Herbal Remedies for Hot Flashes & Night Sweats: Natural Remedies for Menopause


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. 

hmw

HERBAL MEDICINE FOR WOMEN

Want to Learn More About Plant Medicine?

YES, I DO!

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.

You can find these herbs at major health food stores, online (i.e., Herb Pharm, Gaia Herbs, Mountain Rose Herbs), and at some pharmacies and even supermarkets.

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.

Additional Support 

In addition to the above herbal options, I recommend the following dietary and lifestyle strategies to prevent and ease hot flashes:

Diet

  • 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!

Clothing

  • 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!

AJR Sig

 

 

 

 

 

Hasper, I. et al. Long-term efficacy and safety of the special extract ERr 731 of Rheum rhaponticum in perimenopausal women with menopausal symptoms. Menopause: The Journal of The North American Menopause Society (2008) 16(1): 1-15

Heger, M. et al. Efficacy and safety of a special extract of Rheum rhaponticum (ERr 731) in perimenopausal women with climacteric complaints: a 12-week randomized, double-blind, placebo-controlled trial. Menopause: The Journal of The North American Menopause Society (2006) 13(5): 744-759

Kaszkin-Bettag, M. et al. The special extract ERr 731 of the roots of Rheum rhaponticum decreases anxiety and improves health state and general well-being in perimenopausal women. Menopause: The Journal of The North American Menopause Society (2007) 14(2): 270-283

Young Kim S, Kyo Seo S, Mi Choi Y, et al.  Effects of red ginseng supplementation on menopausal symptoms and cardiovascular risk factors in postmenopausal women: a double-blind randomized controlled trial.  Menopause 2012;19(4):461-466

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Colleen

What about vaginal dryness and irritation during intercourse, due to post-menopausal vaginal atrophy? I have not found a lubricant that helps this. Over-the-counter products help with initial penetration, but not with internal discomfort. I went on estrogen therapy for a few months, which helped, but I stopped due to the long-term health concerns associated with it. Would love to hear suggestions on this. Thanks!

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    aviva

    Promise to do a blog on that in this menopause series. I've had great success in patients using a topical probiotic (inserted vaginally) such as FloraFemme with Lactobacillus reuterri and L rhamnosus. These can be taken orally as well or instead. Also, ample fish oil and fat in the diet can make a huge difference. Best, AR

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      Colleen

      Thank you!

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      Lea Garnier

      Can you talk more about plant based bio-identical hormones, and what health risks they may cause. I have been on a very low dose topical cream for about 4 months now, and my Dr. says there are no health risks at all. She has been prescribing them to women for many years, monitors her patients very closely, and has never had an adverse case. Thank you!!

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        aviva

        there are health risks. hormones are hormones. so breast cancer, endometrial cancer, etc are all possible. i do use bio-identicals for women who have SEVERE symptoms of peri-menopause/menopause. usually only after i've tried all other methods. i use topical estrogens only, and oral progesterone when needed for example for serious sleep problems. hope this helps!

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      Becky

      So excited to find this site! For vaginal dryness, I make coconut oil vaginal suppositories (silicone mold used to make ice for bottled water works well) Pour oil in mold. Refrigerate. It hardens & looks like Tampax. I break off 1/3 and insert at bedtime. Nightly at first, then 2-3 times a week. CO is antibacterial & antifungal. I also take SwansonVitamins.com FemFlora orally AM & PM. It is inexpensive. When 2 for 1, I stock up & keep in the refrigerator. Really helps reduce menopause vag. infections due to decreased estrogen. Think I will try emptying several FemFlora capsules & roll the CO suppository in it before inserting. It would be easier to mix in when making the suppository, but not sure how long the probiotic would last outside the capsule. Any ideas?

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Kay

Thank you for this timely blog! I have been taking Femmenessence Macapause (maca) for perimenopause symptoms. I am using it in combination with an adrenal support supplement (methyl-guard plus by Thorne research) and have been feeling so much better! Are you familiar with these products and is it safe to take them indefinitely? You mentioned ginseng in your blog but not maca. I'm trying to avoid the bio-identical hormones. Thank you!

