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Welcome to part 12 of the ODX Menopause Series. In this post we review the National Institute on Aging guidelines for reducing hot flashes and supporting a healthy menopausal transition.
The ODX Menopause Series
- Menopause Part 1: A Quick Overview of a Slow Process
- Menopause Part 2: Biology and Physiology of Menopause
- Menopause Part 3: Increased Risk of Disease Associated with Menopause
- Menopause Part 4: Identifying Menopause: Signs and Symptoms
- Menopause Part 5: Laboratory Evaluation of Menopause
- Menopause Part 6: Cardiovascular Risk in Menopause
- Menopause Part 7: Beyond Hormone Testing in Menopause
- Menopause Part 8: Natural Approaches to Menopause
- Menopause Part 9: Diet and Nutrition Intervention in Menopause
- Menopause Part 10: Characteristic of Herbal Derivatives used to Alleviate Menopause Symptoms
- Menopause Part 11: Lifestyle Approaches to Menopause
- Menopause Part 12: The National Institute on Aging Addresses Hot Flashes
- Menopause Part 13: Hormone Replacement Therapy (HRT) in Menopause
- Menopause Part 14: North American and European Guidelines for Hormonal Management of Menopause
- Menopause Part 15: Bioidentical Hormone Therapy
- Menopause Part 16: Optimal Takeaways for Menopause
- Optimal The Podcast - Episode 10
The National Institute on Aging recognizes the importance of addressing symptoms associated with menopause. Sometimes hot flashes are tolerable if symptoms are mild. However, if symptoms seem intolerable, a 3-month trial of lifestyle changes is recommended before hormone therapy is considered.
- Dress in layers that can be removed.
- Carry a portable fan
- Avoid alcohol, caffeine, and spicy foods that may make hot flashes worse.
- Quit smoking
- Maintain a healthy weight
- Get adequate sleep, keep the room cooler at night, try a bed fan
- Yoga or tai chi have been found to improve menopausal symptoms
- Deep breathing, relaxation breathing
- In a comfortable position, place one hand on the belly, one on the chest
- Slowly inhale through the nose allowing the chest and belly to rise
- Slowly exhale through the mouth, pressing gently on the chest and belly to exhale completely
- Repeat for several minutes throughout the day and before falling sleep
- Selective serotonin reuptake inhibitors (SSRIs), low dose
- Side effects may include dizziness, drowsiness, headache, jitteriness, nausea
- Benefits and risks of natural treatments such as black cohosh, DHEA, and phytoestrogens are still being studied.
Hormone therapy (lowest dose, shortest duration possible)
- Estrogen and progesterone replacement therapy may help treat hot flashes
- Increases risk of blood clots, breast cancer, dementia, gallbladder disease, heart attack, stroke, especially for postmenopausal women over age 60.
- Contraindications include
- Breast or uterine cancer
- History of blood clots, bleeding disorder, heart disease, heart attack, liver disease, stroke, vaginal bleeding, or current possibility of pregnancy.
- Forms include creams, gels, implants, patches, pills, rings.
- Dermal patches may be safest for those at cardiac risk.
- Composition includes conjugated estrogen, estradiol, selective estrogen receptor modulators (SERMs), synthetic or compounded hormones.
- Side effects include bloating, breast tenderness, cramping, spotting or monthly periods.
 The National Institute on Aging. Hot Flashes: What Can I Do? Accessed August 10, 2021.
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