Hot flashes brought on by perimenopause can be embarrassing, uncomfortable and even disrupt your sleep. They start in the face, spread to the chest and then sweep through the body, often accompanied by sweating. According to the National Sleep Foundation, they last about three minutes, which is plenty of time to interrupt sleep. Most women experience hot flashes for about a year during perimenopause, but an unlucky few – about 25 percent – may have hot flashes for as many as five years. 

Fortunately, you don’t have to live with hot flashes and night sweats, says Heide Moeling, M.D., an obstetrician and gynecologist at Piedmont.

Lifestyle modifications to treat hot flashes

Dr. Moeling recommends the following lifestyle modifications to reduce or relieve hot flashes:

• Regular exercise, which has been clinically proven to reduce hot flashes and night sweats.
• Smoking cessation. “Smoking is a huge contributor to hot flashes and smoking cessation can dramatically reduce vasomotor symptoms,” she says.

Medication for hot flashes

In addition to lifestyle changes, medication and supplements can help, including:

Black cohosh supplements. “This is the only herbal preparation that has been clinically proven to provide relief for hot flashes,” she says. “There are minimal and often no side effects or risks associated with taking black cohosh.” The supplement is commercially available as Estroven or Remifemen.

Hormone replacement therapy. “Hormones provide the best relief because they are directly addressing the problem – low estrogen levels,” she explains. “This can be done with low-dose birth control pills or hormone replacement therapy (HRT).” For patients with both hot flashes and menstrual irregularities, HRT will help with both issues.

Non-hormonal prescription medication. “One is an antidepressant (Effexor), one is a blood pressure medication (clonidine) and one is a peripheral neuropathy medication (Neurontin),” she says. “These medications are all useful in reducing hot flashes in certain patients, but they come with their own risks and benefits.” She encourages women to discuss with their healthcare provider which options are appropriate for their individual needs.

If hot flashes are disrupting your daily activities, talk to your doctor.

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