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Elaine Sheff

Aviva, My understanding is that estrogenic herbs are not likely to encourage cancers that respond to estrogen. Could you say more about your caution? Much thanks! And that for all of your inspiring information and the work that you do! Elaine

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    aviva

    Yes, this is the case, but that is usually if there is estrogen dominance or competing environmental endocrine disruptors -- it doesn't mean they can't contribute. So I am cautious! Best, Aviva

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Melissa

Hi Aviva! I am 40 years of age and currently having symptoms similar to menopause. Symptoms include irregular menstruation, extreme fatigue, constant prickly sensations all over my body, night sweats, brain fog, memory loss, mood swings, depression, red face, stomach bloating, and abdominal pain/tenderness. Four years ago I had my tubes tied and my health has deteriorated since then. I am wondering if this is the cause? Is tubal reversal my only option for a normal life? Or am I simply going through early menopause? Thankyou for your time x

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    aviva

    Hi Melissa, This could be menopause, but could be other causes as well -- I'd see a local MD or an integrative/functional medicine physician for a proper workup. Many of your symptoms are not suggestive of menopause at all -- for example, abdominal pain -- so please also see a gynecologist without haste to make sure everything is ok! Take care, Aviva

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Juno

I've had great success with Ashwagandha, an adaptogen herb that was mentioned in another post. It's eliminated almost all hot flashes and night sweats and I noticed it helps with vaginal dryness, too. I usually need only 1 capsule a day, or occasionally 2/day. Hot flashes lessened immediately and discontinued within a week or two after I started taking it.

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A

Do you have any suggestions for young women that have primary ovarian failure? I am on HRT (Vivelle dot and prometrium) as I am only 32, was diagnosed at 27. Is there anything that can help negate the risks of HRT? Any information on ovarian failure would be appreciated. It's hard to find good information on this subject for young women.

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Sandi

Thank you sooo much. I am going on line now to order these herbs. I am desperate and was facing huge costs to try natural hormone therapy. I will let you know how it goes.

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Michele

What makes valerian and kava selective as to its usefulness? I deemed kava unusable because it kept me awake all night. I've been more than reluctant to try valerian!

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    aviva

    Valerian = sleep Kva kava = anxiety relief

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    aviva

    valerian = sleep kava kava = anxiety

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Sofia

What about night sweats at 30 years old a few days before period starts? (It stops a day after period starts) Would the same things help or is this a different problem? The doctor ran some tests but coudn't find anything wrong. This has been going on for 3 years and is sooo annoying! I wonder if it is linked to early miscarriages as I unfortunately had 5 of them. Thank you so much!

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Michelle

I started menopause in my early 40s and hot flashes were very intense. I simply take black cohosh from Whole Foods and it has worked wonders in taming them immensely. Now, they are pretty rare and when they do happen, it is very manageable. I also take 1Tble of virgin coconut oil a day (work up to that and even more is safe) and use it as my primary body lotion. Coconut oil is amazing and you can read more in The Coconut Oil Miracle on all of its benefits.

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Kristin

Are night sweats just the night before a period symptoms of early menopause? I'm only 32 and this just started a few months ago...

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    aviva

    Hard to tell in your individual case -- simple blood tests can tell if you are perimenopausal (estrogen, FSH, LH). I'd check in with your gyne about your concerns -- might be helpful!

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Linda

Just want to say thank you for this. I have been going through these symptoms for about 6 months now and absolutely did not want Hormone Replacement Therapy. I am thankful for your advice and will try these herbs as you have directed. Thank You so much for sharing your training and knowledge with us. You are much appreciated. I always worry about other sites who say "try this herb or this other herb" without any training or citable sources to back it up.

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    aviva

    Thank you, Linda! Warm wishes! Aviva

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Vanessa

A thorough and informative post, as usual! Thanks for sharing your wisdom. Since valerian has the opposite effect on me (I get agitated and when I do fall asleep I have restless dreams), I have found a combination of passionflower and skullcap to be very effective for insomnia.

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Cathy

I had a total hysterectomy including ovaries due to extensive adenomyosis, fibroids, endometriosis, and pelvic congestion syndrome. I'm not doing any hormones and they don't want me to use any herbs that mimic estrogen because I have the genetic mutation where I don't metabolize estrogen. I am taking Serenol which contains.. Chromium (as Chromium Picolinate) 1000 mcg, Swedish Flower Pollen Extract 624 mg, Royal Jelly 24 mg . I'm also taking Chaste Tree Berry. Do you know anything about the Swedish Flower Pollen Extract? It seems to be keeping the hot flashes and night sweats away. The Serenol is kind of expensive but I can't seem to find another brand that has the Swedish Flower Pollen Extract in it or on it's own. I would love to know your opinion. Thank you!!!

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Leah @ LunchwithLeah.com

Hi Aviva, I love all the information you have to offer to women who are desperate for answers. I just wanted to let you know what I linked to this incredibly informative post of yours with my recent blog post 11 Warning Signs You are Unhealthy (that you shouldn't ignore)! (https://lunchwithleah.com/signs-you-are-unhealthy/) so that my readers can benefit from your knowledge. Thank you for providing such great content for women looking for answers!

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