Hot Flashes: Cursed Forever?

Exercise Plus a Cold Drink (Of Water) Can Help

Medically Reviewed by Charlotte E. Grayson Mathis, MD on October 07, 2002

Plug in the fan, friends. It seems like hot flashes are the curse of "the change." Estrogen therapy will help get rid of them. But if we choose not to take HRT (hormone replacement therapy) during menopause, how long must we put up with those unpredictable, uncomfortable sweats?

For answers, WebMD spoke with menopause specialist, Nancy Fugate Woods, PhD, RN, dean of nursing and an epidemiologist at the University of Washington at Seattle.

Actually, many young women are already familiar with hot flashes before they enter menopause, Woods tells WebMD. "Many women have them premenstrually," she says. And more than two-thirds of women experience hot flashes during perimenopause, the few years leading up to menopause that can start as early as your 30s.

But once you hit your 50s and make the transition into menopause, hot flashes will likely last two to three years. "For some women, they can last as long as 10 years, but that is not typical," says Woods. "In fact, a lot of women have no hot flashes at all - or they may have 'warm spells' that they don't really think of as hot flashes. They may think they're simply sweating because they're involved in some activity."

Unfortunately, there's no way of knowing when they will stop.

Hot flashes are a sudden change in the body's thermostat, the part of the brain that regulates our body temperature. That triggers a chain of events that can cause flushing and perspiration.

Who's most likely to get hot flashes? "Women who are sedentary. Also, women with more body fat have more hot flashes, probably because they are more insulated and have a difficult time losing body heat," she says.

"You can deal with them by getting regular aerobic exercise, doing relaxation techniques, and using what's called 'paced breathing' [slow, deep abdominal breathing when you feel a hot flash starting] - like you do in meditation or in labor," Woods says. "Actually, I learned to do paced breathing and found that you can kind of stop a hot flash with it. It's interesting how it works."

Some studies also show that other stress reduction techniques such as massage or yoga can help.

Will hot flashes return after you go off estrogen? Possibly, says Woods. "Doctors usually recommend going off estrogen gradually. Cut the pills in half, take them every other day, and see how things go."

Some believe that supplements such as soy or flaxseed or black cohosh are the answer to treat hot flashes. They may work in some women, but so far the studies are mixed on how effective these alternatives may be.

Some doctors have tried prescribing antidepressants to quell hot flashes -- and studies have shown that this works for women who don't want to risk hormones after breast cancer. However, antidepressants can have their own side effects, Woods adds.

Dressing in layers and sleeping in cooler conditions help some, as does a cold drink of water. "Carry a bottle with you during the day," she suggests. Also, you may have to change your tastes, since alcohol, hot beverages, and spicy foods can set off the sweats.

Coffee can also be a problem, but Woods says, "I'm not giving it up. I'd just as soon take the risk."

Some drugs that women take for other illnesses can also cause hot flashes.

Remember that not treating hot flashes is also an option, as they typically go away on their own in time.

If you are having hot flashes and do not want to take HRT, talk to your doctor about the options.