Alternative Treatments for Hot Flashes

By , SparkPeople Blogger
Editor's Note: Cathy Cram, M.S., is the resident maternal fitness expert on our sister site,

By Cathy Cram, M.S.

This second blog in a three-part series on treatments for menopausal hot flashes focuses on alternative options. This blog topic has been a challenging one to write, as alternative treatments don’t provide a traditional model for applying clinical research results in order to determine how effective a treatment or drug is on a condition. As I’ll discuss later, there are several confounding issues that make it difficult to be able to present clear pros and cons for alternative treatments based on past studies.

As you read through this blog keep in mind that I’ve tried to give you the most accurate overview on each treatment as possible, but these brief conclusions are by no means the last word on the benefits and risks of these hot flash treatments. For more information on current research being done on these and other alternative hot flash treatments check out the resources section at the end of this blog.

Herbal Treatments

Herbal medicine is based on the use of plants as remedies for a wide range of conditions. Herbal supplements (containing either one or several herbs or mixed with other ingredients) are available from health food stores, alternative healthcare professionals, pharmacies, herbalists and the Internet. As such, the range of potency, ingredients, quality and price can vary greatly.

In the US, there is very little regulation on alternative medications, making it difficult to be able to quantify through research that a particular herb or compound has a positive (or negative) treatment effect. The lack of standardization and regulation makes it difficult to determine just how much of an herb or supplement is contained in a product, or if there are additional unlisted ingredients. Another misconception is that any herb or supplement termed “natural” is synonymous with “safe.” There have been many instances of herbal products and vitamin supplements causing serious side effects in some individuals, so do some homework before you try any product, compound or treatment for your hot flashes. Remember that anything you ingest has the potential to help or hurt you, and may interact with medications you currently use.

Many women have found that working with a licensed, alternative medicine professional is the most effective and safe way to get relief from their menopausal symptoms. I spoke with Anne Marie Fine, NMD, a board certified naturopathic physician about what someone should look for when seeking alternative healthcare treatment. Dr. Fine recommended going to the website to find a naturopathic physician (someone who has been trained as a primary care physician, but also has received broad based training in natural therapeutics).

Dr. Fine uses alternative hot flash treatments in her practice, but stresses that each woman’s needs are unique, so the prescribed individual treatment progression is based on each patient’s specific symptoms and response to the prescribed compounds. Dr. Fine also feels it’s important to know the source of your herbs, and she underscores the need for practitioners to use herbs from professional lines that meet Good Manufacturing Practices and are tested for purity and consistency, and processed under strict facility sanitation guidelines. She feels the using these types sources allows her to know exactly what amount of herb is in her preparations as well as the quality of her products.

Black Cohosh
There are several types of Black Cohosh available, as well as a product called “RemiFen” that contains 20 mg of Black Cohosh Extract in each capsule. This herb has been used for a variety of conditions, including menopausal hot flashes. A large Herbal Alternatives study (HALT) that looked at the use of Black Cohosh alone and with other botanicals, did not find any difference in the number of daily hot flashes or night sweats in any of the herbal supplement groups as compared to placebo group. A Database of Abstracts of Reviews of Effects (DARE) done in 2011 concluded that the evidence from the studies doesn’t consistently show a significant effect from the use of Black Cohosh on hot flashes, but suggests more research is needed.

There have been other studies that have showed a decrease in hot flash frequency with the use of Black Cohosh, but as with all herbal research on this topic, it’s been difficult to determine whether this herb is effective for hot flashes because of varying herb dosing and lack of well-designed studies.

This plant has been used to treat premenstrual syndrome and is thought to have a hormone-regulating effect that may be helpful in treating menopausal hot flashes. There is little research available on the effectiveness and safety of this product, and women who have had breast cancer or other hormone-sensitive conditions should avoid this product.

Dong Quai
A study that looked at 71 women who had hot flashes found there was no difference in hot flash relief between those taking Dong Quai and those taking a placebo. Similar studies have also failed to find a significant reduction in hot flash symptoms with the use of this substance.

DHEA occurs naturally in the body and is the substance that is used in the production of estrogen and testosterone. DHEA is also manufactured as a dietary supplement and used to treat age-related conditions. There haven’t been any studies that have shown that DHEA is effective in treating hot flashes, and the safety of this product isn’t established. There is some concern that supplemental use of DHEA may increase the risk for breast cancer.

Ginseng (Panax ginseng or Panax quinuiefolius)
Studies have not shown any benefit with using Ginseng in the treatment of hot flashes, but there is some evidence that this product may help with mood state.

Evening Primrose Oil
This plant oil is used to treat menstrual symptoms such as breast pain and PMS, as well as some inflammatory skin conditions. There is no evidence in the literature that has shown Evening Primrose oil to be effective in reducing hot flashes.

