Why do women experience hot flushes during the menopause?

A very common symptom experienced by women going through the menopause is hot flushes. This often has an impact on sleeping and can effect one’s general day to day life, which can be very distressing. The important thing to remember is that every woman may experience this at some stage, so you are not alone in your experiences.

These symptoms are thought to be due to the fluctuating levels of hormones, mainly estrogen. During the menopause, estrogen levels fall dramatically. It is believed this fall in estrogen has an effect on the way the hypothalamus (control centre in the brain) senses body temperature, which may result in over-heating. This then leads to a counter-response in an attempt to cool the body down. More blood is directed to the skin (one of the causes of hot flushes and reddening of the skin) and the sweat glands start working to cool the body down (menopausal sweat).

Herbs to alleviate hot flushes:

Black Cohosh- It is believed the main mechanism behind Black Cohosh and the reduction of hot flushes could be its ability to act similarly to the hormone estrogen in the body, due to it containing phytoestrogens (compounds that act like estrogen) and reduce the incidence of hot flushes.  A good dose would be somewhere between 40-80 mg per day.

Sage- This herb may help to reduce the incidence of night sweats. It contains estrogen- like properties that can help to increase levels of estrogen. More specifically the sclareol (a chemical compound) it contains mimics the effects of estrogen and has an estrogenic structure which is responsible for stimulating the body to make more estrogen when deficient in this. A good dose per day would be 2500mg.

Red Clover- This herb also works to increase estrogen via the isoflavones (chemical compounds with estrogenic properties) it contains, which helps to reduce the severity of hot flushes both in the day and night, helping to improve sleep. This increase in estrogen also helps to slow down bone loss, which can be another issue associated with the menopause. The recommended dose per day for this is anywhere between 40mg to 200mg to treat hot flushes.

Agnus Castus- This herb is most useful in peri (pre)-menopausal symptoms, which normally pertains to hot flushes. Agnus Castus is an adaptogenic herb, which means it can work to increase or decrease estrogen levels in the body depending if there is a deficiency or not, which in this case there is.  A dose beneficial for hot flushes would be 200mg of the standardised extract per day for at least three months.

Motherwort- As this herb helps to increase estrogen also throughout the body, this is thought to aid in the reduction of hot flushes and night sweats and it also has a calmative effect on the system helping you to go back to sleep if you have woken up due to night sweats. A dose beneficial for the menopause would be a minimum of a ¼ teaspoon per day for at least 4 weeks.

Dietary changes- Diets high in omega 3, organic foods, lean animal and plant proteins, whole grains and antioxidants and low in saturated fats are generally beneficial for hormonal balance, as these are rich in the vitamins and minerals to balance hormonal levels and also have anti-inflammatory properties which may help to balance symptoms such as hot flushes.

Spicy foods, alcohol, chocolate, lemon, hot liquids caffeinated drinks, monosodium glutamate, sodium nitrate, found in cured meats such as hot dogs, bacon and ham and sulphites found in red wine, dried fruits and cheddar cheese should be avoided if these cause any issue, so doing a food diary may be useful to determine which foods are a trigger for hot flushes.

Lifestyle changes:

Other triggers for hot flashes may be smoking, tight clothes, stress or hot environments, as these can affect hormonal balance, trigger the hot flushes by causing inflammation or by simply over-heating, so avoiding these may be helpful, or even minimising some of these may have a positive effect.

Things to consider:

Please exercise caution if you are on any medication, as certain herbs should be avoided in some cases. It is best to inform your GP or a medical herbalist before starting any supplementation in case of any contra-indications.

Also certain conditions like diabetes may be affected by taking herbs such as Sage, as this lowers blood sugar. People with heart disease should avoid taking Motherwort. Black Cohosh, Agnus Castus and Red Clover is not advised in liver disease, endometriosis or cancer.