In the heat of the night

Let’s get down and dirty with a really annoying symptom, shall we?  How about this – hot flashes and night sweats.  For those of us who are or have dealt with them, we know it’s not just a little heat intolerance. 

There’s very little forewarning and there may or may not be triggers.  But the effect is the same – red face, dripping sweat, no small amount of frustration and, perhaps, embarrassment, and then my favorite part when it finally passes (please hear the sarcasm in my voice) – the chills.  Hot flashes and night sweats are going to be a little different for every woman, but that’s the general story. 

Let me start out by saying that this is, in some respects, a rite of passage for women, one way or the other.  I say it that way because menopause can be natural or interventional, like having a hysterectomy.  Regardless, we all potentially will deal with hot flashes and night sweats.  I am also a firm believer that we have ways of supporting our body so that we don’t have to stress or suffer because of a common symptom – rite of passage or not.

Here is my approach to hot flashes and night sweats (and what we’ll talk about here):

  • Talk to your doctor about your symptoms to be sure there isn’t potentially something else going on;
  • Consider the therapies that have been demonstrated in research to be effective;
  • Consider additional options that focus on personal choices and control.

Causes of hot flashes and night sweats

While hormone changes are the most common cause of hot flashes and night sweats, it is worth mentioning some of the other potential causes – thyroid issues, chronic stress, infections like tuberculosis, medication side effects, low blood sugar and some cancers.  If you are starting to experience hot flashes or notice you wake up in a pool of sweat in the morning, it’s worth talking to your doctor about it. 

Conventional Approaches – What to expect when you talk with your doctor

When you discuss with your healthcare provider and both agree that the most likely cause is hormone change, don’t be surprised if they offer you estrogen or progesterone replacement.  Hormone replacement is by far the most common, and most researched, approach to these and other symptoms of perimenopause and menopause. 

One of the other more common approaches your doctor may offer is a medication in a class of anti-depressants known as SSRIs.  Zoloft, or sertraline, is most likely the one that may come up.  These medications have been pretty well-studied and demonstrate improvement in hot flashes and with some of the mood issues that come along with menopause, as well.  Don’t let it throw you if an anti-depressant is the solution offered – this one doesn’t just mean that they think all of this is in your head. 

Integrative Approaches – What does the research say about natural therapies?

Interestingly there is one intervention that scores better points than even hormone replacement or SSRIs in managing these symptoms – acupuncture.  Don’t ask me how it works but it does.  And the research is pretty robust.  One to two treatments a week is typically enough to offer some significant relief, and typically within one to two weeks, too.  Once your symptoms have calmed, the acupuncturist will likely decrease the frequency of treatments.  My one recommendation here is to try and find a provider who treats a lot of women with the same symptoms.  This is like looking for the surgeon who does the most knee replacements; they know the procedure and they have consistently good success. 

Many women are looking for a non-pharmaceutical pill to take that will help.  The research here isn’t as impressive, but Black Cohosh can make a difference for some women with mild symptoms over a short period of time.  The brand most commonly used in the research is Remifemin.  The safety note with this one – how it works isn’t absolutely clear but it likely works on estrogen receptors.  If you have a personal or family history of breast cancer, be careful.

There certainly are others that both providers and individuals swear by – ginger, ginseng, kava, red clover – but there is not solid research demonstrating the effectiveness.  And keep in mind, every pill we take causes an effect by changing something in your body.  Do your research and consider discussing with your doctor before starting any new supplement – risks, benefits, interactions, side effects, etc.

Additional options…

I love Ayurveda.  I use it a lot in my own life and health journey.  It appeals to me because it is the epitome of self-care – food choices, exercise, routine, listening to my body and overall balance.  It just appeals to me.  Ayurveda doesn’t look for a diagnosis.  It looks for balance and imbalance.

When we think of hot flashes and night sweats in Ayurveda, it is interpreted as too much heat (or Pitta) in the body.  To find some balance, we look for ways to decrease heat. 

In your food choices, avoid spicy or salty foods, drink room temperature or cool water (not ice cold), seek out and enjoy sweet, juicy fruits.  Mint is very cooling, so you could try adding mint leaves to your water or having a cup of mint tea. 

In your routine, reduce heat by relaxing in the late afternoon and evening instead of pushing to get that work or those chores done before tomorrow.  Consider a relaxing walk in the evening instead of HIIT or CrossFit. 

And if you like aromatherapy, experiment and see how the smell of rose may help cool cool things down.  There are a lot of other lifestyle approaches to hot flashes and night sweats in Ayurveda if it is of interest to you.  Dr. Nancy Lonsdorf has a great book called The Ageless Woman that I highly recommend!  

Ayurveda uses a lot of herbals.  One product I like for hot flashes and night sweats is VPK Hot Flash Relief.  In all transparency, it is not a product that has been vetted through rigorous research but it is made in the tradition of Ayurveda with well-known ingredients.  My safety note on these – any traditional Ayurveda supplement or herbal has the potential to have excess heavy metals and other contaminants; research has proven that.  The VPK brand is one of my favorites because they are tested multiple times for quality and safety. 

Regardless of how you decide to approach your own experience with hot flashes and night sweats, it’s important to know there are effective options.  Ultimately, it’s about finding what works for you and your body, your goals and your values.  If you do that work before you talk with a doctor, your visit will potentially be a lot easier!

Self-Care Strategy

Be the Expert in You!  I believe we all need to understand that while doctors strive to be experts in their field, they are not an expert in you.  You have to be that expert. 

Before you go see a doctor, know what your goal is for the visit and for the health concern you’ll be discussing.  If it is simply “I want to feel better” then be able to clearly explain how you feel now and how you want to feel in the future.  Be clear and honest with them on what you have tried and haven’t tried, what worked and what didn’t, and what concerns you have.  Know if you’re willing to walk out with a prescription or not. 

And most importantly, if they offer a treatment plan that you know you won’t follow – tell them!  Don’t walk out empty handed or without a real plan to try.  There are almost always alternatives to the typical treatment plan. 

Keep in mind, just like you can say you aren’t going to follow through, the doctor has the right to say “this is it”.  If it comes down to that, ask why.  Ask with curiosity and an open-mind so you can understand why they feel so strongly about the treatment plan.  Ask about risks and benefits.  Ask about alternatives.  Ask if they would recommend the same treatment plan for their mother, wife or daughter if they were in the same situation. 

Doctors want to help and they really do want the best for you.  But they need you to do your part.  After all, this is all about you!

Hey there!  Is fatigue another symptom you fight on a daily basis?  If so, I have a free resource, Fight Fatigue with True Self-Care, just for you.  Get your copy here!


Ayurveda, communication, hot flashes, menopause, self-care, Self-Care Strategy

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