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    Alternative therapies for hot flashes/who suffers the most
    Mary Jane Minkin, MD posted:
    Hi everyone-
    Lainey suggested that we chat about these topics, which I guess do come up "occasionally"-like every day!
    Just a primer on hot flashes: about 20% of menopausal women get no hot flashes; about 20% are totally wiped out by them-and the rest of us are in the middle. We have no idea why this happens-hormone levels are the same in the severe sufferers and the folks who get none-as I explain to my med students, a sure Nobel Prize for the folks who figure this one out.
    Certain conditions make them worse. Smokers go through menopause about 1-2 years earlier than non smokers, and suffer worse hot flashes than non smokers when they do. Obese women have more severe hot flashes than slender women.
    Certain ethnic groups show differences. Asian women seem to have less of a problem with hot flashes; African American women seem to have worse problems.
    Hot flashes for many women are worse in the perimenopausal years; and hot flashes do tend to get better over time. However, even after 10 years since the last period, about 15% of women still have significant hot flashes.
    What can we do on our own to make things better? A regular exercise regime seems to work (exercise helps just about everything). Avoiding known triggers helps. What are typical triggers? Red wine, hot coffee, spicy foods-those bother many women.
    Sleeping in as cool a room as you can usually helps at night; and keep another nightgown next to the bed if you wake up soaking.
    Layered dressing is good for the daytime.
    What about foods? There is some data to suggest that soy foods tend to be helpful (see the comment on Asian women- who eat high soy diets.) There is some controversy about soy products in women with breast cancer; I would recommend you clear that with your oncologist.
    There is very little data on other food products being helpful.
    As far as over the counter products: there is some data on black cohosh (although again it is controversial)-I personally recommend the German brand, Remifemin (Alert: I have consulted for the company, but I was asked to consult because I do recommend it)-in Germany herbal products are very carefully regulated; in the US some brands are better regulated than others. Cohosh is not a plant estrogen (that is the concern about soy: soy is rich in isoflavones, which many folks refer to as weak plant estrogens)
    Again, there is very little data on other herbal products.
    As far as prescription remedies, of course there is estrogen: which is the substance to which all other remedies is compared, as it works the best. Two alternative medications which are prescribed currently (although what is called "off-label"-they are not officially recommended on the label for this indication) are SSRI and SNRI antidepressants, and gabapentin (Neurontin). Of course, as with all recommendations, you want to check in with your health care provider, as your situation may not be optimal for these recommendations.
    But as I tell all my patients: there is some help for just about every one!
    Mary Jane
    Lainey_WebMD_Staff responded:
    Exercise helped me a great deal. Just walking briskly for 1 hour, twice a day has almost completely stopped my hot flashes. I also cut red meats and increased my fruits and veggies.

    Have you ladies tried to change your diet, or increase exercise?
    An_205908 responded:
    I heard Evening Primrose Oil can help, especially combined with Black Cohosh. But I've not tried the latter.

    My best friend keeps an old-fashioned fan with her at all times, pretty and practical and folds away nicely.
    RBGarner responded:
    Does Amberen really work? I have read the claims on the web site, but am skeptical to make the heafty investment. Any thoughts on this?
    jmetwin responded:
    I am trying low dose anti-depressent suggested by my gynocological encologist and it is working
    Nomind540 responded:
    Black Cohosh has helped some before & I'm trying it again as well as healthy eating and increasing my walking. But I do have a question about meds that I am on and weather or not they can / are increasing hot flashes and if hot flashes are decreasing med effects... am on high doses of pain meds for over 5 yrs now and just read how part of brain effected by menopause and herbal products is the part where seritonin (spelling sorry) is produced... is my meds making things worse? They don't seem to work as well - is menopause somehow causing a difference? Hot flashes are severe - I celebrate a night when I can sleep 3 hrs without waking soaking wet.Any info is gratefully accepted.
    chezlou responded:
    Are heart pulps part of this whole menopause thing? I read on a blog about it but right now trying to draw a connection between the two. The heart pulps (flip flops) are happening at night. Almost to the point of not being able to sleep. I started a discussion...then I saw this one.

    Just need some help here. I feel like I'm going crazy
    LittleMarley replied to Lainey_WebMD_Staff's response:
    Yes I have done both an found a great inprovment.
    dawnw58 responded:
    Hi. I have been having extreme night sweats and an occasional one during the day. My biggest concern is my low body temperature. It usually is around 97 but has been running in around 95. What can be causing this? Is there anything I can do to change this?
    nanzhud responded:
    Due to direct family history of Ovarian Cancer, I had a Supracervical Hysterectomy with Bilateral Salpingo Oophorectomy on December 13th 2010. At my post-op appointment I discussed with my GYN my hot flashes and night sweats. Basically 24/7 about every 5 minutes! Resulting in very little sleep. Because of my family history and the link between ovarian and breast cancer, I cannot do HRT. The Dr. perscribed for me .25mg of (off-label) Zoloft. When I didn't feel much change, she increased it to .50mg. It was like night and day. At that point, I just wanted something to help. Now, 2.5 weeks later, I'm reading and researching and wondering if this is the right medicine to be on. I feel like I should have done a bit more research first, but was pretty desperate. Now, I believe that since its just been a little over 2 weeks, I want to wean myself off of the Zoloft and try to find a natural remedy, like the Black Cohosh. What is the best way to wean myself off of the .50mg of Zoloft?
    Thank you!
    christskid responded:
    I have a question about premenopause numbers. What does the FSH, LH and TSH need to be? What is menopausal and what is pre and what is not in menopause yet? I have results and do not know what they mean.
    redsox24 responded:
    I take 5000 IU of Vitamin D. My hot flashes and night sweats completely disappeared.
    Paladin9 replied to chezlou's response:
    Yes, the can be a part of peri-menopause. In fact there are 35 symptoms of which heart palpitations are a part. But, you should always consult with your doctor to be sure.
    Lainey_WebMD_Staff responded:
    If you ladies have questions for the community, or our expert, Dr. Minkin please post using the discussion icon. Sometimes questions aren't found in a thread.

    Yours in health,
    Lainey :)
    Loonah responded:
    Hi Mary Jane

    I just posted today, I don't know if you watch the posts, but I sure need some help/advice...I posted 3-10-11. Thanks much!

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