Estrogen is very effective in reducing the frequency and severity of hot flashes. There seems to be a direct correlation--increasing the dosage decreases the severity.

Sleep Deprivation

Don’t underestimate the effect of night sweats and the resulting loss of sleep on your overall health and well-being. Sleep deprivation is a contributing factor for some of the mental confusion, mood swings, and anxiety that often accompany menopause. 

Phytoestrogens

Sleep deprivation and night sweats are two areas where many of the phytoestrogens (estrogenic substances in plants like soy) may be beneficial. Soy foods and herbal products have all proved useful in relieving hot flashes for some women. Their relative safety makes them a good first choice of treatment.  You won’t need a major study to tell you if phytoestrogens are working – you’ll know.   However, for many women phytoestrogens are not strong enough to control the symptoms, and prescription estrogens may be a better choice.                                                                                                      

Breast Cancer Risk

Prescription estrogen does not seem to increase the risk of breast cancer when used for the short-term (under 5 years) treatment of hot flashes.  The preliminary results of the large Women's Health Initiative study did not show any increase in the breast cancer rate until a threshold of 4-5 years was reached.  After that, a slight increase in the breast cancer rate was observed in those taking Premarin (equine estrogens) and Provera (synthetic progestin).  No increase has been seen yet in those taking only Premarin.

Alternative treatments for hot flashes for women with breast cancer include the prescription drugs clonidine, Megace, Effexor, Prozac, and over-the-counter (OTC) bioflavanoids (Peridin-C).  Most recently a small study has suggested that the prescription drug Neurontin might prove useful.

Progesterone Creams

A few studies have shown that topical progesterone cream is effective in reducing hot flashes. Over-the-counter progesterone creams have a great variation in the amount of progesterone they contain.  Progesterone creams containing mexican yam are ineffective because the human body has no enzyme to convert mexican yam to progesterone.

What are your needs? 

Ask yourself:

When looked at in medical studies, treatments for hot flash symptoms have a placebo response of up to 65%; it is noteworthy that most other medical treatments have a 30% placebo response rate. Because two-thirds of women report relief from hot flashes with any type of treatment including a sugar pill, many companies feel free to claim that their products help with hot flashes.  Therefore,  it is important to look carefully at controlled studies to find the most evidence of effectiveness.

The most effective alternative treatments for hot flashes:

You are probably thinking that there are some items missing from this list.  What about dong quai, vitamin E, evening primrose oil to name a few?  The list reflects the treatments that have been shown to be the most effective in placebo-controlled studies. Most supplements have a low side effect profile, so there is little harm (other than to your pocketbook) in trying different treatments to see what works for you.

Benefit to Risk

The benefits are probably greater than the risks: If you are suffering from hot flashes and have no history of breast cancer.

The risks are probably greater than the benefits: If you have a history of breast cancer.

If you want to treat these symptoms as simply as possible, just start with the alternative treatments to see if they help you.

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