Menopause & perimenopause

Help for hot flashes and night sweats — causes and natural solutions

by Marcy Holmes, NP, Certified Menopause Clinician

Do these descriptions sound familiar to you?

“You’re trapped in a small room with the heat turned up the highest it will go.”

“There’s something crawling under your skin and it’s spreading to every limb, gathering more and more heat until it feels like you have a sunburn on the inside of your body.”

“It’s the middle of the night, and you wake up from a dead sleep feeling like you’ve been doused with a bucket of cold water.”

Our patients have all kinds of ways to describe their hot flashes and night sweats. Hot flashes and night sweats are symptoms that announce loud and clear: your body is going through a major hormonal transition. And these symptoms dramatically disrupt women’s lives. They can keep you from sleep, social interaction, work, travel, exercise, sex — and much more. Apart from the inconvenience they cause, night sweats in particular can affect your overall health because continual lack of sleep may lead to a whole host of mental and physical concerns. Perhaps the most frustrating aspect of hot flashes and night sweats is the sense of powerlessness they can give you over your own body.

And finding a solution can be even more frustrating! Healthcare practitioners frequently offer antidepressants or HRT, which many women don’t want. Progesterone creams, soy, and herbal remedies for menopause symptoms, like black cohosh or red clover, are widely available, but it can take a while to figure out what dose is effective (and you have to be careful that you’re getting them from a reliable source with good quality controls).

At Women to Women, we’ve spent years looking at natural solutions to hot flashes and night sweats, and in our experience women get the best results using a combination approach tailored to their individual needs. Whether you are going through perimenopause, menopause, or weaning off hormone replacement therapy (HRT), these are transitions your body is naturally equipped to handle. And given adequate support, you can regain comfort — and trust — in your body! Let’s take a closer look at some causes and natural solutions for hot flashes and night sweats so you can determine the approach best for you.

We aren’t truly overheating — the brain just thinks we are

Even though hot flash physiology has been studied for about four decades or so, scientists don’t fully understand what causes them. The prevailing theory is that menopausal hot flashes and night sweats are the result of mixed-up signaling between the body’s hormones and the brain.

Hormonal balance in the body is orchestrated by the region of the brain called the hypothalamus. Via a series of complex feedback loops, pulses of hormones and neurotransmitters stimulate or inhibit activity to achieve dynamic balance in the body. As our hormones naturally shift during perimenopause and menopause, the body resets its normal hormonal balance. Some women’s neuroendocrine (nerve/hormone) pathways are more affected by the change than others, and symptoms such as hot flashes or night sweats, among many others, can result.

Three out of four women in menopause experience hot flashes and night sweats, but we still don’t fully understand why some get them and others don’t. In women experiencing hot flashes, it appears that the natural decrease in ovarian estrogen output in menopause leads to changes in the temperature-regulatory part of the hypothalamus. In simple terms, we think this causes a bump-down in your thermostat. Because the temperature your brain considers optimal for your body gets lowered, altered hormone-signaling just before a hot flash causes your brain to “think” you’re too hot, so it sends out “Release heat!” messages to the peripheral body.

To release this heat, the body reacts instantly by increasing heart rate and dilating vessels to circulate more blood, as well as opening the sweat glands over the skin’s surface. These are the classic vasomotor symptoms of menopause.

Hot flash and night sweat trigger #1: stress

There are many known triggers for hot flashes and night sweats, but stress — emotional and physical — is what they all have in common. Poor nutrition is a form of physical stress easily overlooked during hormonal transitions like menopause. To help explain how it can make such a huge difference we’ve dedicated a whole page to nutrition and hot flashes. Anxiety and other forms of emotional stress are the most commonly recognized hot flash triggers at the top of women’s lists.

A few months ago I saw a woman in her early 50’s who’d never had a hot flash or a night sweat — until her mother died. About a week after her mother’s death, she said she woke up in the middle of the night drenched — her pajamas, pillow, and sheets were soaked. Even her hair was wet and matted down. She told me she’d been expecting menopausal symptoms to kick in soon because of her age, but still felt surprised and scared when this happened. What’s interesting is that she hasn’t had a repeat occurrence since that night. After giving it some thought, she connected the experience to the stress associated with her mother’s death.

Women share scenarios like this one with us time and again in our clinic and Personal Programs. I’m relieved that emotional stress is being increasingly recognized as a major cause of women’s hot flashes and night sweats, because we’ve been making this connection with women for years. A University of Pennsylvania study of over 400 menopausal women showed a direct correlation between anxiety and the severity and frequency of their hot flashes. An NIH study demonstrated that deep, paced breathing and relaxation exercises done throughout the day significantly decrease frequency and severity of flushing symptoms — further supporting the precept of stress as a major trigger. In a study at Indiana University called Breathe for Hot Flashes, researchers are investigating how women being treated for breast cancer can better manage their hot flashes uses breathing techniques.

Stress occurs on all levels in the body, and just as certain foods and drugs can be toxic to your system, so too can stress and negative emotions. They can lead to increased levels of stress hormones in just the same way fear and anxiety can. The investment your body has to make in sustaining high levels of stress hormones can end up bankrupting your other hormonal pathways — especially at menopause.

I know emotions are not faucets we can turn off and on at will, but they do always have something to teach us. Whatever your hot flash triggers, I encourage you to explore the possibility of an emotional component.

What about herbs for hot flashes and night sweats?

