By Patricia Scanlon
It used to be that managing menopause symptoms – hot flashes, night sweats and mood swings – meant one thing: hormone replacement therapy.
Doctors long believed that hormones were best for not only combatting those bothersome menopausal symptoms, but also for preventing heart disease and osteoporosis.
But in the early 2000s, a major U.S. study revealed that hormone replacement therapy wasn’t protective against either condition and actually increased the risk of both stroke and breast cancer.
As a result, many women stopped taking hormone therapy.
Today, we know that in some cases hormone therapy can be effective and safe. Still, many women prefer drug-free ways to deal with the menopausal symptoms that occur in our late 40s and early 50s as our bodies begin to produce less estrogen.
Many women continue to have moderate to severe hot flashes for an average of nearly five years after menopause, according to a University of Pennsylvania study published in early 2014 in the journal Menopause. In fact, more than a third of women experience moderate or severe hot flashes for 10 years or more after menopause.
To avoid taking estrogen – but still find relief – some women have turned to remedies, such as soy, herbs and other supplements. But do these natural remedies make menopause easier?
“[Supplements and herbs] are generally not very effective, [according to] well-done medical research trials,” says Diana Bitner, M.D., an OB-GYN at Spectrum Health Medical Group in Grand Rapids, Mich., who is a specialist in midlife and menopausal medicine.
“But for some individual women, they are effective,” she adds.
“These symptoms can be the result of many co-factors, such as sleep deprivation, life events and associated stress, vitamin and dietary excesses or deficiencies, medical problems. Depending on an individual woman’s situation, a given treatment might work or it might not,” Dr. Bitner says.
Read on to see if a natural remedy might provide relief from your menopausal symptoms.
Of all the natural remedies for menopause, soy has been the best studied. But whether it’s effective is still unclear.
Soy contains high levels of estrogen-like compounds called phytoestrogens, which mimic women’s natural estrogen. Some experts believe that these phytoestrogens may give your body enough of a boost to counter menopause symptoms.
Most major studies looking at soy’s effect on hot flashes and other symptoms have been inconclusive. But one analysis showed promising results: University of Delaware researchers in 2012 reviewed 19 previous studies, examining a total of more than 1,200 women. They found that women having two daily servings of soy for six weeks to a year can reduce their hot flash frequency and severity by as much as 26%.
For soy to relieve hot flashes, intestinal bacteria must convert it into a compound called equol, Dr. Bitner says. Not all women have the right kind of bacteria in their intestines.
“In some of the newer soy supplements, the soy has [already] been converted to equol, and these may be more effective, depending on a woman’s health situation and lifestyle,” she says.
Caution: High doses of soy may increase your risk for breast and other hormone-sensitive cancers such as ovarian and uterine cancer, some studies suggest. (Learn more about what influences your breast cancer risk.)
So if you have one of these cancers or are considered at high risk for developing any of them, always talk to your health-care provider before taking soy in food or supplement form, the National Institutes of Health’s National Center for Complementary and Alternative Medicine recommends.
Some researchers have investigated whether another type of phytoestrogen, known as lignin, might help reduce menopausal symptoms.
Lignans are found in high-fiber foods such as cereals, grains and beans, as well as in flaxseed.
But results haven’t been promising, according to a 2011 Mayo Clinic study in which researchers evaluated 188 women with hot flashes. The women were randomly divided into two groups, with one group eating a flaxseed bar every day, and the other eating a fiber bar with placebo.
After six weeks, no difference was found between the two groups. Interestingly, about one-third of the women in both groups experienced a 50% reduction in hot flashes.
Caution: Because flaxseed, like soy, can act like estrogen in the body, women who have estrogen receptor-positive breast cancer should avoid flax in supplement form, and eat only moderate amounts of ground flaxseed (no more than two to three tablespoons per day), says the Oncology Nutrition practice group of the Academy of Nutrition and Dietetics.
Black cohosh has also had mixed results for reducing hot flashes.
