“Many women will benefit from lifestyle changes, stopping smoking, improving diet and regular exercise. These do not necessarily reduce symptoms but improve…”.1

Umbrella
What may the Hot Flushes Management Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Hot Flashes/Flushes Healthy Living
  • Hot Flashes/Flushes Management

Management

What may hot flushes management include?

DotS hot flushes management may include:

  1. Daily Pattern
  2. Triggers
  3. Healthy Living
  4. Physical Activity
  5. Weight
  6. Alcohol
  7. Smoking
  8. Attitude
  9. Stress
  10. Relaxation, Meditation, Mindfulness and Yoga
  11. Paced Breathing
  12. Hypnosis
  13. Sleep
  14. Sex
  15. Cool Tips
  16. Natural Products
  17. Phytoestrogens
  18. Evening Primrose Oil
  19. Cure or Not
  20. Hormone Therapy
  21. Hormone Therapy Alternatives

1. Daily Pattern

Can hot flushes have a daily pattern?Hot Flushes Management

In Who Gets Hot Flashes and When? the (United States) Breastcancer.org elaborate on:

“The most common time of onset is between six and eight in the morning, and between six to ten at night”.2

2. Triggers

Is there an association between triggers and hot flushes?

The International Menopause Society note:

“They often start for no apparent reason, but they may also be provoked by such factors as embarrassment, coffee, alcohol, temperature change, and so on”.3

In Hot Flashes: Diagnosis & Treatment – Lifestyle & Home Remedies the (United States) Mayo Clinic explain:

  • “Watch what you eat and drink. Hot and spicy foods, caffeinated beverages, and alcohol can trigger hot flashes. Learn to recognize your triggers and avoid them”.4

3. Healthy Living

Is there an association between healthy living and hot flushes?

In NonHormonal Treatments for Menopausal Symptoms: Lifestyle Changes the Australasian Menopause Society elaborate on:

“Many women will benefit from lifestyle changes, stopping smoking, improving diet and regular exercise. These do not necessarily reduce symptoms but improve overall wellbeing and can make symptoms easier to tolerate. (Please refer to AMS Information Sheet Lifestyle and behavioural modifications for menopausal symptoms)). Dressing in layers, avoiding spicy food and avoiding excess alcohol and caffeine may also assist”.5

4. Physical Activity

Is there an association between physical activity and hot flushes?

In Menopause Management: Healthy Living – Lifestyle & Symptoms of Menopause the (Australian) Jean Hailes for Women’s Health (JH) explain:

“Women who try to make their lifestyle as healthy as they can appear to have fewer menopausal symptoms, and those symptoms are less severe”.6

5. Weight

Is there an association between weight and hot flushes?

The JH note:

“Women who are overweight may have more hot flushes than women of a healthy weight”.7

In Hot Stuff: What’s New About Hot Flashes? Who Gets Them? the author elaborates on:

“Body fat appears to be a mixed story and depends on age or stage of menopause. Women who are overweight or obese have more hot flashes when they are younger and having either regular or irregular menstrual cycles. Yet once these women are well past their final menstrual period, they don’t necessarily have more hot flashes”.8

6. Alcohol

Is there an association between alcohol and hot flushes?

Yes and no. In Drink To Your Health At Menopause, or Not? How Much Is Bad? the NAMS elaborate on:

“Drinking may trigger hot flashes for some women, although that isn’t based in research. So determine whether it’s a personal trigger for you. (As for a general risk of experiencing hot flashes and night sweats, some studies find alcohol increases it, whereas others find the opposite)”.9

7. Smoking

Hot Flushes ManagementIs there an association between smoking and hot flushes?

In Hot Stuff: What’s New About Hot Flashes? Who Gets Them? the author notes:

“Smoking is a clear risk factor for hot flashes, so if you are a smoker, stopping may help”.10

According to the Mayo Clinic:

  • “Don’t smoke. Smoking is linked to increased hot flashes. By not smoking, you might reduce hot flashes, as well as your risk of many serious health conditions, such as heart disease, stroke and cancer”.11

8. Attitude

Is there an association between attitude and hot flushes?