For decades, synthetic and equine forms of estrogen were the therapy of choice for hot flashes in menopausal and perimenopausal women, but many women now are looking for a more natural approach, especially after the reported risks associated with synthetic hormones. At Women to Women, we’ve developed an alternative, combination approach that delivers excellent results while optimizing a woman’s long-term health. Central to the success our patients and Members report is phytotherapy — the use of plants, both in the form of whole foods and as standardized extracts and supplements for healing purposes.

You may have read articles or studies claiming that herbal remedies don’t work. This could relate to the modern cultural expectation that popping a pill should deliver instant results. The intimate healing relationship between the female mind-body-spirit and the plant kingdom is thousands of years old. At Women to Women, we have seen that it may take a little more time before you see results with phytotherapy for hot flashes and night sweats, than with hormone replacement therapy or other prescription medications. Just as some women are more sensitive to or — less often — need stronger drug therapy, not all women respond alike to plant therapies. But through the years we have determined a particular combination of phytotherapeutic herbs that offers synergistic benefits for most women.

The benefit to using herbs for your hot flash relief is that they work with your neuroendocrine system, to help hormonal messaging between your brain, nervous system, and endocrine organs. Plant-based therapy can help increase or decrease cellular responses depending on what your unique body needs. We call this an adaptogenic effect, and it works because we evolved alongside the plant world. Within your cells, the responses taking place that originate from the plant world are called phytocrine responses. Phytocrines are the bioactive molecules in plants that share features with our own hormones and can directly connect with your endocrine system. By either encouraging the body to make more of a certain hormone, mimicking the body’s hormones, or stimulating the same response in the body as a natural hormone, plants can help the body maintain hormonal balance completely naturally and without the side effects often present with prescription medications.

The following plants have been used by generations of women for hot flashes, night sweats, and other menopausal symptoms:

Together these plant species form the basis of our phytotherapeutic treatment protocol for hormonal imbalance. In our practice of integrative medicine, herbal options are used together with a foundation of healthy lifestyle and dietary choices. Used within this setting, women with hot flashes and night sweats most often find phytotherapy can gently guide them to the hormonal balance most natural to their bodies.

5 natural ways to reduce hot flashes and night sweats — from Women to Women

Most of the women we meet in our clinic and Personal Programs prefer to use the most natural, least invasive methods available for health care. For them, addressing their menopausal symptoms by filling a prescription doesn’t hold the appeal it might for others. Antidepressants, anti-anxiety drugs, sleeping pills, and synthetic hormones, the solutions conventional medicine continues to offer women for hot flash relief, are not the first line of therapy at Women to Women. For 25 years we’ve been offering women safe alternative solutions that effectively address the underlying causes of hot flashes and provide equivalent — if not superior — results. Here are some options we find helpful:

1) Understand your triggers. The first step in pulling the plug on your hot flashes is to identify and understand your triggers. Are you more prone at certain times of the day or night? Do certain foods set you off on a heat wave? Track these observations and patterns in your journal or Women to Women’s Wellness Diary.

2) Nourish your body’s neuroendocrine pathways. Eat whole, fresh foods, and balance your meals and snacks with plenty of fruits and vegetables, healthy fats, and protein. Add a top-grade multivitamin-mineral complex, essential fatty acids, and soy to augment your core nutrition and ensure an adequate supply of the micronutrients your body needs for neurotransmitter and hormonal balance. With a solid nutritional foundation, you will find the passage through menopause to be a lot less bumpy. (To learn more, read our dietary pointers for quelling hot flashes.)

3) Stay active. Recent research suggests exercise helps calm hot flashes by reducing anxiety. In a small study looking at the effect of exercise on overall menopause symptoms, women who exercised experienced reduced hot flashes, while those who did not experienced an increase. Whatever form of exercise you enjoy makes for better hormonal health, provided it does not make you feel more stressed-out or overheated. Forms of exercise that raise core body temperature can trigger hot flashes, so be sure to provide ample cool-down time, and avoid dashing off to undertake anything stressful after your work-outs.

4) Cultivate emotional health. Make a commitment to follow a path that brings you emotional wellness. Take incremental steps to reduce stress, whatever form it takes in your life. Whether that means setting better boundaries at work, home, or within your community, learn to value your own well-being enough to keep commitments and expectations reasonable. Use your inner guidance to seek out and cultivate practices that calm rather than stimulate your inner thermometer. In our experience women find meditation, prayer, yoga, biofeedback, Emotional Freedom Technique, and the Hoffman Quadrinity Process to be extremely helpful.

5) Add gentle hormonal support when needed. Given that phytohormones approximate the molecular configuration of the hormones produced in our own bodies, it stands to reason that we’re better equipped to utilize them safely and effectively than pharmaceutical drugs or synthetic forms of hormone therapy. If you’re considering herbal support, a product containing a range of plant constituents, like the one we offer in our Personal Program, can offer synergistic benefits that a single herb may not. You may also want to explore acupuncture and Traditional Oriental Medicine (TOM), or talk to your practitioner about bioidentical hormones.

After all, it’s your body

Waking up in a pool of perspiration at night or having to leave an important meeting because of a hot flash can be frustrating, or frightening, or embarrassing. No one likes to feel helpless or limited to one-size-fits-all solutions. Take comfort in knowing that there are safe natural ways to help limit the frequency and severity of your hot flashes and night sweats.

Your body is magnificent in its ability to recover and maintain balance through life’s transitions — sometimes it just needs more support — on both the physical and emotional planes. A natural combination approach can help you restore hormonal balance and regain personal comfort — while tuning in to your body, finding greater peace of mind, and creating better long-term health.

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