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Hot flushes affect up to 80% of women and is a common symptom accompanying menopause. Symptoms can last from 30 seconds to 5 minutes and may occur multiple times a day, or as infrequently as once a month. Women who experience flushes at night may have disturbed sleep and feel irritable and fatigued the next day. In addition, some women find the symptoms embarrassing when in the company of others.
Most women enter menopause sometime between the ages of 45 and 55 with the average age being around 51, and symptoms of flushes can last for on average 5.5 years. However, some women will continue to have symptoms until their 60’s and 70’s.
With menopause the ovaries slow their production of oestrogen and progesterone, reducing the monthly cycle of egg release (ovulation). In peri-menopause an egg is released in fewer cycles until eventually the ovaries stop releasing eggs. When this occurs menstruation ceases. Hot flushes are related to the fluctuations in hormones during this time, specifically the drop in oestrogen.
During a flush the blood vessels dilate near the surface of the skin, usually on the face and chest, causing redness, warmth and sometimes perspiration.
Essentially, hot flushes are a heat loss mechanism to allow the blood to cool and lower core body temperature. In menopausal women the loss of thermoregulation can occur due to low DHEA (as a result of chronic stress) and neurotransmitter imbalances, including increased nor-adrenaline and corticotrophin-releasing hormone (CRH) and low GABA and serotonin.
Maintaining a healthy weight, reducing certain foods, increasing wholesome foods and exercise can help reduce hot flushes. Decrease caffeine, alcohol and smoking. These are linked to increased menopausal symptoms.
Aim for 7-8 serves of vegetables, 2-3 serves of fruit and 30g of fibre - from wholegrains, nuts, seeds and legumes. Reduce meat, fat and sugar. Research has shown a diet high these, particularly trans fats, increased the incidences of flushes and night sweats.
Being over-weight may increase the risk of symptoms.
Hot flushes are associated with higher body mass index, urinary urgency, and vaginal dryness. Evidence suggests that having an excessive body mass index (BMI) increased the likelihood of hot flushes, while dietary and exercise measures that lead to BMI reductions, reduced symptoms.
Vitamin E and essential fatty acids can also help with skin and vaginal dryness often associated with menopause.
Phytoestrogens are plant-based compounds that have mild oestrogenic effects in the body. There are three main types of phytoestrogens; isoflavones, lignans and coumestans.
These can be found in high concentrations in foods such as soybeans, linseeds, alfalfa and mung bean sprouts.
Herbs which can help with hot flushes include:
A systematic review of 17 trials showed red clover to be an effective herb for reducing hot flushes in menopausal women. Black cohosh was also found to be beneficial for hot flushes in a 2005 review of 12 clinical trials conducted. Hops was also demonstrated to improve symptoms of hot flushes over a 12-week period, even at low doses. Consult a naturopath of herbalist before taking herbal extract to ensure suitability and avoid interactions with other medications and health concerns.
If sleep disturbances are related to anxiety, these herbs may help.
A wholesome diet, regular exercise, maintaining a healthy weight -supported by herbal and nutritional supplements, may help reduce symptoms during transition through menopause.