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14 Natural Remedies For The Worst Symptoms Of Menopause
Flushing. Flashing. Power surge. Night sweats. Personal summer. The lexicon for hot flashes is as varied as the women they affect. And while hot flashes are, without a doubt, the most troublesome symptom of menopause—and the most common menopause symptom to send women to their doctor's office—they are by no means unavoidable.
What determines whether you experience this milestone of menopause lies partly in your weight (overweight women are more likely to experience hot flashes), your ancestry (African American and Latino women tend to have the most flashes, Asian women the least), and your diet and lifestyle (if you're a yoga aficionada, you may be spared the worst; if you smoke, get ready to sweat).
We wish we could tell you exactly what causes hot flashes and exactly how to banish them. Unfortunately, even the experts in the field still haven't figured out the underlying cause, although they do know that estrogen loss alone doesn't fully explain them. But really, does it matter exactly why you're flashing? All you really want to know is how to cool yourself. Turns out there are several natural options that go beyond hormones. Some are lifestyle changes, and some involve complementary and alternative medicine such as herbs, vitamins, and mind/body techniques. These 14 natural remedies will need weeks, not hours, to begin working, but over time they should help relieve your hot flashes.
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Paced breathing, also called diaphragmatic breathing, involves breathing in slowly through your nose for at least 5 seconds and out slowly through your mouth for at least 5 seconds. You'll know you're doing it right if you see your abdomen rise with each breath in and feel your lungs inflate. You'll find it quite a contrast to your normal tight, tense, shallow breathing. Like other mind-body therapies, paced breathing calms the sympathetic nervous system and enhances circulation. One study of 33 women with frequent hot flashes compared the effects of eight sessions of paced breathing training, muscle relaxation, and biofeedback. Women doing the breathing exercises had half as many hot flashes as those doing biofeedback. They also breathed more slowly overall. The key to getting benefits from paced breathing is practice. Although the women in this study spent 15 minutes a day, twice a day, practicing paced respiration, we think you can break it into smaller time slots, say, 5 minutes at a time, six times a day. Good times to practice are when you're in the car (particularly if you're stuck in traffic), watching TV, or checking e-mail.
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Are you a catastrophic thinker? You are if, for instance, your flight is canceled and you freak out about missed meetings and a destroyed career. Or if, at the first tingle of a hot flash, you immediately focus on how miserable you're going to feel because you know—you just know—you're going to be drenched in a few minutes, lose your train of thought, and require an hour or more to return to your "normal" self. What if, instead of immediately leaping to the worst possible scenario when things go wrong (like hot flashes), you focused on managing the situation? Yes, you might sweat a bit, but if you take off your sweater and pull out the handheld fan you've been carrying for just such an occasion, you can minimize the damage. Or you might silently congratulate yourself for throwing that spare blouse in your briefcase this morning. That type of thinking, British researchers found in several studies, can actually reduce the intensity of the flash. Conversely, thinking of yourself and the flash negatively can make it worse. So learn to think about the positives of every flush: Your skin looks better when it's flushed; it's one more step on the path to no more periods; you're burning more calories, even if just for a few minutes; and you're saving money on heating bills. If you're having trouble doing this on your own, try cognitive behavioral therapy, which involves learning the facts about your condition, challenging your previous thinking about it, and developing specific steps to handle it.
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Progressive muscle relaxation involves tensing then relaxing each group of muscles in your body. Experts think it works for hot flashes by reducing release of the stress hormone norepinephrine. British researchers studied progressive muscle relaxation in 150 women being treated for breast cancer. The women had severe hot flashes from their treatments but couldn't take hormones. The researchers assigned the women to either relaxation therapy (in which they met once with a therapist for training in deep breathing, muscle release, and guided imagery) or a discussion session about hot flashes with a nurse. After a month, the women in the relaxation-therapy group had 20% fewer—and less severe—hot flashes than those in the comparison group. Although this study was done in women with breast cancer, it should work just as well in menopausal women without cancer. You can learn progressive muscle relaxation through audio recordings, books, or classes.
Or just try this: Lie down in a comfortable position, scrunch your forehead muscles together as tightly as you can while breathing in, and then let them all relax while you breathe out. Next, do the same with your nose and cheek muscles. Continue working your way down your body, one muscle group at a time, until you reach your toes.
Who knew that Child's Pose could help return your body temperature to that of a 12-year-old? Yet a small study in 14 postmenopausal women who were having four or more moderate-to-severe hot flashes per day found that learning eight restorative yoga poses and taking a weekly 90-minute restorative yoga class for 8 weeks led to an average one-third drop in the number of hot flashes and in their severity. Restorative yoga focuses on relaxing the body in restful postures using props such as blankets, bolsters, and straps. The poses are usually sustained for 5 to 10 minutes each, putting you in a deep state of relaxation.
