--- title: "Cool Confidence - How to Navigate Hot Flashes and Night Sweats in Menopause" entity: "blog" canonical_url: "https://www.dramytung.com/blog/managing-hot-flashes-in-the-perimenopause-transition" markdown_url: "https://www.dramytung.com/llms/blog/managing-hot-flashes-in-the-perimenopause-transition" lastmod: "2024-12-02T11:42:00.000Z" --- Conquering Menopause_ Hot Flashes & Night Sweats # Perimenopause Hot Flashes & Night Sweats: Essential Checklist Symptoms to Recognize [ ] Sudden heat sensation in upper body [ ] Rapid heartbeat during hot flash [ ] Skin reddening/flushing [ ] Excessive nighttime sweating [ ] Chills after heat episode Lifestyle Management [ ] Layer clothing [ ] Use breathable fabrics like cotton [ ] Lower bedroom temperature [ ] Stay hydrated [ ] Manage stress levels Dietary Triggers to Avoid [ ] Spicy foods [ ] Caffeine [ ] Alcohol [ ] Refined sugars [ ] Processed foods Tracking & Management [ ] Create a symptom journal [ ] Identify personal triggers [ ] Note frequency and duration of episodes Medical Considerations [ ] Consult your primary health care provider and/or Menopause society certified practitioner [ ] Discuss your symptoms [ ] Review potential treatments [ ] Consider hormone replacement therapy Lifestyle Interventions [ ] Practice stress reduction techniques [ ] Try meditation [ ] Regular exercise [ ] Maintain healthy sleep schedule # Why am I feeling hot and sweating for no reason? Experiencing hot flashes and night sweats during the menopause transition can be frustrating and disruptive. The constant hot-cold-hot-cold and waking at night to change pajamas and sheets is an extremely uncomfortable experience for many women. The feeling of feeling flushed with heat in your body radiating up your neck and face all while sitting at your desk. Your beet red cheeks aren't a sign you're embarrassed, it's often a hot flash! These are very disturbing and uncomfortable experiences for women. It can wreck havoc on not only one's sleep but on their mental and emotional health. The good news is that there are safe and effective strategies that can help manage these symptoms, helping you regain control of your sleep and your life. Understanding your symptoms is the first step toward finding relief. # I'm in my 30's or 40's why do I need to know this now? Perimenopause marks the transitional phase of the decade leading to a woman's final menstrual period defined as 'menopause'. The average age of menopause is 52 yoa in North America, which means the perimenopausal years can start in a woman's late 30's or early 40's. During this time, various hormonal changes occur, impacting your menstrual cycle, ovulation, and overall well-being. So although not all women will experience symptoms in their 30's and 40's, some women will begin to experience them and it is important to understand the changes in the body. # Hormonal Changes and Their Impact During the menopausal transition, your body undergoes significant hormonal changes. These shifts cause fluctuating estrogen and progesterone levels even more then what was experienced during a woman's 20's-30's. Estrogen and progesterone level changes resulting from declining follicles, can lead to irregular menstrual cycles and changes in ovulation. Skipped cycles or shorter or heavier periods are all common during this time. Estrogen might increase or decrease, influencing hot flashes and night sweats. Low progesterone levels can also cause heavier periods, as well as mood swings, feeling of anger or irritability, not being able to manage stress the way "you used to be able to", and increased feelings of anxiety. Menopausal symptoms are highly prevalent; they are sufficiently bothersome to drive almost 90% of women to seek out their healthcare provider for advice on how to cope. # Nutrition, Lifestyle and Non-Hormonal Interventions Managing hot flashes during the perimenopause transition involves various lifestyle adjustments and hormonal and/or non-hormonal therapies. Focus on diet, exercise, and mindfulness techniques, as well as discussing other treatment options with your primary care provider. Your diet plays a crucial role in managing hot flashes. Incorporating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help balance blood sugar. I have a [free Mediterranean diet 7-day check list](/med-diet/hormone-health)which you may find helpful. Avoid hot flash triggers such as spicy foods, caffeine, and alcohol, which may worsen your symptoms. Physical activity also contributes to overall well-being. Regular exercise can help manage weight gain, which is common during perimenopause. Aim for at least 150 minutes of moderate exercise weekly, such as brisk walking, swimming, or cycling. This not only helps reduce hot flashes but also boosts mental health and improves sleep quality. Incorporate at least 3 times a week some form of resistance training as part of your 150 minutes a week. These can be done with free weights, weighted vests, resistance bands or your own body weight such as in pilates. # Mindfulness and Stress Reduction Techniques Stress can increase the severity of hot flashes. Implementing mindfulness practices can help reduce anxiety and improve your emotional state. Techniques such as meditation and deep breathing exercises can be very effective. I recommend simple tools to my patients to help calm their mind. Slow deep breaths can help to calm the body and mind and taking a walk especially in nature is a great way to reset your body and mind. Finding even a few minutes daily for mindfulness meditation can enhance relaxation. You might set aside time in the morning or evening for this practice. Consider using mobile apps or guided videos to assist you. Prioritizing your mental health is essential during this transitional phase. Some of the favourite apps I've recommended are the Calm, Medito, and Head Space. Acupuncture is another option worth considering. Some studies suggest that acupuncture may help alleviate hot flashes by balancing energy flow in the body. It’s essential to seek a qualified practitioner to ensure safe and effective treatment. Exploring these alternatives can provide you with additional tools to manage your symptoms. # Hormone Therapy Hormone therapy is considered the first line treatment for managing hot flashes in peri and menopausal women. 