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The science of stopping hot flushes Part 2: non-medical therapies

As we’ve seen, there’s an array of medical treatment for hot flushes. But let’s say that for health reasons you can’t use them, or you don’t want to. Surveys show that 50-80% of women with flushes try some sort of non-hormonal or non-medical therapy.

Last year the North American Menopause Society (NAMS) carried out a scientific review of these options. You might be surprised to know, as I was, that after sifting through the science, their top accolades went to psychological therapies: cognitive behavioural therapy (CBT) and clinical hypnosis. 

CBT is widely used for treating problems such as depression and anxiety. It helps people to identify negative or unhelpful thoughts and behaviours and replace them with more positive ones. In the study that NAMS identified, women were allocated to either a 2-hour group session each week for 4 weeks, a self-help program using a CD and a book, or no treatment. 

The focus was on developing accepting attitudes to flushes and sweats, plus learning stress reduction and slow belly breathing. Sixty-five per cent of women doing the group sessions and 73% in the self-help program reported substantial improvement in their experience of flushes. Frequency of flushes also fell by around 40%.  

Hypnosis combines deep relaxation with mental imagery and suggestion. Like CBT, women who’ve used it report fewer flushes of less severity. 

Some therapies show promise, but NAMS says there’s not enough evidence yet. These include weight loss, and certain derivatives of soy isoflavones. 

In one study, women who lost around 4kgs or more were 23% more likely to eliminate flushes, and women who lost 10% or more of their body weight were 56% more likely to eliminate flushes. We do need more research on this, but if you’re overweight and dealing with flushes, shedding a few kilos could make a difference.

On the soy front, research using isoflavones has been hit-and-miss, but a study using a product called Novasoy 400 concluded that taking a dose 2-3 times a day provided relief, whereas taking it once a day didn’t.

There’s not much hard evidence for over-the-counter supplements such as black cohosh (sold as Remifemin), red clover (Promencil), maca, dong quai, vitex (or chasteberry), omega-3 oils, or evening primrose, even though you can no doubt find women who swear by them. 

It’s standard advice to avoid ‘trigger’ food and drink (such as spicy or hot foods, alcohol or coffee), but NAMS isn’t convinced by the research. You’ll have to check that out for yourself because what triggers a flush for one woman can have no effect on another. One of the beauties of menopause is that we’re forced to pay attention to and learn about our own bodies. 

There’s also no evidence that exercise reduces flushes, even though it can help with symptoms such as anxiety and depression.  

The research on acupuncture isn’t clear: women who use it seem to fare better than women who don’t, but in studies comparing ‘real’ and ‘sham’ treatment the results are similar. 

Data on smoking is clear though. It makes flushes worse. 

If I was advising women, say in their 40s, for whom menopause is ahead, I’d say get yourself fit and healthy physically, mentally and emotionally. If your hormones are out of whack now, you’re going to have a tough time in your 50s, so do what it takes to bring your system into balance. Start making time for yourself and don’t be burning the candle at both ends. 

My hunch is that if well-balanced women do get flushes and sweats, they’ll be on the easier end. 

Photo source: Bigstock

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Saturday, March 26, 2016 | Rhonda Anderson