In Make Your Menopause A Positive Experience the author elaborates on:

“The attitude with which you embark upon this transition can have a tremendous impact on your experience of it, as well as on your choice of behaviors. Studies bear this out: negative beliefs held prior to menopause can be predictive of a more difficult time. For instance, the more catastrophic your thoughts about hot flashes, the more intense they will be”.12

9. Stress

Is there an association between stress and hot flushes?

In Symptoms of Menopause: Hot Flushes & Night Sweats the JH elaborate on:

“Many studies show stress and anxiety can influence the frequency and intensity of hot flushes and sometimes certain foods or alcohol can also have an impact”.13

10. Relaxation, Meditation, Mindfulness and Yoga

Is there an association between relaxation, meditation, yoga and mindfulness and hot flushes?

In Hot Flashes: Diagnosis & Treatment – Lifestyle and Home Remedies the Mayo Clinic elaborate on:

  • “Relax. Some women find relief from mild hot flashes through meditation; slow, deep breathing; or other stress-reducing techniques. Even if these approaches don’t quell your hot flashes, they might provide other benefits, such as easing sleep disturbances that tend to occur with menopause”.14

In Hot Flashes: What Can I Do? Lifestyle Changes To Improve Hot Flashes the (United States) National Institute on Aging (NIA) note:

  • “Try mind-body practices like yoga or other self-calming techniques. Early-stage research has shown that mindfulness meditation, yoga, and tai chi may help improve menopausal symptoms”.15

11. Paced Breathing

Is there an association between breathing and hot flushes?

In Hot Flashes: What Can I Do? Lifestyle Changes To Improve Hot Flashes – What Is Relaxation Breathing? the NIA explain:

“Deep breathing, relaxation breathing, and paced respiration all refer to a method used to reduce stress. It involves breathing in (inhaling) deeply and breathing out (exhaling) at an even pace. Do this for several minutes while in a comfortable position. You should slowly breathe in through your nose. With a hand on your stomach right below your ribs, you should first feel your stomach push your hand out, and then your chest should fill. Slowly exhale through your mouth, first letting your lungs empty and then feeling your stomach sink back. You can do this almost anywhere and several times during the day, whenever you feel stressed. You can also try this if you feel a hot flash beginning or if you need to relax before falling asleep”.16

In Paced Breathing: Can It Help With Hot Flashes? What Is “Paced Breathing” and Is It Helpful for Menopause Symptoms, Such As Hot Flashes? the Mayo Clinic elaborate on:

“Paced breathing is slow, deep, diaphragmatic breathing. With normal breathing, you take about 12 to 14 breaths a minute. By comparison, with paced breathing you take only 5 to 7 breaths a minute. The paced breaths are slow, smooth and deep enough to move your diaphragm — the muscular wall located beneath your lungs — as you take deeper breaths. The goal of paced breathing is to reduce the stress chemicals your brain produces and facilitate a relaxation response”.17

12. Hypnosis

Is there an association between hypnosis and hot flushes?

In Hot Stuff: What’s New About Hot Flashes? Are Drugs the Only Answer? the author notes:

  • “Hypnosis has the potential to help reduce both the occurrence of hot flashes and their effect on a woman’s life. It’s one of the few approaches that can do both. However, there is a very specific protocol that your healthcare provider should follow”.18

13. Sleep

Is there an association between sleep and hot flushes?

The IMS note:

“Hot flushes at night can lead to sleeplessness and insomnia”.19

In Hot Flashes: What’s the Connection To Sex? Sleep Disturbances and Reduced Energy the NAMS elaborate on:

“Although studies have not shown a clear cause-and-effect relationship between hot flashes and sleep disturbance, nighttime hot flashes and night sweats certainly do not make for restful sleep. The result can be fatigue and less energy for sex”.20

14. Sex

Is there an association between sex and hot flushes?

In Hot Flashes: What’s the Connection To Sex? the NAMS elaborate on:

“Studies have shown that severe hot flashes can be negatively associated with sexual activity”.21

15. Cool Tips

What are some cool tips for dealing with hot flushes?