17-B estradiol or (Estradiol) therapy can effectively reduce the frequency and intensity of these symptoms. It is commonly prescribed for women with moderate to severe hot flashes or what we call "Vasomotor symptoms". Frequent vasomotor symptoms can last more than 7 years during the menopause transition and persist for 4.5 more years after the final menstrual period. (Avis, et al, 2015) For those with a uterus (i.e. you have not had a hysterectomy), you would need to use combined topical 17-B estradiol (gel, cream or patch form) with a progesterone (oral micronized progesterone or Prometrium ) to protect the uterus and prevent endometrial hyperplasia (thickening of the uterus). Hormone replacement therapy is a safe and effective treatment for the management of hot flashes and night sweats. It is important to have the discussion with your primary health care provider about the benefits and the risks of using it. I recommend all my patients read the Menopause Society position therapy on hormone replacement therapy [here](https://files.hivecdn.com/861765ab-cd85-4b43-ae89-4c18fea8341c/menonote-deciding-about-ht-2022.pdf). # Non-Hormonal Medications There are several non-hormonal medications that have been shown to help reduce hot flashes. If you cannot use hormone therapy, alternatives like fezolinetant, a non-hormonal drug, are emerging as options. Discuss with your medical doctor to find the right therapy tailored to your needs. Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) like venlafaxine , can be effective. These may help manage the emotional components of menopause as well. Gabapentin is another option. Originally used for nerve pain, it can also reduce hot flashes. Clonidine , a medication for high blood pressure, has also shown some effectiveness in reducing hot flashes, though it might have side effects. Your medical doctor can discuss the pros and cons of each with you. # Where do you go from here? This is time in a women's life where it is ok to ask for help and to lean on your health care providers for support. There are many safe and effective tools to manage your symptoms and you don't have to suffer. With the right strategies, you can manage symptoms effectively and maintain your quality of life. During women's midlife, it is important to focus on optimizing one's health to be the best for herself so she can show up for her family, her kids, her partner and her work. If you are struggling with hot flashes or night sweats or have questions about this time in your life, I encourage you to seek out a practitioner who is certified by the Menopause Society (formerly the North American Menopause Society - NAMS) and you can search for one [here](https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx). As a Naturopathic Doctor and a Menopause Society Certified Practitioner (MSCP) I am here to guide you on your health journey. You can book a discovery call with me [here](/contact) and follow along with me on [Facebook](http://www.facebook.com/dramynd), [Instagram](http://www.instagram.com/dramytung) or [Tiktok](http://www.tiktok.com/dramytung). To your best health, Dr. Amy J. Tung, ND, MSCP Naturopathic Doctor Disclaimer : This blog is for informational purposes only and does not constitute medical advice. Always consult healthcare professionals before starting any new treatment or supplement regimen. # References Aminimoghaddam, S., & Abolghasem, N. (2019). A Review of Management of Perimenopausal Hot Flashes. Journal of Obstetrics, Gynecology and Cancer Research. https://doi.org/10.30699/jogcr.4.1.5. Avis, N., Crawford, S., Greendale, G., Bromberger, J., Everson‐Rose, S., Gold, E., Hess, R., Joffe, H., Kravitz, H., Tepper, P., & Thurston, R. (2015). Duration of menopausal vasomotor symptoms over the menopause transition.. JAMA internal medicine, 175 4, 531-9 . https://doi.org/10.1001/jamainternmed.2014.8063. Delamater, L., & Santoro, N. (2018). Management of the Perimenopause. Clinical Obstetrics and Gynecology, 61, 419–432. https://doi.org/10.1097/GRF.0000000000000389. Freeman, E., Sammel, M., Gross, S., & Pien, G. (2015). Poor sleep in relation to natural menopause: a population-based 14-year follow-up of midlife women. Menopause, 22, 719–726. https://doi.org/10.1097/GME.0000000000000392. Kim, K., Kang, K., Kim, D., Kim, H., Yoon, H., Lee, J., Jeong, J., Lee, M., Jung, H., & Choi, S. (2010). Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women-a multicenter randomized clinical trial. Menopause, 17, 269-280. https://doi.org/10.1097/gme.0b013e3181bfac3b. Santoro, N. (2016). Perimenopause: From Research to Practice.. Journal of women's health, 25 4, 332-9 . https://doi.org/10.1089/jwh.2015.5556. ## Interested in learning more about working with me? Book a free discovery call virtually (Ontario residents only). Book Now