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Keeping cool: how to treat hot flashes

Jason Coleman

Hot flashes are a normal part of any woman’s progression through menopause that are often viewed as a simple passing phase. While many women go through menopause with little discomfort, others have a much harder time dealing with their symptoms and look for available treatment options.

This week on “Take Care,” Dr. JoAnn Manson discusses hot flashes and the things that women can do to reduce the severity of their symptoms. Manson is professor of medicine at Harvard Medical School and chief of preventive medicine at Brigham and Women’s hospital.

Click 'Read More' to hear our interview with Dr. Manson.

Hot flashes may be felt throughout the body, but they originate in the brain.

“A hot flash is due to a change in the thermostat in the brain,” Manson says.

This change is due to decreasing levels of estrogen and causes the range of temperatures that the body can tolerate to decrease. The smaller range makes women more sensitive to slight increases in heat. 

When hot flashes occur, blood vessels near the skin dilate to help the body dissipate heat, giving the skin a flushed appearance. Hot flashes can occur at night, causing women to sweat and wake up from the feeling of dampness.

Some women have little discomfort associated with hot flashes, while other women experience regular and extreme hot flashes that occur several times daily. The primary indicator of the severity of hot flashes is genetics.

Manson says that controlling stress is essential for reducing hot flashes.

“[It’s] very important trying to develop different strategies for minimizing the effects of stress on our bodies.” 

Identifying and reducing other triggers is important. These include hot drinks, caffeine, alcohol, spicy food, and smoking. 

Manson says that “there are many lifestyle modifications that can be made before turning to medications or pharmacologic approaches.”

Lowering the temperature of your house and bedroom can help as long as you keep the space at a temperature that is still comfortable. 

Dietary supplements have also become popular treatments for hot flashes, but evidence suggests that they seem to help select groups of women and do little to help the majority of women.

“Overall, the rigorous clinical trials have shown minimal benefit from dietary supplements,” Manson says.

If a woman makes the proper lifestyle changes and still experiences severe hot flashes, Manson says there are hormone therapies and medications that can be effective. The best candidates for hormone therapy are younger women in the early stages of menopause who have little risk or exposure to heart disease and breast cancer. 

The most common types of medications used for hot flashes are anti-depressants and anti-seizure medications, many of which have been approved by the FDA for use in the treatment of hot flashes. 

Many women may choose to ignore their hot flashes, but for those who experience more severe symptoms, treatment can provide relief and a higher quality of life.