Help for Hot Flushes

What’s going on? My daughter is having hot flushes in puberty. So are my friends in perimenopause and women I know who are menopausal. It seems hot flushes cross all ages and it is one of the most distressing signs in the landscape of perimenopause and menopause. It’s a signal to the world that something is up with your hormones and why women seek help because it interferes so much with work, home and social life. 

Let’s track what may be happening in your physiology. 

  • The hypothalamus, the master temperature control centre of the brain perceives stress.
  • Estrogen sets the temperature.
  • When estrogen drops suddenly from high to low then back up again in puberty, perimenopause or drops down permanently in menopause it’s the trigger that has fiddled with the thermostat in the hypothalamus. 
  • Enter stress and the release of adrenaline and the on/off switch is flicked on.
  • Hello hot flush or night sweat.

Research suggests women who seem to be most at risk of hot flushes include those that have had particularly bad PMS symptoms around early perimneopause, higher weight, stopping estrogen treatment suddenly, high stress levels or a combination of all these factors.

Stress to the body could be anything from a difficult phone call or conversation at work, a blow up at home, irregular times for eating and sleeping, alcohol and smoking. The standard medical approach to managing hot flushes is limited to estrogen therapy, which in perimenopause can be counter productive or even dangerous if your estrogen levels are high one minute and low the next. 

“Hot flushes are a barometer of too much stress in your life.” 

Dr Bethany Hayes

What to do about hot flushes?

Redefine your plate. Start with 30% protein like wild caught fish, eggs or grass fed meat. 30% good fats include avocado, olive oil, tahini, ghee. 40%, the biggest portion is made up of above ground vegetables. This 30:30:40 is a great start to managing your blood sugar one of the biggest drivers of the stress response and hormone imbalance.

Supplement with magnesium, B vitamins and taurine, the brain calming amino acid that helps to block adrenaline and boost GABA ( ref Lara Briden, Naturopathic Doctor and author of the Period Repair Manual).

Go to bed earlier and sleep longer when you can. Other solutions include:

  • Breathing with peppermint oil

In my work I have had success with women who have acknowledged that their stress levels are the biggest driver of hot flushes. With one client we practised alternate nostril breathing whilst inhaling peppermint oil.  Do this anytime you have a hot flush or feel one coming on. Any relaxation therapy, mind body therapy, and acupuncture can have the same effect. It lowers your stress response and your thermostat.

  • Walking

Getting out in nature, walking, yoga or any exercise you love can help reset the stress thermostat. Exercise increases circulation in the brain, improves brain plasticity and new neural networks decreasing the risk of Alzheimer’s and dementia. So if you feel like you are loosing your marbles then movement of any kind will help you feel more connected, along with the burst of endorphins.

  • Slow down

Say no more often, let go of things that don’t serve you, create more space and time for yourself, even if that means putting others off. Have conversations at work to create a flexible work life balance, maybe a 4 day week or working from home.

  • Herbs

Black cohosh a herb marketed under the brand Remifemin is available at most pharmacies. Studies show that black cohosh can reduce the number and severity of hot flushes and night sweats. Sage essential oil and as an herbal tea can also offer some relief

  • Natural progesterone

Micronised body identical progesterone marketed in Australia as Prometerium© has been shown to reduce hot flushes and improve sleep. Progesterone taken before bed is calming and sleep promoting and has a range of beneficial effects from women in perimenopause and menopause. It requires a prescription from your doctor or can be compounded by a pharmacist. 


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