Researchers think one reason for yoga's benefits is the sense of control it provides, a sense you learn to bring to the hot flash itself. The deep relaxation that occurs with restorative yoga also engages the parasympathetic nervous system, the part of the nervous system that controls unconscious responses such as sweating. Other types of yoga, such as Bikram, have also been shown to have similar benefits.
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Mindfulness-based stress reduction combines mindfulness meditation with yoga and other movements. It helps you focus on your body and understand how your unconscious thoughts and feelings affect your physical and emotional health. Studies have found that it can calm numerous unconscious processes in your body, such as reducing pain and lowering blood pressure, so it makes sense that it could improve your body's temperature control. Plus, it restores some of that much-needed control we've talked about. When researchers at the University of Massachusetts Medical School in Worcester had 15 women with frequent hot flashes learn mindfulness-based stress reduction in a weekly class for 8 weeks, the women's quality of life improved overall as the severity of their hot flashes plummeted by 40%. It's best to learn mindfulness meditation through a class, however, rather than on your own to make sure you're doing it right. Find a mindfulness meditation program near you.
We're talking hypnosis. Forget the hypnosis you've seen magicians and comics perform. The hypnosis we're referring to is performed by specially trained medical professionals, often doctors. The hypnotherapist teaches you to relax and suggests mental images to focus on during a hot flash to make you feel cooler. In other words, you learn to use your mind to control your body's reactions and to handle stress better. In a Baylor University study of 26 breast cancer survivors who had severe hot flashes after their cancer treatments catapulted them into menopause, five sessions of hypnotherapy with a psychologist led to a 68 percent drop in hot flashes, along with less anxiety and insomnia. Preliminary data suggest hypnosis works just as well for women experiencing natural menopause. Look for a practitioner trained in "medical hypnosis." A good source is the American Psychotherapy and Medical Hypnosis Association.
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It makes intuitive sense that the more excess weight you're hauling around, the hotter you'll feel—with or without menopause! And, in fact, studies have found that overweight women often have more hot flashes than healthy-weight women. This could be because excess fat traps heat, making you sweat more to cool off your body, or because the blood vessels in overweight women dilate more when they encounter heat or stress. That dilation brings more blood to the surface of the skin, making you feel hotter.
The good news, according to a study published in theArchives of Internal Medicinein 2010, is that losing weight could help you lose your hot flashes. Researchers at the University of California, San Francisco, put 226 overweight or obese women with an average age of 53 on an intensive weight loss program and compared them with 112 women of similar weight and age. About half the women in each group had bothersome hot flashes. The women in the weight loss group had 1-hour sessions with nutrition, exercise, and behavioral-change experts; were supposed to get at least 200 minutes a week of physical activity like brisk walking; and were told to follow a 1,200-to 1,500-calorie-a-day diet. After 6 months, the weight loss group dropped an average of 17 pounds, while the control group lost only 4. The more weight the women lost, the more their hot flashes improved. Overall, every 11 pounds lost reduced the number of hot flashes by about a third.
Even if the most exercise you've done in the past 20 years was carrying in bags of groceries from the car, it's not too late to start, particularly given the possibility that working out could cool your flashes. Spanish researchers evaluated 48 women, ages 55 to 72, all of whom suffered similarly from hot flashes. During the study, half of them exercised 3 hours a week for a year, and half continued their couch potato ways. By the end of the study, just a third of the women who worked out still had bad hot flashes, while two-thirds of the nonexercisers still rated their symptoms as severe. The women who exercised on a regular basis also reported that they felt better overall, both physically and mentally.
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This is by no means the only study to show benefits from exercise on hot flashes. A study from the American College of Sports Medicine found strength training helped slash hot flashes and headaches by 50%. A study published in 2010 in the journalClimactericevaluated the effect of exercise on 336 healthy women ages 45 to 55 and found that the more physical activity the women got, the fewer and less severe their menopausal symptoms—and half of the women had no symptoms at all! Yet another study found that aerobic exercise (think brisk walking, biking, running, dancing) reduced the severity of hot flashes in 55% of postmenopausal women.
If you like tofu, edamame, and miso; prefer soy milk to cream in your coffee; and sub out ground beef for TSP (textured soy protein), you're in luck. There's a good chance that your love of this low-fat protein may protect you from hot flashes. Soy contains powerful estrogen-like compounds called phytoestrogens, which bind to estrogen receptors and mimic some of estrogen's effects in your body. The most prevalent phytoestrogens in soy are the isoflavones genistein, daidzein, and glycitein. Daidzein is believed to be the one with the greatest impact. After eating soy, certain bacteria in your gut convert daidzein into an estrogen-like compound called S-equol. We know from studies in Japanese women that those who produce S-equol after eating soy have fewer and milder menopausal symptoms than women whose bodies make less S-equol. How much your body produces depends both on the type of bacteria in your large intestine and on the amount of soy you eat, but researchers estimate that about half of Asians and about a third of people of North American and European descent can make S-equol. Supplements of equol (the synthetic equivalent to the S-equol your body makes) are even being marketed as an alternative to soy. In a study presented in October 2010 at the North American Menopause Society (NAMS) annual meeting, equol supplements cut hot flashes by 50% or more for up to 42% of women who tried them. Equol also relieved muscle and joint pain and showed evidence that it may help maintain bone density.
