Are you in your mid-to-late-40s, maybe your early 50s and noticing that your body is changing?
- You’re still having periods, but they’re not the same. They may be shorter, longer, lighter, or heavier, and you can no longer set your clock by them if you could before.
- Maybe you’re sleeping a little less well, waking up too early in the morning and having trouble falling back to sleep.
- Your libido just isn’t what it used to be.
- A few pounds seem to be creeping up around your middle.
- You’re overheated and sweating more than usual, and at inconvenient times?
What’s happening? Simple. You’re on the cusp of menopause.
What is Menopause?
Menopause is the change in our hormones, a decline in estrogen and progesterone that brings us into our “wisdom years.”
It’s a natural transition and an awesome time in life where we get to expand into speaking our truth, care less about what people think about us, and have time to nurture ourselves and our personal dreams. But some of the symptoms can be a royal pain. Many women find hot flashes, insomnia, and mood changes draining and disruptive.
It's also a big deal time in our lives. All of this happening just as kids leave home for college, long-time marriage dynamics may be changing, and your sense of yourself may be changing as you do a midlife self-assessment – so your coping skills may feel like they are on a temporary hiatus.
The actual menopause is defined as when we’ve been period-free for a full year and for most women around the world this occurs around age 51. But there’s a big lead up for many women – often several years of symptoms heralding a change that then may persist after menopause happens. The lead up is referred to as “perimenopause” which in simple terms means the time around the menopause. Going forward in this article I refer to symptoms that occur during this time as peri/menopause to keep things simple.
This series of articles on natural approaches to menopause will start with one of the most common symptoms: hot flashes.
Hot Flashes and Night Sweats
Hot flashes occur when hormonal changes cause a sudden, temporary spike in body temperature. As many as two-thirds of American women experience them. They can occur anytime, with most women who have them reporting several flashes per day, but some women with more severe symptoms having them as often as hourly — and sometime this goes on for over a decade!
Symptoms range from a mild sensation of heat rising up in your body and face, to a seriously uncomfortable feeling of being overheated and even a drenching sweat that can be profoundly embarrassing if your face suddenly reddens or you perspire profusely at an inconvenient time, like in front of a board meeting or while giving a public speech.
Hot flashes at night – night sweats – can soak your PJ's and sheets, wake you up in a chill, and make sleep miserable. While these symptoms usually resolve over time, for some women they persist for years and are disruptive to quality of life.
But there is help!
Medications are Available – But They Have Side-Effects & Risks
At this time in life many women, even those who previously have been “all natural” in their health choices, start considering hormonal medications to stop the symptoms: antidepressants to quell hot flashes and a sleep medication to get a better night’s rest.
For some women, hormone replacement therapy (HRT) in the form of bio-identical hormones is the right choice. And even integrative and functional medicine doctors can be all too quick to dispense them. But not every woman can or, for health reasons, should take hormones. Even natural hormone therapies are not without risks for any woman.
One of my goals is to help women avoid unnecessary and potentially risky medication use. So while I do prescribe them sometimes, outside of severe symptoms, they are a last resort in my practice. Unless symptoms are severe and debilitating, I always suggest a natural approach to my patients first, as I am suggesting to you here.
Dr. Aviva's Herbal Hot Flash Remedies
Over the past 30 years I've developed and used many herbal formulations that effectively relieve peri/menopausal symptoms. Here are my top herbal remedies for your hot flashes. These herbs have been shown to be effective based on clinical trials – and most have centuries of traditional herbal use behind them for safety.
Six to twelve weeks (6-12 weeks) is a good amount of time to try these herbs separately or in combination, to see if you get the level of symptom relief you are seeking. If you need to consider medication options, you always can, but most women find that these natural approaches relieve symptoms completely or at least enough to avoid medications, and without the side effects and risks of conventional treatments.
Dr. A’s Cool Down Extract
This blend combines several herbs that have demonstrated their effectiveness in cooling down hot flashes. I recommend getting the individual extracts from Herb Pharm, Gaia Herbs, or Mountain Rose online and mixing them yourself. You can purchase an empty 4 oz. dropper bottle from Mountain Rose, or mix these in a glass bottle and take the recommended dose daily.
I’ve put the equivalent capsule dose from scientific studies next to the herbs when relevant.
