Understanding and Managing Menopausal Hot Flashes

Hot flashes can be triggered by the hormonal shifts of menopause, but similar symptoms may also arise from other health conditions. Nore Women’s Health’s team of specialists is trained to distinguish menopause-related hot flashes from those caused by other medical issues, ensuring women receive accurate diagnoses and effective treatment. This is achieved through:

• Comprehensive evaluations that consider age, menstrual history, symptom patterns, and overall health.
• Advanced testing when necessary to rule out other causes, such as thyroid dysfunction or neurological conditions.
• Education on both common and lesser-known menopause symptoms, empowering women to better understand their bodies and seek timely care.

Personalized Hormone Therapy Options

Nore Women’s Health offers both traditional Hormone Replacement Therapy (HRT) and Bioidentical Hormone Replacement Therapy (BHRT), tailoring each plan to the individual’s symptoms, health history, and preferences:

Bioidentical Hormone Replacement Therapy (BHRT)

Uses hormones derived from plant sources that are chemically identical to those produced by the human body.  BHRT is often preferred by women seeking a more “natural” approach and can be customized to each patient’s unique hormone profile based on detailed lab testing.

Available in various forms, including creams, gels, oral troches, and long-lasting hormone pellets where these plant-based hormone pellets are inserted under the skin, providing consistent hormone release for up to three months and reduces the need for daily dosing.

BHRT can effectively reduce the frequency and severity of hot flashes, improve sleep, stabilize mood, and support overall well-being.

If you choose to do Bio-Identical Hormone Therapy, the results from these tests are combined with your age, weight, and personal symptoms will help us determine the correct delivery method and dosage for you as an individual.

Traditional Hormone Replacement Therapy (HRT)

• Utilizes standardized, FDA-approved synthetic or animal-derived hormones.
• Offers well-established efficacy for hot flashes and other menopause symptoms, with dosing and combinations tailored to individual needs.

Both HRT and BHRT can be delivered via pills, patches, creams, or injections, depending on lifestyle and medical considerations.

Collaborative, Patient-Centered Care

Nore’s nurse practitioners and physicians take time to explain the benefits, risks, and differences between BHRT and HRT, ensuring women make informed decisions.

Treatment plans are developed collaboratively, considering patient values, preferences, and any concerns about side effects or long-term safety.

Comprehensive Symptom Management

Hot flashes rarely occur in isolation. Nore Women’s Health addresses the full spectrum of menopause-related symptoms, including:

•     Night sweats
•     Sleep disturbances
•     Mood swings and anxiety
•     Memory and concentration issues (“brain fog”)
•     Vaginal dryness and discomfort
•     Weight gain and metabolic changes
•     Bone density loss and joint pain

By treating the underlying hormonal imbalance, Nore’s therapies can provide relief from multiple symptoms, not just hot flashes.

Non-Hormonal and Lifestyle Support

For women who cannot or prefer not to use hormone therapy, Nore Women’s Health offers:

• Guidance on lifestyle modifications, such as diet, exercise, and stress management, which can help reduce hot flash frequency.
• Education on dietary phytoestrogens (e.g., soy, flaxseed) and supplements, as well as non-hormonal medical options when appropriate.

Insurance and Affordability

Nore accepts most major insurance plans and offers transparent pricing, making advanced menopause care accessible to a broad range of women.

Several natural remedies may help manage hot flashes, though their effectiveness varies and scientific evidence is often mixed or limited. Here’s a summary of the most studied and commonly used approaches:

Lifestyle and Behavioral Strategies

• Regular exercise: Engaging in physical activity several times a week can reduce the frequency and severity of hot flashes for some women.
• Stress reduction: Techniques like yoga, meditation, mindfulness, and deep breathing exercises may help ease hot flashes and improve coping.
• Environmental adjustments: Dressing in layers, using fans, sipping cold drinks, and keeping living spaces cool can provide immediate relief.
• Avoiding triggers: Reducing intake of spicy foods, caffeine, and alcohol, and quitting smoking, may lessen hot flash episodes. 

Dietary Approaches

• Plant-based foods: Diets rich in fruits, vegetables, whole grains, nuts, and seeds-especially those containing phytoestrogens like soy, flaxseed, and sesame-may help some women, though evidence is inconsistent.
• Cold drinks: Drinking cold water or fruit juices can help you feel cooler during a hot flash.

