When you have vasomotor symptoms, or hot flashes and night sweats, you most likely want one thing: relief. Fortunately, you have many options that can help you find just that. Prescription medications, over-the-counter remedies, and lifestyle changes can all make a difference in how often you have symptoms and how severe they are.
Hormone Replacement Therapy
One of the most effective ways to reduce vasomotor symptoms is hormone replacement therapy, which is also known as HT or HRT.
During menopause, your estrogen and progesterone levels go down. This change in hormones makes it harder for your body to regulate its temperature. This is what leads to hot flashes and night sweats.
Hormone replacement therapy offsets the drop in estrogen by boosting your hormone levels to relieve symptoms.
There are two types of HRT:
Estrogen therapy. This treatment is best if you’ve had a hysterectomy, or surgery to remove your uterus. To get the estrogen, you may take a pill, wear a patch, or use a cream, vaginal ring, gel, or spray.
Estrogen progesterone/progestin hormone therapy (EPT). This treatment is also called combination therapy. It’s best if you still have your uterus. You may take a pill or wear a patch to get the dose of hormones.
You may have side effects if you take hormone replacement. Many women experience:
- Bleeding and spotting
- Breast tenderness
- Mood swings
For most women, these side effects are mild. But if they bother you, talk to your doctor.
HRT has health benefits that go beyond easing hot flashes and night sweats. Your chances of these conditions are lessened if you take this treatment:
- Colon cancer
- Osteoporosis (bone loss)
Other benefits of HRT include:
- Less joint pain
- Lower mortality rate, if you take it in your 50s
- Mood improvement
- Reduced tooth loss
But this type of treatment also carries risks. If you take it, you have a greater chance of:
- Breast cancer, if you take it for a long time
- Blood clots and stroke
- Dementia if you start it later in life
- Endometrial cancer
- Gallbladder problems
For people who can’t take hormone therapy, a new drug called fezolinetant may cut the number of hot flashes they have and how serious they are. As of mid-2022, this drug is awaiting FDA approval.
Other Prescription Medications
Your doctor may recommend a nonhormonal prescription medication to improve your symptoms.
Some drugs, like antidepressants, are “off-label.” This means the FDA hasn’t approved them to treat vasomotor symptoms, but experts consider them a safe and effective option.
Antidepressants. Right now, only one antidepressant is FDA-approved to treat hot flashes: a low-dose form of paroxetine (Brisdelle, Paxil).
Other selective serotonin reuptake inhibitors (SSRIs) are off-label but may make your hot flashes less frequent and less intense.
Side effects of antidepressants may include drowsiness, dry mouth, nausea, sleep problems, sexual problems, and weight gain.
Blood pressure medication. Clonidine (Catapres) is a drug used to treat high blood pressure. It comes in pill or patch form.
With this medication, you may have side effects, including constipation, dizziness, drowsiness, and dry mouth.
Anti-seizure medication. Gabapentin (Neurontin) and pregabalin (Lyrica) are anti-seizure drugs.
Side effects of gabapentin and pregabalin include dizziness, drowsiness, swelling, fatigue, trouble concentrating, and weight gain.
Urinary medication. Oxybutynin (Ditropan) is a pill or patch approved to treat urinary conditions. Side effects include constipation, dizziness, dry eyes, dry mouth, and nausea.
Other medications also help with vasomotor symptoms. Talk to your doctor about what’s right for you.
Stellate Ganglion Block
In this procedure, your doctor injects an anesthetic into a pair of nerve clusters in your neck. This blocks them from transmitting sensation to the brain. It’s commonly used to treat pain and swelling. More research is needed to see if it helps with moderate and severe hot flashes.
You’ll find many supplements that claim to help with symptoms. But there hasn’t been enough research on most of these for us to know if they’re safe and effective. Among them are:
- Black cohosh
- Dong quai
- Evening primrose oil
- Progesterone cream
- Soy (plant estrogen)
- Vitamin E
- Wild yam
These products aren’t regulated, so it isn’t clear if they’re safe or effective. Some may even be dangerous if you have other health conditions. Talk to your doctor before you take an over-the-counter remedy for hot flashes.
Alternative and Complementary Treatments
Acupuncture. Some people say acupuncture makes their hot flashes better, but studies have shown mixed results. We need more research to see if it’s an effective treatment.
Hypnosis. It’s possible that hypnosis can cut back on how often and how intense your hot flashes are. Some research supports this, and it’s recommended by the North American Menopause Society.
Meditation. Mindful meditation helps you to focus on what’s happening in the moment. Research is unclear, but some people say it helps with symptoms. It may also help you sleep better, which is helpful if menopause gets in the way of a good night’s sleep.
Relaxation techniques. Stress is a known trigger of hot flashes. Relaxation strategies like deep breathing and guided imagery help you manage stress better.
Therapy. A type of therapy called cognitive behavioral therapy (CBT) likely won’t reduce your symptoms, but it can help you manage your reaction to them so they bother you less.
The lifestyle choices that you make can have a big impact on how often you have hot flashes and how intense they are.
To reduce vasomotor symptoms, try these lifestyle changes:
- Avoid common triggers like heat, spicy food, caffeine, and alcohol.
- If you smoke, quit.
- Limit alcohol.
- Exercise regularly.
- Stay at a healthy weight.
- Avoid hot weather as much as possible. Stay indoors during the hottest part of the day and try to exercise or run errands in the morning or evening when it’s cooler.
- Turn down your thermostat.
- Dress in light layers that you can take off and put back on, depending on how warm you feel.
- Drink cold drinks to help yourself stay cool from the inside out.
Photo Credit: jcphoto / Getty Images
American College of Obstetricians and Gynecologists: “What Can I Do to Help With Hot Flashes?”
Breastcancer.org: “Exercise and Nutrition to Ease Hot Flashes.”
Cleveland Clinic: “Hot Flashes,” “Hormone Therapy for Menopause Symptoms,”
Mayo Clinic: “Hot Flashes.”
University of Maryland Rehabilitation and Orthopaedic Institute: “Stellate Ganglion Blocks.”
Clinicaltrials.gov: “A Study of Fezolinetant to Treat Hot Flashes in Women Going Through Menopause (Daylight).”