.
However, if you are entering menopause -- which typically occurs in a woman's late 40s or early 50s -- I think the evidence does not show an increased risk of heart disease. Indeed, hormone therapy taken at that age to relieve hot flashes may actually protect you from heart disease. I'll address the question of how your age affects your risk from hormone therapy in another column.
(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)