If you’re standing out on your back steps in the depths of winter, holding an iced coffee and fanning yourself as your neighbors walk past, muffled to the hilt in sweaters, scarves, mittens, and wool hats, you might be in menopause or perimenopause.

Estimates vary, but anywhere up to 85% of women in the menopause transition experience hot flashes, and for some women, they can be devastating.

HRT (hormone replacement therapy) can be very effective for a lot of women, and the risks we thought we understood may actually be far less than we feared.

But if you can’t or choose not to go the HRT route, there are other options which many women believe have provided real relief from hot flashes and other menopausal symptoms.

Learn about all your options for managing symptoms

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We should say from the outset that these alternative therapies often don’t have major clinical studies to prove their efficacy, or studies have shown little or no benefit beyond what a placebo might do.

However, every woman’s body is different, and we think it’s worthwhile to give you all the information, so you can make the most informed choice for you.

genneve thanks Dr. Arianna Staruch, Dean for the School of Naturopathic Medicine at Bastyr University, for her expert assistance on this article. Learn more from Dr. Staruch by watching her presentation at genneve’s M event.

We do recommend – strongly – that you talk with a doctor before adding supplements to your regimen. “Natural” doesn’t necessarily mean “safe,” and many remedies can interact with medications or conditions, so please talk to a doctor.

Alternative therapies to help with hot flashes

What else is out there? Quite a lot, it turns out.

Mindfulness is the act of being aware of everything around you, of being fully in the moment, without judgment. “When you’re mindful, you are actively involved in the activity with all of your senses instead of allowing your mind to wander,” says the Chopra Center. You’re also less concerned with future impacts because you’re wholly in the now, and that can be much a less stressful approach to life.

So how does mindfulness help reduce hot flashes? Well, according to a recent Mayo Clinic study, it may not. What mindfulness may do is help how women respond to hot flashes. Rather than getting upset, mindfulness can help women move through the hot flash, perceiving it as less disruptive and stressful.

Acupuncture. Recent research from the University of Copenhagen appears to indicate real benefit from acupuncture, reporting “a fast and clinically relevant reduction in moderate-to-severe menopausal symptoms during the six-week intervention.”

Women in the study claimed significantly decreased hot flushes, night sweats, and general sweating, as well as improvement to emotional and physical symptoms and skin and hair symptoms. “No severe adverse effects were reported,” which is always good to hear.

Yoga. Doing strenuous exercise before bed is generally not recommended as a strategy for avoiding night sweats. However, yoga, qigong, and tai chi may all help promote a better night’s sleep. According to Psychology Today, all of these practices can calm the nervous system, which should, says Functional Nutritionist Nicole Negron, reduce the number, duration, and intensity of hot flashes.

Relaxation breathing. Another tactic for riding out a hot flash (and potentially shortening the duration and lessening the intensity) involves relaxation breathing. This is slow, measured, even breathing in through the nose, out through the mouth, filling the diaphragm before the chest. It’s a great way to reduce stress and stay calm in a hot flash.

Complementary and Alternative Medicine

Herbs/vitamins/supplements. Again, we remind you to talk with your doctor before adding new substances to your diet. Some herbs can have negative health impacts or interact with medications, so have a frank and full conversation with your doc before introducing new things.

Additionally, supplements, herbs, compounded drugs, etc., are not generally regulated by the FDA, so it’s not always possible to know what you’re getting.

One thing you might do is work with a Naturopathic Doctor to be sure you’re taking the right things in the right amounts in the correct way, and that your treatments are coming from a reputable source.

Black cohosh, Latin name Actaea racemosa, previously known as Cimmicifuga racemose. Other common names include black snake root, black bugbane, or rattleweed. Native to North America, it has been used medicinally by First Nation peoples for a very long time, says the US National Institutes of Health, including for women’s reproductive issues.

To date there are 180 scientific articles listed in PubMed that include Black cohosh and menopausal symptoms, including 29 clinical trials. The results from these trials are mixed, with some showing benefit and some no difference from placebo. The most recent published in 2018 in the Journal of Education and Health Promotion showed that black cohosh decreased the number of hot flashes and improved quality of life scores.

A 2017 systematic review of journal articles on herbal preparations for menopausal symptoms showed that there are a number of common herbs that have benefit for menopausal women.

Some of the herbs included in the review are:

Sage. (Salvia officinalis) Yes, the stuff you’ve eaten at Thanksgiving has shown some effect on sweating as seen with hot flashes, as well as improving memory. However, excessive use of sage may cause rapid heart beat and seizures. In addition, it may lower blood sugar levels which could cause dangerous interactions with diabetic medications, so please talk with your doctor before taking sage as medication.

Red clover. (Trifolium pretense) Most studies seem to indicate red clover has no significant effect on hot flashes, though one study using fermented red clover made great claims of success. The North American Menopause Society says there are few reasons to be concerned about taking red clover except that in some animal studies, there was concern it “may have harmful effects on hormone-sensitive tissue,” so those with a personal or family history of hormone-sensitive cancers should be sure to talk with a doctor first.

Valerian root. (Valerian officinalis) This herb helps to increase levels of the calming neurotransmitter GABA and so is known to help promote sleep and decrease anxiety. Some women have found relief from hot flashes in valerian root as well. There are several “do not take if” warnings to be aware of, namely that it can increase side effects of medications, so if you are taking any medications or have any health conditions, talk to your doctor before adding valerian. Also, it can make you sleepy and less functional, so don’t take and then drive.

Maca. (Lepidium meyenii) This herb has gotten a lot of attention lately. However, a systematic review in 2011 of published papers on maca found four randomized trials that showed benefit, but the studies were too small to draw firm conclusions.

Maca root is native to Peru, and its recent claim to fame of increasing libido poses a threat to the sustainability of this plant in the wild. The lack of data to support health claims and the lack of safety information poses a threat to consumers as well, according to the Journal of Ethnopharmacology 2018. It seems this is an herb whose marketing outruns its scientific evidence.

Vitamin E. Studies in the past has shown that Vitamin E may help with mild hot flashes, says the Mayo Clinic. Supplements are OK; getting it from food is better. Nuts, seeds, and oils from nuts and seeds are good sources of Vitamin E. But don’t go crazy with the supplements – too much Vitamin E can increase bleeding.

Soy. This staple of Asian diets has long been studied for its health benefits. The isoflavones isolated from soy have also been studied as a dietary supplement. Because the concentrated isoflavones of soy supplements may be problematic for those with breast cancer concerns, we strongly suggest that women eat soy foods rather than take soy pills. In its least-processed forms, such as tofu, edamame, or miso, soy is very nutritious and may actually help reduce the risk of breast cancer recurrence. Soy also may reduce hot flashes.

How to make safe choices

If you’re considering adding a supplement to your diet to help with menopause symptoms, remember that you are adding it in hopes that it will have a medicinal effect – and you wouldn’t take penicillin without a doctor’s advice and oversight, would you? So please don’t add medicinal plants and herbs without that same expert assistance.

If you aren’t sure how to go about finding a safe distributor of quality products, you can start on the US Department of Health and Human Services, at the National Institutes of Health. There, the National Center for Complementary and Integrative Health has considerable resources to help you be an informed, safe consumer.

And always, always talk with your doctor. Without knowing the full range of medications and supplements you’re taking, she can’t identify potential interactions or help you make the best decisions for your health.

Have you tried alternative and complementary therapies to manage menopause symptoms? What did you try? How did it work? We’d love to hear all about it, so please share on our community forums, tell us in the comments below, let us know on our Facebook page, or share in Midlife & Menopause Solutions, our closed Facebook group.


Shannon Perry

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