From medication to acupuncture: The best ways to manage hot flushes

Ask any woman what the worst thing about going through the menopause is and chances are they’ll say the sweating and intense rush of heat that spreads across the whole body and face when they experience hot flushes. While the average age of menopause in Australia is 51, women can start experiencing hot flushes before they reach menopause and may still experience them many years after they stop having their period.

Research published by the Mayo Clinic shows that a significant percentage of women in their 60s, 70s and 80s still experience hot flashes and night sweats, while the North American Menopause Society claims that more than half of all middle-aged women who still have regular cycles will experience hot flashes. Brisbane-based obstetrician and gynaecologist Gino Pecoraro recently told Starts at 60: “As many as 60 per cent of women will continue to have hot flushes in particular until they die. While 40 per cent don’t, up to 60 per cent do and it depends on which study you read as to what percentage. It can have a major impact on a woman’s life.”

Women experience hot flushes and other menopausal symptoms such as vaginal dryness, irritability, mood swings, difficultly concentrating and difficulty sleeping because the body produces less oestrogen. In many cases, it’s this hormone that’s used as a treatment to ease symptoms and women will be prescribed hormone replacement therapy (HRT) to increase levels of oestrogen in the body via patches, creams or tablets.

Some women may also need to take another hormone called progesterone – which is usually released in the ovaries. Pecoraro explained: “If you’ve got an intact uterus, you need to have progesterone as well, otherwise we can cause a thickening or overgrowth of the lining of the uterus. In time, it can become precancerous or even cancerous.”

Because HRT is a type of medication, it’s possible for women to experience side effects including cramps, headaches, bloating, breast tenderness and feeling sick. In these cases, other medication may be used to reduce hot flushes.

“There are some side effects to treatments and that’s why you need to discuss any proposed treatment with your general practitioner or gynaecologist who knows about such things,” Pecoraro said, adding that women may also be at increased risk of blood clots and a higher risk of breast cancer if they take both progesterone and oestrogen. He added: “But they’re more than balanced by the decrease of broken bones and the decrease risk in bowel cancer if you take, for example, combined oral hormone replacement therapy.”

For women who are concerned, Pecoraro said that some medication used to treat high blood pressure is effective in reducing hot flushes, while some antidepressants can also have similar effects.

“If women don’t want to use hormonal treatments, we can try them,” he said.

Of course, these medications can also come with side effects and it’s always important to talk with a GP or health professional about which option is going to be best for you. Other research shows that natural therapies may also be beneficial in reducing hot flushes.

Research published earlier this year in the BMJ Open Journal found a brief course of acupuncture could help ease hot flushes and other menopausal symptoms including sweating, mood swings and skin and hair problems. The benefits were found to be particularly rewarding for women with moderate to severe symptoms and saw reductions in hot flushes, excess sweating, mood issues, sleep problems and issues with hair and skin. Participants in that study reported significantly less troubled hot flushes after just three weeks.

“There is some evidence that calming thoughts or mindfulness may help with hot flushes as well,” Pecoraro added.

He also said that diet can sometimes make hot flushes worse and women should stay away from caffeinated drinks such as coffee and soft drinks, alcohol and even spicy foods if they’re trying to reduce the severity of symptoms.

“There’s plenty of stuff, both hormonal and non-hormonal – including lifestyle – that can be done to make their lives a little bit easier,” Pecoraro explained. “They don’t need to live with those symptoms and they just need to ask for help and go see someone who can help them.”