Menopause is big business. During the past two years, more than 100 new products for menopause — herbs included — have burst into the market. In the past 12 months alone, women have spent in excess of $600 million for alternative menopause therapies. One of the reasons for this new menopausal economy is hot flashes.

During a hot flash, sometimes called hot flush, the chest, shoulders, neck and head suddenly feel hot for anywhere from a few seconds to 30 minutes. In the most extreme cases, these flashes of heat create drenching perspiration. Other women experience only a slight warming sensation. Most are somewhere in between. Night sweats are hot flashes that occur during sleep. A slight chill sometimes follows the heat surge.

Approximately three-quarters of women have hot flashes, typically affecting women in their late 40s a few years before menopause begins and menstruation has ceased. Hot flashes usually last three to five years.


The Role of Oestrogen

Declining oestrogen levels are thought to trigger hot flashes. Not just menopause, but surgical removal of ovaries (the main source of oestrogen) and even giving birth, can cause oestrogen levels to drop and possibly spark hot flashes. Many women with breast cancer take medications, such as tamoxifen, designed to decrease oestrogen output and, as a result, they too can experience hot flashes.

Oestrogen is the most commonly prescribed conventional treatment for hot flashes and other menopausal complaints. Oestrogen, however, must be avoided by some women, especially those with a history of uterine cancer, phlebitis (inflammation of the vein), varicose veins, hypertension, oedema, fibroids or fibrocystic breasts, as well as those with breast cancer or a strong family history of breast cancer.

Other women simply cannot tolerate the side effects that come with hormonal therapy. These side effects can include breast tenderness, hair loss, acne breakouts and headaches, just to name a few. A third group prefers to use more natural means such as lifestyle and, if needed, other alternative therapies and phytoestrogenic herbs.

Research on alternative treatment is most favourable for phytoestrogens, a broad category of plant-based oestrogen-like compounds found in food and medicinal herbs. Phytoestrogens are similar to oestrogen because of their molecular shape and how they function in the body.


Diet and Lifestyle

Eating foods high in the 20 or so phytoestrogens known — in particular, legumes and beans, nuts, fruits, wholegrain cereals, flaxseeds, teas and berries — may reduce the number or severity of hot flashes. In Asia, where diets are rich in phytoestrogens, hot flashes and other oestrogen-related conditions, such as osteoporosis, breast cancer and heart disease, tend to be less prevalent.

Staying cool, both mentally and physically, also helps. Dress in layers of clothing so you can shed garments when hot flashes hit. Choose natural fibres that breathe and absorb perspiration like cotton. During a hot day, cool off with a fan and a chilled drink. For some women, hot drinks and spicy food provoke hot flashes. Caffeine, nicotine and alcohol may increase the intensity of hot flashes. Last but certainly not least, chill out by practising relaxing techniques through exercise, yoga, meditation and scheduled breaks.


3 Herbs to Try

For women currently taking prescription oestrogen, it is unwise to switch to herbs without a doctor’s guidance. Although phytoestrogens are gentler than synthetic oestrogens, caution should be exercised. If you are pregnant, have thrombophlebitis (inflammation of the vein), a disorder or cancer connected with oestrogen use, any type of oestrogen should be avoided until you visit a practitioner skilled in herbal medicine.

1. Soy

Soy may be considered more of a food than herb, but nonetheless, has become famous in herbal circles for its cooling isoflavones. Research on soy and hot flashes is more abundant than most other herbs. Most studies find at least some benefit to soy. One double-blind, placebo-controlled trial of more than 100 women found that 60 gm of soy protein per day reduced hot flashes by 45% after 12 weeks. The placebo group experienced a 30% reduction in hot flashes. Oestrogen replacement diminishes hot flashes by 70%. More reasons to enjoy tofu with your meals!

2. Black Cohosh

Black cohosh is a large perennial plant found in forests spanning from Tennessee to Ontario. Among American Indian and folk healers, black cohosh has a long history of use for women’s condition, including menopause. According to many German studies, it effectively relieves hot flashes and other menopausal complaints. One trial conducted in Germany found that 80% of 630 women taking the herb had a decline in menopausal symptoms within four weeks.

3. Red Clover

Red clover was first recognised by American Indians for its medicinal and culinary traits. There is little scientific research on its therapeutic value, but there is no doubt that red clover contains phytoestrogenic compounds. Less clear is how effective it is for hot flashes. Anecdotal research, however, supports the herb’s beneficial effects on hot flashes. It is found in many menopausal products and some women do find that this herb indeed helps with their hot flashes.