- 1 oz. chaste tree tincture (regulates hormones, reduces menopausal symptoms)
- 1 oz. lemon balm tincture (cools hot flashes, improves mood)
- 1/2 oz. motherwort tincture (relaxing, calming, cools hot flashes and menopausal symptoms)
- 1/2 oz. black cohosh tincture (80 mg twice daily, cools hot flashes, improves menopausal mood and symptoms)
- 1/2 oz. hops tincture (100-200 mcg for at least 12 weeks, cools hot flashes, relieves vaginal dryness)
- 1/2 oz. sage leaf tincture (cools hot flashes)
To prepare: Combine the different extracts in a 4 oz. dropper bottle or glass bottle.
Dose: Take 1 teaspoon in 1/4 cup hot water, 2-3 times daily. You can take this formula until hot flashes are no longer a problem.
Note: Omit sage leaf and hops extract if you have a history of estrogen receptor positive cancer as they are estrogenic.
Ginseng for the Ladies!
3 gm. per day (3-6 capsules) of Chinese ginseng (Panax ginseng) taken daily not only reduces hot flashes, but can boost your libido and lower high cholesterol! Take in the early part of the day as ginseng can be stimulating and interfere with sleep.
Not Your Grandma’s Rhubarb
Rheum rhaponticum, or Rhubarb, in the form of an extract called ER731 has been shown in a clinical trial to be very effective in the treatment of hot flashes. The proprietary extract can be found in the product Estrovera by Metagenics. This can be ordered online or obtained through an integrative medical or naturopathic physician. Take as directed on the package or try Herb Pharm’s Rhubarb Extract as directed on the bottle.
Valerian for More than Sleep
225 mg of Valerian in capsules taken 3 times daily can dramatically reduce hot flashes after just 4 weeks of use, and in most people, is also a gentle, non-addictive sleep aid that does not lead to morning grogginess.
Holy Pine Bark Bat Girl!
Pycnogenol, an extract of pine bark, is not only an excellent antioxidant, but has been shown to be effective in reducing hot flashes in a dose of 60-100 mg twice daily.
First Aid for Sleep
Since hot flashes can affect your sleep, consider adding in an extract blend for sleep. This combination has herbs for sleep that also reduce hot flashes:
• 1/2 oz. passion flower extract (or 80 mg before sleep)
• 1/2 oz. valerian extract (or 250-500 mg twice daily)
• 1/2 oz. lemon balm extract
To prepare: Combine the different extracts in a dropper bottle or glass bottle.
Dose: Take 1/2 teaspoon every 30 minutes for 90 minutes before going to bed. If necessary, take an additional 1/2-teaspoon during the night if you wake and have trouble going back to sleep.
Alternatively, try Herb Pharm’s Relaxing Sleep blend:
This contains Valerian, Passion flower, Hops, Chamomile flower, and Catnip leaf (nope, not just for the kitties!) and is an excellent blend that contains herbs for both sleep and hot flashes.
Caution: Do not take sleep herbs with prescription sedatives without your physician’s guidance.
In addition to the above herbal options, I recommend the following dietary and lifestyle strategies to prevent and ease hot flashes:
- Emphasize a plant-based diet rich in phytoestrogens including cupfuls of cooked green leafies like kale, collard greens, broccoli, and Napa cabbage daily, as well as legumes such as garbanzo beans and lentils.
- Add Flax seed, 1 TBS fresh ground daily, to your daily diet
- “Fatten up”: Ample good quality dietary fat, including olive oil, coconut oil, butter or ghee, and walnut oil, as well as fresh avocado is necessary for maintaining hormone synthesis. In fact, if you are underweight you have a higher risk of having hot flashes – and there is no connection between good quality dietary fat and a higher risk of high cholesterol – with olive oil it's just the opposite!
- Dress in layers so if you feel yourself heating up, you can cool down in a flash.
- Keep the clothing layer closest to your skin breathable – 100% cotton is light and absorbent.
- Carry a shirt change with you – if you do work up a major sweat, you don't have to go throughout your day feeling clammy or sporting pit stains.
For Night Sweats
- Wear cotton pajamas (or sleep in the buff) so you don't have to change clothes at night. Keep an extra sheet next to the bed so you can quickly strip down the bed and toss a fresh sheet on with the least possible sleep disruption.
- Sleep with the bedroom no warmer than 68 degrees F to keep cool under covers.
- Layer your bed covers so you can cool down and warm up easily
Going through major changes in our phase of life, particularly in a culture that values youth over wisdom, is not a psychological breeze. Add to it symptoms that feel anything like a breeze – in fact, they feel more like an inferno – and it's not a picnic. The recommendations in this article have helped literally thousands of women sail more easily through and past hot flashes.
I wish the same for you!