Like soy, flaxseed is high in estrogen-like phytoestrogens, particularly lignans, which could account for its benefits. Studies are mixed, but when Mayo Clinic researchers had 29 women with annoying hot flashes eat 1.5 ounces of crushed flaxseed daily for 6 weeks, they found the average number of hot flashes dropped by half and their severity fell by 57%. The women also said their mood improved and that they had less joint or muscle pain, fewer chills, and less sweating. Flaxseed is a great source of insoluble fiber, which can help control your weight and cholesterol levels. Since there doesn't appear to be any danger from adding flaxseed to your diet, it's worth a try. However, the therapeutic dose of 40 grams, or 4 tablespoons, of ground flaxseeds comes along with 16 grams of fat and about 200 calories. So make sure the flaxseeds are taking the place of unhealthy fats, not being added on. To get the full benefits, crush the flaxseeds before eating. An easy way to do this is with a coffee grinder. Keep the ground seeds in your refrigerator and add a few tablespoons to your oatmeal or yogurt every day.
While vitamin E is known for its antioxidant properties, it can also help your arteries work better and reduce inflammation—all of which could improve hot flashes. In an Iranian study published inGynecological and Obstetrical Investigationsin 2007, 51 women experiencing severe hot flashes took 400 IU of vitamin E every day for 4 weeks or a placebo. After a week without either vitamin E or the placebo, they switched; the vitamin E group took the placebo, and the placebo group took vitamin E. When the women took the vitamin, they had significantly fewer and less severe hot flashes, leading the researchers to conclude that vitamin E was a good option for women with hot flashes. If you decide to try vitamin E, stick to a supplement that supplies 400 IU a day; higher amounts could slightly increase your risk of dying early.
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Black cohosh, a member of the buttercup family, is one of the most researched herbal options for hot flashes. The herb is thought to act like estrogen in the body, decreasing luteinizing hormone (a hormone that's secreted by the pituitary gland and that may play a role in hot flashes) and affecting serotonin receptors, which are also involved in hot flashes. Nonetheless, the data on this herb are mixed. One study showed that black cohosh reduced hot flashes by 84 percent. In another, it worked just as well as estrogen in reducing hot flashes; still others have found that the herb has little, if any, benefit. Perhaps the study that got the most attention was the Herbal Alternatives for Menopause Trial (HALT), sponsored by the National Institutes of Health (NIH) and published in 2006. It included 351 women ages 45 to 55 who took either 160 milligrams a day of black cohosh alone; a multiherb pill with black cohosh and nine other ingredients; a multiherb pill plus counseling to increase the amount of soy in their diet; hormone therapy (estrogen with or without progestin); or a placebo. The frequency and severity of the women's menopausal symptoms fell by about a third over a year whether the women took black cohosh or a placebo. Only estrogen therapy significantly improved their hot flashes.
Bottom line: Black cohosh is worth a try. It's safe (the most commonly reported side effect is mild nausea), and it does work in some women. Although there were reports of liver failure in women taking high doses of the herb, a report from the NIH found no evidence that the black cohosh was responsible. Still, make sure to tell your doctor if you take it. Look for products containing the most-studied dose: an extract standardized to contain 1 milligram of triterpene glycosides, calculated as 27-deoxyactein, per 20-milligram tablet. Take 20 milligrams twice daily or 40 milligrams once a day.
The anecdotal evidence of using sage (Salvia officinalis) to reduce sweating and hot flashes is significant, but until recently, there were no studies on its benefits. That changed in late 2010, with the publication of a Swiss study evaluating the effects of a once-daily sage tablet on 71 postmenopausal women. The researchers found that the average number of hot flashes dropped by half within 4 weeks and by 64% within 8 weeks. Women with severe and very severe hot flashes had even greater benefits, with 79% and 100%, respectively, seeing improvements. Brew your own tea with 1 tablespoon of fresh sage leaves or 1 heaping teaspoon of dried sage per cup of boiling water. Let the sage leaves steep for 5 minutes, then strain. You can drink the tea hot or iced, and add some lemon, stevia, honey, or agave nectar to make it more refreshing.
Seriously? Sticking needles in your body could really improve hot flashes? Possibly. A randomized, controlled trial of 267 women published in the May/June 2009 issue of the journalMenopausefound that women who had 10 acupuncture treatments over 12 weeks had far fewer hot flashes than those who received a sham procedure. The women getting the acupuncture also reported that they slept better and had less pain. We don't exactly know why acupuncture works when it does work. There's some evidence that needling acupuncture points affects the sympathetic nervous system, as well as the release of hormones such as cortisol, endorphins, and serotonin. As with many of the options listed here, you need to give this treatment time to work. It may take several sessions before you notice any improvement.
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