Long used in Native American medicine, it’s known by a number of colorful names: black snakeroot, bugbane, bugwort, rattleroot, rattletop and rattleweed.
These days, the dark, gnarled roots of the black cohosh herb are frequently used in supplements and remedies to relieve female discomforts.
During menopause, the pituitary gland (a pea-sized organ at the base of the brain) produces increased amounts of LH (luteinizing hormone), which is believed to be a cause of hot flashes. Black cohosh is thought to block production of this hormone, reducing the occurrence of hot flashes.
But no solid science supports that, according to a 2012 review of black cohosh studies published in The Cochrane Library. The reviewers evaluated 16 studies involving 2,027 menopausal women who had taken an average daily oral preparation of 40 mg of black cohosh for an average of 23 weeks. There was no significant difference between black cohosh and placebos in the frequency of hot flashes.
Caution: Some studies have found a potential link between black cohosh and liver damage. Bottom line: Talk to your doctor before using black cohosh or any other herbal supplement.
Yoga, meditation and other relaxation techniques all relieve stress, which help you cope with menopausal mood swings.
Try these 5–minute meditation exercises.
Clinical hypnosis may also be beneficial for reducing hot flashes, according to researchers at Baylor University’s Mind-Body Medicine Research Laboratory in Waco, Texas.
During the five weeks of the 2012 study, 187 women received weekly sessions of hypnotic relaxation therapy by therapists. They also practiced self-hypnosis using audio recordings and visualizations, such as a snowy path or a cool mountain creek. By the fourth session, hot flashes had decreased about 70%, and at a three-month follow-up, the decrease averaged 80%.
To find a member of the American Society of Clinical Hypnosis near you, visit the society’s member referral search page.
5. Healthy Fats and Fatty Acids
Consuming a balance of omega-3 and omega-6 fatty acids is important to the heart health of women going through menopause. Menopause doesn’t cause heart disease, but after menopause, certain risk factors for heart disease increase, including high blood pressure and high cholesterol.
Omega-3 fatty acids are particularly good at lowering triglycerides, Dr. Bitner says.
Check out these recipes rich in omega-3s.
Rather than relying on a particular remedy, experts say it’s better to make sure your overall habits are healthful.
That means following a healthy diet (low in simple carbs and high in fruits, vegetables and whole grains), exercising regularly, not smoking, following daily stress reduction techniques and losing weight if you’re overweight.
“A healthy lifestyle is everything,” Dr. Bitner says. “Women who get through menopause with few symptoms are either very lucky, which is rare, or are in a really healthy place as they begin menopause.”
Patients often come to her for a second opinion because they’re taking hormone medicine and still having symptoms, Dr. Bitner says.
“They think the hormones are not working,” she says, but it often turns out that the real cause of their symptoms is a trigger such as dehydration, weight gain, sleep deprivation, alcohol, sugar or stress.
“Once we find work-arounds and healthy solutions such as avoiding the triggers, the symptoms go away,” she adds.
“Research shows that hot flashes are more common in obese women, so maintaining a healthy weight will help keep hot flashes at a minimum,” says Mary Rosser, M.D., an OB-GYN at Montefiore Medicine Center in New York City.
Hot flashes/Night sweats
- Whenever possible, avoid caffeine, alcohol, spicy foods and hot baths and showers.
- Don’t smoke
- Drink lots of water to stay hydrated during the day, but just sip at night. (You don’t want to disturb the quality sleep you do get by getting up to use the restroom all night.)
- Keep your bedroom cool, use cotton sheets, and try cooling products such as a cooling pillow.
- Wear lightweight, natural fiber, moisture-absorbing clothing to sleep.
- Wear layered clothing during the day, because it can be chilly after the hot flash.
- Maintain a consistent sleep/wake routine.
- Sleep in a cool, dark, quiet room.
- Turn off the TV and electronics at least 30 minutes prior to sleep.
- Avoid caffeine and excess alcohol late in the day.
- Drink a little milk before bed. The tryptophan may help with sleep.
- If you can’t sleep, don’t fight it. Read instead of worrying that you can’t sleep.