The number one thing I get asked about perimenopause is how to stop hot flushes. It’s not just the “flash” or flush, as the wave of heat is sometimes followed by sweating and feeling very uncomfortable. When this happens in public some women feel embarrassed or annoyed, which can trigger a stress response and more flushes! At night flushes can interrupt sleep, sometimes very frequently. Beyond repeatedly tossing the blankets off and on, in extreme cases wet flushes means having to change nightwear and sheets. Weeks, let alone years, of sleep disturbance will make even the most good-natured person cranky, fatigued and even depressed.

The first article in this series explored the stages and symptoms of menopause, as well as why stress is such an important factor. But what can you do to stop hot flushes naturally?

Five lifestyle remedies to stop hot flushes

1. Exercise

With the loss of oestrogen, both bone strength and heart health are more vulnerable after menopause. Fortunately most forms of exercise can counteract some of these issues, ground stress which is a known trigger for hot flushes, and elevate moods. I call this “lifestyle HRT”. If you could get exercise in pill form, it’d be a best seller. What’s more most physical activities are free, provide an opportunity to hang out in nature (another stress-buster) and can be done alone or socially.

It’s easy to vary the types of exercise to benefit both your mind and body. For example Vitamin D soaked daily walks while practising curiosity, clinical pilates to tone your body and counteract bladder weakness, or dancing for fun. A good trick for procrastinators is to give yourself no more than a month to get moving. By the end of that time if you’ve still not got off the couch, consider signing up with a personal trainer or exercise physiologist.

2. Eat more plants

Most plant foods contain beneficial compounds known as phytoestrogens. When broken down in the body they have a weak oestrogen-like effect, which has been proven to reduce hot flushes. Unlike pharmaceutically derived oestrogens, these food sources may actually help protect against recurrence of breast cancer so they are safe for all women to eat them.

Phytoestrogens are abundant in soy products, legumes, seeds, nuts and whole grains. Think of typical ‘hippy’ foods like sprouts, tempeh, tahini, and hummus and give them a modern twist in cooking. They’re also packed full of vitamins and minerals that your body needs when feeling stressed. These plant foods are also a good source of calcium and magnesium, and in the optimum ratio that makes it easier for the body to absorb and use these nutrients.

Here are some easy ways to eat more phytoestrogen-rich foods:

• Keep raw seeds and nuts on hand for snacks, or sprinkle on salads.
• Drink a small bowl of miso soup instead of a second coffee.
• Mix up a batch of muesli with lots of nuts and seeds and eat with soy milk and fresh fruit.
• Include a couple of legume-based meals each week such as dhal, white bean dip or beans, lentils or sprouts in salads.

3. Learn to chill

Calming down can cool the flushes. Conversely getting “het up” and stressing out is a guaranteed trigger. Rather than reacting to having another hot flush, which will only make it worse, try to mentally detach from the reaction and be curious about what your mind and body is telling you. People, places and even memories can trigger hot flushes especially if they provoke anxiety. Menopause is a great teacher if you choose to listen.

Meditation and other mindfulness practices can lower your stress bar so less important things will trigger a response. Exercise, tai chi, creative practices and laughter are also reliable “chill pills”. If these measures aren’t sufficient a naturopath can prescribe herbs for your nervous system (as well as other menopause-specific remedies), or recommend a psychologist.

4. Change your tipple

When most women tune into what triggers their flushes, other than emotional reactions, caffeine or alcohol are often the culprit.

When you’re stressed, tired or irritated, suggesting you stop drinking or limit these beverages is probably the last thing you want to hear. A couple of scenarios I frequently come across in the clinic is women complaining that their makeup sweats off, when applying it in the morning after a hot cup or tea or coffee, or find they’re waking up multiple times during the night with hot flushes after even one glass (let alone a bottle) of wine.

This is a time to be kind to yourself. Try slowly cutting out the caffeine and reserve alcohol for special occasions, rather than a regular “reward”. Stopping or reducing both caffeine and alcohol will improve your sleep, daytime energy and turn the heat down.

5. Romance the bed

Sleep disturbance is a major annoyance for many women transitioning through the menopausal years. Get the basics sorted first, such as going to bed a little earlier than usual and investing in bedding made from natural fibres like cotton sheets, a cotton blanket and a light wool doona. Ditch the feathers as due to their insulating properties you’ll actually get hotter through the night under a down quilt.

And while we’re talking about bed, what about sex? Some women feel like having more sex during menopause but a drier vagina can make it uncomfortable or downright painful. Lube is your best friend for any kind of penetration. You might want to negotiate a wider repertoire of play with your partner, and learn new ways together to communicate both verbally and sensually. Satisfying sex (alone or with others) is a great way to reduce stress and release those happy hormones.

But what if you have zero desire for intimacy? Not being interest in sex isn’t a problem if you’re not in a sexual relationship or have a partner who has a similarly low libido. If it’s the opposite situation, without open and honest communication it’s likely to create more hot-flush inducing stress. Resentment, avoidance and guilt are emotions you can no longer afford to ignore in midlife. They can impact on both your physical and mental health if you don’t address them. If you can’t work it out together, individual or couples therapy might be a worthwhile investment.

A few more tips to ease hot flushes and other bothersome symptoms

If you’re still smoking, stop! Just like hot drinks, inhaling warm smoke is a known trigger for flushes. Consulting a hypnotherapist when you’re truly ready to stop, helps many long-term smokers change a habit of a lifetime.

Dress in layers and stick to natural fibres, can help you manage the heat. Avoid synthetic materials, no matter how light they feel on the rack, these fabrics don’t breathe and will trap any sweat.

Drink lots of water, especially with hot sweats you’re loosing more fluid than you may realise and dehydration can make stress worse. Some women experience bladder weakness with the onset of menopause and mistakenly drink less in an attempt to reduce the incontinence. Getting help to strengthen your pelvic floor from a specialist continence physiotherapist or clinical pilates is a better option.

Black cohosh has been proven to help ease hot flushes and other menopausal symptoms. But as an experienced herbalist, I find it works better in combination with other herbs tailor-made for your unique symptoms.

There’s not a single natural remedy for intrusive menopausal symptoms. Women come to this stage in life with unique histories and complex coping mechanisms. For some people, the diet, lifestyle or ways of dealing with stress that has got them through the previous decades no longer work. Seeing an experienced naturopath can help you through these lifestyle changes, and provide practical through this transition.

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Read the third installment – my menopause story – where I road test all the naturopathic diet, lifestyle and herbal knowledge.

Is menopause getting you down? Let’s work together to make this transition easier.

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• Menopause part three: my story
• More than just our hormones
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