Herbal and Dietary Supplements

Many supplements marketed for menopausal symptoms are supported by small or inconsistent studies, with mixed or inconclusive results. Herbal supplements are not regulated by the FDA in the same way as prescription drugs. In addition, natural supplements can cause side effects or interact with prescription medications. Natural does not always mean safe or effective.

So while some dietary and herbal supplements may offer relief from hot flashes, they should be approached with caution. The limited evidence, quality control concerns, and risk of side effects mean they’re best used under medical supervision, and ideally as part of a broader strategy that includes lifestyle changes, medical options, and symptom monitoring.

• Black cohosh: Some studies suggest black cohosh may reduce hot flashes, but results are mixed and rare side effects like liver problems have been reported.
• Soy isoflavones: Found in foods like tofu and soy milk, these plant estrogens may help some women, but research findings are inconsistent. Food sources are preferred over supplements.
• Red clover: Contains isoflavones and may reduce hot flash frequency, but more research is needed to confirm its effectiveness. It may be risky for women with estrogen-sensitive cancers or taking hormonal medications.
• Flaxseed: Contains phytoestrogens and omega-3s; some women report benefits, but evidence is mixed.
• Evening primrose oil: Some studies suggest it may help, but results are not definitive and mild gastrointestinal side effects are possible.
• Other herbs: Dong quai, ginseng, and others are sometimes used, but most have not shown clear benefit in studies and may have risks or interact with other medications.

Always consult a physician, especially if you are on other medications or have a health condition such as:

• Breast cancer (past or present)
• Blood clotting disorders
• Liver disease

Mind-Body Therapies

• Cognitive Behavioral Therapy (CBT): Can reduce how much hot flashes bother you, even if it doesn’t reduce their frequency.
• Hypnosis: Some evidence shows hypnosis may help both the frequency and severity of hot flashes.

Acupuncture

Acupuncture: Some studies suggest it may help reduce hot flashes, while others show no significant benefit. Results are mixed.

Other Considerations

• Consult your healthcare provider before starting any supplement, as herbal remedies and dietary supplements can interact with medications or have side effects.
• Effectiveness varies: What works for one person may not work for another, and strong scientific evidence is lacking for many natural remedies.

YES!

Bioidentical Hormone Replacement Therapy (BHRT) can help relieve hot flashes in many women going through perimenopause and menopause.

How BHRT Works for Hot Flashes

BHRT involves the use of hormones—typically estrogen and progesterone—that are chemically identical to those produced by the human body. These hormones are usually derived from plant sources (like soy or yams) and are compounded or standardized to match each individual’s hormonal profile.

Since hot flashes are primarily triggered by a decline in estrogen levels and subsequent disruption of the brain’s thermoregulation, restoring estrogen through BHRT can help stabilize the hypothalamic “thermostat” and expand the narrowed thermoneutral zone. This reduces the likelihood of overheating sensations and sweating episodes.

Evidence of Effectiveness

Clinical studies show that estrogen therapy—whether bioidentical or conventional—is the most effective treatment for hot flashes. According to the North American Menopause Society (NAMS), hormone therapy remains the gold standard for managing vasomotor symptoms (i.e., hot flashes and night sweats) in women under age 60 or within 10 years of menopause, provided they are low-risk candidates.

BHRT is considered effective when:

• Customized dosing is used to closely mimic the body’s natural hormone levels.
• Regular monitoring ensures hormone levels stay within a safe and therapeutic range.

Important Considerations

• Risks and benefits of hormone therapy (including BHRT) depend on personal health history, age, timing of initiation, and whether estrogen is taken alone or with progesterone.
• Women with a uterus typically need progesterone alongside estrogen to protect against endometrial cancer.
• Not every woman is a good candidate for BHRT—especially those with a history of breast cancer, blood clots, or cardiovascular disease.

For many women, BHRT can provide meaningful relief from hot flashes by replenishing estrogen and restoring hormonal balance. However, treatment must be personalized, monitored by a knowledgeable provider, and weighed against potential risks. Discussing your symptoms and health history with our menopause specialists is the best first step.

If you choose to do Bio-Identical Hormone Therapy, the results from these tests are combined with your age, weight, and personal symptoms. They will aid us in determining the correct delivery method and dosage for you as an individual.