In Managing Menopause: Don’t Let Symptoms of Menopause Reduce Your Quality of Life: Hot Flushes/Night Sweats – What You Can Do suggest:

Hot Flushes Management

  • “Carry a hand-held fan to cool your face, or a small water spray to spritz your face”.22

In Menopause Management: Healthy Living the JH’s Tips for Dealing With Hot Flashes include tips for:

  • “Food and Drink…
  • Environment…
  • Helpful Therapies…”.23

16. Natural Products

Is there an association between natural products and hot flushes?

In 4 Things To Know About Menopausal Symptoms and Complementary Health Practices. 2 the (United States) National Center for Complementary and Integrative Health (NCCIH) elaborate on:

“Many natural products, such as black cohosh, soy isoflavone supplements, and DHEA, have been studied for their effects on menopausal symptoms, but scientists have found little evidence that they are helpful. There is also no conclusive evidence that the herbs red clover, kava, or dong quai reduce hot flashes”.24

In Menopause & Herbs the JH also elaborate on the evidence of different herbs used for the management of hot flushes.

Hot Flushes ManagementIn Complementary Medicine Options for Menopausal Symptoms the Australasian Menopause Society include a table of benefits and risks of complementary medicine.

17. Phytoestrogens

Is there an association between phytoestrogens and hot flushes?

In Phytoestrogens: Key Points the JH note:

  • “The effect of phytoestrogens on menopausal hot flushes varies between individuals, as only a third to a half of individuals have the gut bacteria that convert the phytoestrogens to a more potent form”.25

In Soy: What Have We Learned? the NCCIH also note:

  • “Soy isoflavone supplements may help to reduce the frequency and severity of menopausal hot flashes, but the effect may be small”.26

18. Evening Primrose Oil

Is there an association between Evening primrose oil and hot flushes?

In Effectiveness of Natural Therapies: Don’t Go It Alone the JH explain:

“Recent research on menopause found that out of a large group of women in Australia, the second-most used natural therapy was self-prescribed Evening primrose oil for the treatment of hot flushes. Unfortunately for these women, and completely unknown to them, another piece of research found that Evening primrose oil is no better than taking a dummy pill for the treatment of hot flushes. There are natural therapies that are effective and evidence-based for the treatment of hot flushes, but Evening primrose oil is not one of them”.27

19. Cure or Not

Is there a cure for hot flushes?

In Menopause FAQs: Hot Flashes – Q. Are there treatments for hot flashes? the NAMS elaborate on:

“A. Although the available treatments for hot flashes do not cure hot flashes, they do offer relief. Hot flashes usually fade away eventually without treatment, and no treatment is necessary unless hot flashes are bothersome. A few women have an occasional hot flash forever. There are a number of low-risk coping strategies and lifestyle changes that may be helpful for managing hot flashes, but if hot flashes remain very disruptive, prescription drug therapy may be considered”.28

20. Hormone Therapy

What is the most effective treatment for hot flushes?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016 is:

  • “MHT, including tibolone and the combination of conjugated equine estrogens and bazedoxifene (CE/BZA), is the most effective treatment for vasomotor symptoms (VMS) associated with menopause at any age, but benefits are more likely to outweigh risks if initiated for symptomatic women before the age of 60 years or within 10 years after menopause”.29

21. Hormone Therapy Alternatives

Are MHT alternatives available to relieve hot flushes?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT is:

  • “If MHT is contraindicated or not desired for treatment of VMS, selective serotonin reuptake inhibitors and serotoninnorepinephrine reuptake inhibitors such as paroxetine, escitalopram, venlafaxine and desvenlafaxine, which have been shown to be effective in randomized controlled trials (RCTs), may be considered. Gabapentin may also be considered”.30

In Hot Stuff: What’s New About Hot Flashes – Are Drugs the Only Answer? the author elaborates on:

“You have options. I am a proponent of behavioral approaches, because although these approaches may take more active engagement from you, they can eliminate the need to take a medication and may have other mental or physical health benefits. Menopause is the time to adopt positive health behaviors. These behaviors can help not only improve quality of life, but also improve health later in life. Although much more research is needed on behavioral treatments for hot flashes, here are some of my personal recommendations that I often discuss with women:

  • Hypnosis…
  • Mindfulness-based stress reduction…
  • Cognitive behavioural therapy…
  • Weight loss…
  • Keep your environment…
  • Yoga…
  • What about exercise?…”.31

Health Care Provider

What if I would like help with my hot flushes management?

