Medicines that work for menopausal hot flashes

If you’ve ever found yourself gripping the frame of an air conditioner or fan on full blast to tame a hot flash, this article is for you. A hot flash is more than an intensely uncomfortable moment. It can drench you in sweat and leave you frustrated and irritable. (Sometimes, a little too irritable.)

Fortunately, you don’t just have to deal with hot flashes until they naturally go away. There are safe, effective medications that can help you manage them and get back to feeling like yourself. 

We’ll cover what’s going on in your body that causes hot flashes, then explore your options that can actually help.

What are hot flashes?

Hot flashes are one of the most well-known symptoms of perimenopause and menopause. They are sudden waves of heat that start at your face and neck and spread throughout your body. They’re often accompanied by sweating, heart palpitations, and sometimes chills as they pass. Hot flashes can also bring on feelings of dizziness, anxiety, and irritability. Hot flashes usually last between one to five minutes, and can happen day or night, without warning. 

One of the main causes of hot flashes is the change in estrogen levels that affects how your brain regulates body temperature. As estrogen drops during perimenopause, your brain’s thermostat (the hypothalamus) becomes oversensitive and overreactive. When it thinks your body temperature has changed, it opens blood vessels and triggers sweating to cool you down, even when you don’t need it.

Wondering what helps with hot flashes? They often lessen over time, but if they’re disrupting your daily life, treatments like menopause hormone therapy (MHT), nonhormonal medications, and lifestyle changes can help keep them in check.

How do you treat hot flashes?

Most hot flash treatments fall into three categories: prescription, nonprescription, and lifestyle changes. For some women, hot flashes fade over time as hormones stabilize, but you don’t have to just wait it out. We’ll start with the most effective option. 

Prescription estrogen therapy often provides the most relief from hot flashes. Like any medication, there are benefits and potential risks. So, it’s important to have a candid discussion with your doctor. Based on factors like your age, personal and family medical history, and where you are in menopause, they can help you make an informed decision if estrogen is the right choice for you. However, for many women going through perimenopause and menopause, it’s life-changing.

If MHT isn’t a good fit for you, or if you prefer not to use it, there are other options. Nonhormonal prescription medications can help reduce hot flashes, and certain lifestyle changes can make them less frequent or intense. We’ll walk through all of these approaches so you can find what works best for you.

Menopause hormone therapy (MHT)

Menopause hormone therapy (MHT) replaces the estrogen and sometimes progesterone that naturally decline during perimenopause and menopause. For many women, this is one of the most effective ways to relieve hot flashes and other menopause symptoms. MHT can help stabilize your internal temperature control, reducing the frequency and intensity of hot flashes.

Depending on your symptoms and medical history, your provider may recommend:

• Estrogen-only therapy: Usually for women who have had a hysterectomy.
• Combined estrogen and progesterone therapy: For women with a uterus. The progesterone protects against uterine cancer.
  

MHT comes in several forms for hot flash treatment, including tablets, patches, gels, and creams. Best practice is to use the smallest effective dose for the shortest duration needed to relieve symptoms. Many women find relief within a few weeks, with full effects typically appearing after one to three months of consistent use.

There’s a lot of misinformation floating around about MHT. That’s why it’s important to do your research and come to your doctor with any questions to get the real scoop. Like any other medication or treatment, MHT can cause side effects. The most common include breast tenderness, bloating, mood changes, and headaches. Long-term use and starting MHT more than 10 years after menopause or after age 60 carry additional risks. It’s important to review your complete medical history with your doctor before starting therapy.

If you’re considering MHT, talk with a doctor about whether it’s right for your situation. QuickMD doctors can help you weigh the benefits and risks based on your personal health profile. 

Nonhormonal prescription medications

If you cannot or would prefer not to take MHT, there are other prescription options available that can help you effectively manage your hot flashes. Though many of these medications were originally developed to treat other conditions, they’ve been shown to help regulate the brain’s temperature control system. 

