Coping with menopause and night sweats

Many women experience hot flashes and night sweats during menopause and perimenopause but they can reduce or prevent these uncomfortable symptoms in a number of ways.  Hot flashes are sudden feelings of heat that spread mainly through the face, neck, and chest. Night sweats happen when hot flashes occur at night. Up to 85 percent of women report hot flashes during menopause. Hot flashes are also thought to be more common among African-American women and tend to increase with age.

Menopause and hot flashes–Menopause is a normal stage of life. Surgery or chemotherapy cause the menopause in some people who have these treatments.  According to the National Institute on Aging, natural menopause occurs between 45 and 55 years of age and lasts for around 7 years, but can continue for up to 14 years.

Some estimates state that the occurrence of hot flashes may run for an average of 5.2 years. And the earlier in life they occur, the longer time period they may last. Hot flashes and night sweats occur before and during menopause because of changing hormone levels, including estrogen and progesterone, affecting the body’s temperature control.  Changes in these hormone levels affect the action of other hormones that are responsible for regulating the body’s temperature. This causes the characteristic feelings of sudden warmth, flushing, and excessive sweating. The frequency of hot flashes and night sweats differ between people. Some only experience occasional hot flashes while, for others, the symptoms can get in the way of daily life.

Treatment and prevention–Although some women learn to deal with menopause-related hot flashes and night sweats and can live a normal life with them, for other women they can be quite disturbing. Doctors recommend that women make lifestyle changes to manage hot flashes for 3 months before trying medication.

Different factors may increase hot flashes and night sweats in different people. Individuals can try making a note of triggers and avoiding them. According to the National Institute on Aging, common triggers include:

• alcohol
• spicy food
• caffeine
• smoking

Other lifestyle tips include:

• Stay cool. Wear light clothes or dress in layers so you can remove them when a hot flash strikes.
• Keep a fan beside the bed. This will help when people experience night sweats.
• Keep the room temperature low. Open windows and use a fan or air conditioner to keep air circulating in the room.
• Take a cool shower during the day and before bed.
• Run cool water over the wrists. There are many blood vessels in the wrists, so this may be a good way to cool off quickly.
• Keep a healthy weight. Hot flashes can be more frequent and severe if people are overweight or obese. Keep a healthy weight by doing regular exercise and sticking to an active lifestyle.
• Relax and reduce stress. Slow and deep breathing and meditation are techniques that can help relieve stress and reduce hot flashes.

Alternative medicine–Many women find relief from the symptoms of menopause through using alternative medicine practices, though these remedies may not work for everyone.  Mind and body techniques that may improve symptoms include:

• Mindfulness meditation. Research from 2011 suggests that mindfulness may reduce how much bother women experience from hot flashes and night sweats.
• Cognitive behavioral therapy (CBT). Research from 2014 suggests that CBT can reduce how problematic women find hot flashes and night sweats.

Dietary Supplements–Some women may find that herbal remedies help. However, there is little research about their effectiveness, and some may interact with other medications or have harmful side effects.  If women wish to try dietary supplements to improve hot flashes, they can ask their doctor about the following:

• Phytoestrogens. A review of studies from 2015 suggests that phytoestrogens may reduce the frequency of hot flashes without having serious side effects. Phytoestrogens are plant compounds that have some similar properties to estrogen.
• Black cohosh. Black cohosh is an herbal preparation. A 2010 review of studies suggests that this supplement may reduce the frequency of hot flashes and night sweats.

Medication–Hormone therapy, or hormone replacement therapy (HRT), is where people take medication that contains estrogen to regulate hormone levels. HRT can relieve many menopausal symptoms, including hot flashes and night sweats.

Women who had their uterus removed by hysterectomy can take estrogen alone. But women who still have their uterus are at risk of endometrial cancer if they do so, and they should take a medication that contains both estrogen and progesterone. By combining these two hormones, it may reduce the risk of endometrial cancer compared to administering estrogen alone.

A doctor will tailor hormone therapies for the individual, according to relevant risk factors, and will prescribe the lowest effective dose of hormones to reduce side effects. Doctors do not usually recommend hormone therapy for women who have had a type of cancer that is sensitive to hormones, such as breast cancer. The reason for this is because these cancers grow faster in the presence of additional hormones. Similarly, doctors do not recommend this treatment for women who have had a blood clot.

Antidepressants–Various medications that are categorized as antidepressants can also be used to reduce hot flashes and night sweats, although they are not as effective as hormone therapy.  However, they are a good option for women who cannot receive hormone therapy.

The FDA approved the use of paroxetine, an antidepressant, to treat hot flashes. Other antidepressants may also help, including venlafaxine and fluoxetine.  Dizziness, nausea, dry mouth, weight gain, or sexual dysfunction are possible side effects of these medications. Antidepressants can be an effective treatment for hot flashes and may only need to be taken during the menopausal transition when symptoms are occurring.

Other Medications–There are several prescription medications that can be used to relieve hot flashes and night sweats. However, these are off-label so not approved for this use and should not be taken for menopausal symptoms unless prescribed by a doctor.

These include:

• Clonidine, an anti-hypertensive drug usually used to lower high blood pressure. It can be taken as a pill or by skin patch. Possible side effects include constipation, dizziness, difficulty sleeping, and dry mouth.
• Gabapentin, an anti-epileptic drug usually used to treat seizures. Possible side effects are difficulty sleeping, dizziness, and headaches.

Outlook–Most women experience hot flashes and night sweats when going through menopause. Some women only experience occasional hot flashes that do not get in the way of daily life, but for others, they can be very uncomfortable.

Women can try home remedies to help with menopausal symptoms, and in severe cases, they can turn to medications, including hormone therapies.

It is always advisable to speak with a doctor about the best and safest methods for relieving menopausal symptoms, as these can vary among individuals.

Joana Cavaco Silva is a writer with Medical News Today.