If you would like help with your hot flushes management, it may be in your best interest to choose to talk to your health care provider about this. Together you can look for a pattern, discuss your options and if required, agree on who maybe the best person to help you.

In Hot Flash Relief Without Hormones the author elaborates on:

“As many as 75% of perimenopausal women in North America experience hot flashes, and for a quarter of these women, hot flashes are so disturbing that they seek help”.32

The Mayo Clinic also note:

“Discuss the pros and cons of various treatments with your doctor. If hot flashes don’t interfere with your life, you probably don’t need treatment. Hot flashes subside gradually for most women, even without treatment, but it can take several years for them to stop”.33

In 4 Things To Know About Menopausal Symptoms and Complementary Health Practices. 4 the NCCIH remind us:

“Tell all your health care providers about any complementary health practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care”.34

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  1. NonHormonal Treatments for Menopausal Symptoms: Lifestyle Changes. Content Updated: September 2018. Australasian Menopause Society http://www.menopause.org.au/hp/information-sheets/600-nonhormonal-treatments-for-menopausal-symptoms Accessed: 12 August 2019
  2. Who Gets Hot Flashes and When? Last Modified on 29 March 2016. Breastcancer.org http://www.breastcancer.org/tips/menopausal/treat/hot-flashes/who Accessed: 12 August 2019
  3. Hot Flushes and Night Sweats – Background Information: What Triggers Them? October 2011:1. International Menopause Society http://www.imsociety.org/downloads/world_menopause_day_2011/wmd_media_backgrounder.pdf Accessed: 12 August 2019
  4. Hot Flashes: Diagnosis & Treatment – Lifestyle and Home Remedies. 10 February 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 12 August 2019
  5. NonHormonal Treatments for Menopausal Symptoms: Lifestyle Changes. Content Updated: September 2018. Australasian Menopause Society http://www.menopause.org.au/hp/information-sheets/600-nonhormonal-treatments-for-menopausal-symptoms Accessed: 12 August 2019
  6. Menopause Management: Healthy Living – Lifestyle & Symptoms of Menopause. Last Updated 16 July 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 12 August 2019
  7. Menopause Management: Healthy Living – Lifestyle & Symptoms of Menopause. Last Updated 16 July 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 12 August 2019
  8. Thurston, R. Hot Stuff: What’s New About Hot Flashes? Who Gets Them? 14 August 2017 http://www.menopause.org/for-women/menopause-take-time-to-think-about-it/consumers/2017/08/14/hot-stuff-what-s-new-about-hot-flashes Accessed: 12 August 2019
  9. Drink To Your Health At Menopause, or Not? How Much Is Bad? North American Menopause Society http://www.menopause.org/for-women/menopauseflashes/exercise-and-diet/drink-to-your-health-at-menopause-or-not Accessed: 12 August 2019
  10. Thurston, R. Hot Stuff: What’s New About Hot Flashes? Who Gets Them? 14 August 2017 http://www.menopause.org/for-women/menopause-take-time-to-think-about-it/consumers/2017/08/14/hot-stuff-what-s-new-about-hot-flashes Accessed: 12 August 2019
  11. Hot Flashes: Diagnosis & Treatment – Lifestyle and Home Remedies. 10 February 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 12 August 2019
  12. Kagan, L. Make Your Menopause A Positive Experience http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/make-your-menopause-a-positive-experience Accessed: 12 August 2019
  13. Symptoms of Menopause: Hot Flushes & Night Sweats. Last Updated 04 February 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-symptoms Accessed: 12 August 2019
  14. Hot Flashes: Diagnosis & Treatment – Lifestyle and Home Remedies. 10 February 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 12 August 2019
  15. Hot Flashes: What Can I Do? Lifestyle Changes To Improve Hot Flashes. Content Reviewed: 26 June 2017. National Institute on Aging https://www.nia.nih.gov/health/hot-flashes-what-can-i-do Accessed: 12 August 2019