Common options include:

• Effexor XR (venlafaxine): An SNRI antidepressant used to treat depression, anxiety disorders, and certain mood disorders. Works on the serotonin and norepinephrine pathways to reduce hot flashes.
• Paxil (paroxetine): An SSRI antidepressant that treats depression, anxiety disorders, and some forms of panic disorder. Reduces hot flashes by impacting serotonin pathways. Available as a low-dose formula called Brisdelle, the only SSRI FDA-approved specifically for hot flashes.
• Lexapro (escitalopram): An SSRI used for generalized anxiety disorder and depression. Helps lessen the severity and frequency of hot flashes by acting on serotonin.
• Prozac (fluoxetine): An SSRI antidepressant used for depression, anxiety, obsessive-compulsive disorder, and other mood disorders. Reduces hot flashes by modulating serotonin levels in the brain.
• Neurontin (gabapentin): A medication for nerve pain and seizures. Decreases hot flashes by acting on the nervous system to regulate temperature.
  

Each medication works differently, and you should work with your doctor to ask about different options to see which works best for you. Common side effects include nausea, dizziness, and changes in sleep or mood. Always talk with your doctor before taking, switching, or stopping medications so you can taper safely and minimize side effects.

Over-the-counter treatments

If you’d rather start with over-the-counter options, there are several supplements that some women find helpful for mild hot flashes. However, it’s important to know that supplements are not regulated by the FDA. This means safety, dosages, ingredients, and effectiveness are not monitored and can vary widely between brands. Research on these supplements shows mixed results, and they tend to be less effective than prescription options. If you are interested in supplements, look for brands that use third-party testing for quality assurance.

Common supplements some women try for hot flashes include:

• Soy isoflavones: Plant-based compounds that may help with mild hot flashes by acting as weak estrogens in the body. 
• Black cohosh: Traditionally used for menopausal symptoms, though scientific evidence on its effectiveness is limited and mixed.
• Ashwagandha: An adaptogenic herb used to reduce stress and anxiety, which may indirectly help with hot flashes by improving overall well-being.
• Flaxseed: Contains plant compounds with weak estrogenic activity that may help with hot flashes. Also offers cardiovascular benefits, including regulating blood pressure and cholesterol. 
• DHEA: A hormone your body naturally produces to make estrogen and testosterone. Some studies suggest it may help with hot flashes, but it can interact with medications and isn’t appropriate for everyone. 
  

These supplements can take up to several weeks to show any effects, and results vary from person to person. Before starting any supplement, talk with your doctor to make sure it’s safe and won’t interact with any health conditions or medications you’re taking.

Lifestyle changes to treat hot flashes 

Hot flashes can be annoying and unpredictable, but lifestyle changes can make them easier to manage. Paying attention to your environment, what you eat and drink, and your stress levels can make a real difference in how often and how intensely hot flashes occur. Here are a few changes that can help:

• Stay hydrated: Drinking cold water throughout the day helps regulate body temperature. Aim for at least 8 cups of water per day and consider adding electrolytes to replace what you lose through sweating.
• Avoid triggers: Spicy foods, alcohol, and caffeine can worsen hot flashes and night sweats by interfering with hormone balance and sleep quality. Try limiting these or replacing them with alternatives like herbal tea, decaf coffee, or milder seasonings.
• Exercise regularly: Light to moderate activity like walking or strength training improves circulation, supports hormone balance, and may reduce hot flash frequency. Aim for 150 minutes of moderate aerobic exercise per week.
• Maintain steady blood sugar: Avoid sugary or highly processed foods that trigger hot flashes through blood sugar spikes. Focus on leafy greens, lean proteins, complex carbohydrates, and healthy fats like nuts and avocados.
• Keep cool at night: To consistently get a good night’s sleep, keep your bedroom temperature set to 65-68°F and use cooling blankets or sheets.
• Dress in layers: Wear breathable fabrics like cotton or linen that you can easily remove when a hot flash starts. 
• Practice stress management: Keeping your nervous system calm may help reduce the intensity of hot flashes. Experiment with yoga, deep breathing, or mindfulness techniques and see which works best for you.

Speak with QuickMD doctors to discuss treating your hot flashes or other menopause symptoms

You don’t have to deal with hot flashes on your own. Menopause hormone therapy (MHT) can help tame hot flashes, but you have other options, too! No matter what you choose, having someone in your corner who can help you better understand what’s happening during perimenopause and menopause can make a world of difference. Here at QuickMD, you’ll work with supportive, knowledgeable doctors who can walk you through your options and help you find what works best for you.