The best way to manage hot flushes is to prevent them from occurring. Once a hot flush occurs, make yourself as comfortable as possible and as is socially appropriate: remove some of the layers of intentionally layered clothing, try to perform a relaxation exercise, open a window, etc.
- Stop smoking — Smoking actually acts as a toxin to the ovaries and is associated with changes in estrogen. Smoking is also associated with an earlier onset of menopause.
- Limit alcohol consumption — Alcohol has been associated with causing hot flushes. But, as always, moderation is important.
- Exercise regularly — Regular exercise can reduce stress and also decrease the incidents of hot flushes.
- Try to reduce stress — You have to find out what method of stress management works for you. What causes relaxation in others may actually create stress for others. Figure out how to find your relaxed state. Some find relief in yoga, massage, meditation, a cup of herb tea or acupuncture.
Medical Management of Hot Flashes
For many women, estrogen replacement therapy may provide relief from hot flushes. However, not all women should have or will want to have estrogen replacement therapy. This is a personal decision. Every woman considering estrogen replacement therapy should discuss it with her healthcare provider. Then the type of estrogen, dose and method of administration must be customized. There is no one therapy that is best for all women.
If a woman is perimenopausal, standard hormone replacement therapy with estrogen and progesterone may not be sufficient for relief of her symptoms. If she is a healthy nonsmoker and can take hormones, she may do better on a low-dose birth control pill.
The lowest dose birth control pill has about four times the estrogen of the standard hormone replacement therapy dose. The additional estrogen in an oral contraceptive pill acts to suppress the hormone roller coaster that occurs during perimenopause and is responsible for symptoms such as hot flushes. Also, the additional estrogen acts to prevent egg development and suppress ovulation so that one does not become pregnant — a definite possibility during perimenopause.
Some “natural” therapies may actually act as estrogens and may provide relief from hot flushes. However, it is crucial to discuss the use of any alternative therapy with your healthcare provider. There are not enough well-designed, conclusive studies to say that these therapies do not have some of the “bad” actions of estrogen as well.