  16. Hot Flashes: What Can I Do? Lifestyle Changes To Improve Hot Flashes – What Is Relaxation Breathing? Content Reviewed: 26 June 2017. National Institute on Aging https://www.nia.nih.gov/health/hot-flashes-what-can-i-do Accessed: 12 August 2019
  17. Paced Breathing: Can It Help With Hot Flashes? What Is “Paced Breathing” and Is It Helpful for Menopause Symptoms, Such As Hot Flashes? 06 January 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/expert-answers/paced-breathing/faq-20119343 Accessed: 12 August 2019
  18. Thurston, R. Hot Stuff: What’s New About Hot Flashes? Who Gets Them? 14 August 2017 http://www.menopause.org/for-women/menopause-take-time-to-think-about-it/consumers/2017/08/14/hot-stuff-what-s-new-about-hot-flashes Accessed: 12 August 2019
  19. Women and Menopause Fact Sheet: Facts. October 2012:1. International Menopause Society https://www.imsociety.org/downloads/world_menopause_day_2012/wmd_general_menopause_backgrounder.pdf Accessed: 12 August 2019
  20. Hot Flashes: What’s the Connection To Sex? Sleep Disturbances and Reduced Energy. North American Menopause Society http://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/hot-flashes Assessed: 12 August 2019
  21. Hot Flashes: What’s the Connection To Sex? North American Menopause Society http://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/hot-flashes Assessed: 12 August 2019
  22. Managing Menopause: Don’t Let Symptoms of Menopause Reduce Your Quality of Life: Hot Flushes/Night Sweats – What You Can Do. 02 October 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/news/managing-menopause-dont-let-symptoms-of-menopause-reduce-your-quality-of-life Assessed: 12 August 2019
  23. Menopause Management: Healthy Living – Tips for Dealing With Hot Flushes. Last Updated 16 July 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/menopause/menopause-management Assessed: 12 August 2019
  24. 4 Things To Know About Menopausal Symptoms and Complementary Health Practices. 2. This Page Last Modified: 11 August 2016. National Center for Complementary and Integrative Health https://nccih.nih.gov/health/tips/menopause Accessed: 12 August 2019
  25. Phytoestrogens: Key Points. February 2104. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/natural-therapies-supplements/phytoestrogens Assessed: 12 August 2019
  26. Soy:  What Have We Learned? Updated: September 2016. This Page Last Modified 01 December 2016. National Center for Complementary and Integrative Health https://nccih.nih.gov/health/soy/ataglance.htm Accessed: 12 August 2019
  27. Effectiveness of Natural Therapies: Don’t Go It Alone. Last Updated 27 February 2017 — Last Reviewed 15 June 2016. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/natural-therapies-supplements/effectiveness-of-natural-therapies Assessed: 12 August 2019
  28. Menopause FAQs: Hot Flashes – Q. Are there treatments for hot flashes? North American Menopause Society http://www.menopause.org/for-women/menopause-faqs-hot-flashes Accessed: 12 August 2019
  29. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 http://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 12 August 2019
  30. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 http://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 12 August 2019
  31. Thurston, R. Hot Stuff: What’s New About Hot Flashes? Are Drugs the Only Answer? 14 August 2017 http://www.menopause.org/for-women/menopause-take-time-to-think-about-it/consumers/2017/08/14/hot-stuff-what-s-new-about-hot-flashes Accessed: 12 August 2019
  32. Utian, W. Hot Flash Relief Without Hormones. 24 September 2015. North American Menopause Society http://www.menopause.org/for-women/consumers/2015/09/24/hot-flash-relief-without-hormones Accessed: 12 August 2019
  33. Hot Flashes: Diagnosis & Treatment – Treatment. 10 February 2018. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 12 August 2019
  34. 4 Things To Know About Menopausal Symptoms and Complementary Health Practices. 4. This Page Last Modified: 11 August 2016. National Center for Complementary and Integrative Health https://nccih.nih.gov/health/tips/menopause Accessed: 12 August 2019
Topic Last Updated: 12 August 2019 – Topic Last Reviewed: 12 August 2019
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