A 2008 study done with breast cancer survivors who had hot flashes found that women who took part in weekly hypnosis sessions had a 68% reduction in hot flashes per day compared with controls. In addition, the hypnosis group had a significant improvement in their sleep and reduced anxiety and depression levels.

Homeopathy uses a minute, diluted amount of an active ingredient to treat a specific condition. There’s little quality research that’s looked at the use of homeopathy for hot flashes, and what studies have been done show no difference in results using homeopathy versus placebo.

Phytoestrogens are plant based estrogen-like compounds that have been used in the treatment of hot flashes. The type of phytoestrogen that has shown promise in the treatment of menopausal symptoms is the isoflavone group found in soybeans, soy products and red clover. There have been numerous studies on the use of isoflavones in the treatment of hot flashes with some showing benefit and others none, but confounding results make it difficult to determine whether the use of isoflavones is beneficial and safe for long-term use.

Red Clover
The flowers from this plant are used to make extracts that can come in tablet or capsule, tea or liquid form. There have been mixed results in the studies looking at Red Clover and hot flash treatment, and it’s been concluded at this time that red clover doesn’t have any significant value on its own as a menopausal treatment. Red Clover contains estrogen-like compounds, so women who have had reproductive organ or breast cancers should consult with their healthcare provider before using this herb.

Acupuncture uses fine needles placed in specific areas of the body to help relieve a wide range of physical and emotional conditions. Some practitioners use a form of acupressure, (using the fingers to apply pressure to areas of the body instead of needles) and both techniques have been used to help reduce hot flashes. Most studies on acupuncture and hot flashes have shown conflicting results. A recent meta-analysis (an analysis of several similar studies to determine whether the combined results show a significance effect) failed to find beneficial effects of acupuncture when compared with placebo for hot flashes.

The bottom line concerning alternative hot flash treatments is that more research is needed in this area. The following are the main issues concerning alternative treatment research outcomes:
  • Not enough well designed studies have been done on alternative menopausal hot flashes treatments to be able to draw strong conclusions (i.e.: cause and effect).
  • Many studies have not used standardized products so it’s very difficult to determine how much of a specific herbal product was used in each study.
  • There haven’t been enough studies on combinations of alternative treatments that may be effective for reducing hot flashes during menopause.
  • The alternative medicine model uses a personalized, whole-body approach that can consist of a comprehensive array of treatments and dietary modifications for the treatment of a condition. The wide variety of alternative treatment options that may be used for one condition make this type of treatment difficult to study with the traditional research model.
The good news is that one of the leading investigators in the field of alternative medicine, the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health has begun to design outcomes based studies that more closely resemble the treatment approach an integrative physician would provide. The ongoing studies from this organization, as well as other clinical trials, will help increase the knowledge base of what types of alternative treatments may provide hot flash relief.

Lastly, the most important factor to consider if you decide to use alternative treatments is to seek the guidance of a Naturopathic physician who uses a whole-body approach. It takes a combination of education, experience and expertise to effectively and safely use alternative treatments, so don't risk your health by trying to navigate this field on your own.

American Association of Naturopathic Physicians

American Psychotherapy and Medical Hypnosis Association

Journal of Alternative Medicine Review

National Center for Complementary and Alternative Medicine

Catherine Cram, M.S. is the author of Fit Pregnancy For Dummies, and the owner of Comprehensive Fitness Consulting, LLC. Catherine’s company specializes in providing prenatal postpartum fitness information to health-care professionals.

Have you tried any of these remedies?

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CECELW 11/29/2020
I had no idea DHEA helps with hot flashes Report
There are good aides for all ailments that are not a pill. Just read up on what you are thinking about and know all side effects! Report
GEORGE815 8/11/2020
Thanks Report
REDROBIN47 7/22/2020
Thanks for the info. Report
I wasn't aware that there was anything that would help hot flashes, I'm glad I read this. Thanks Report
I used evening primrose oil for PMS but haven't had severe enough hot flashes to try any of these. I would try each or a combo to see what worked best. Cohosh is pretty standard as is the clover. Making as a tea to drink is ideal & taken daily. Report
Thanks for sharing. Report
I haven't tried any of these. I'm not sure I want actually. I take meds for chronic issues. I wouldn't risk it Report
thanks Report
I have tried estroven but none of the others. Thank you for this one! Report
Thanks for sharing. Report
Tried black cohosh but it made the hot flashes worse, I have been having hot flashes for 25 years and nothing seems to stop them Report
I used Dong Quai Report
I used Dong Quai Report
I used to take Black Cohosh, Flax Seed and Evening Primrose Oil. This combination was prescribed by a Naturopath and it worked fine for me. Report
good info. Thanks Report
Thanks for your comments! It's helpful to hear what's worked for you in reducing hot flashes and was hasn't. Report
I have two chaste berry bushes in my back yard. I used to make a tea with them that helped with my hot flashes. I do not get hot flashes much any more but they are out there and the little lavender colored flours are quite pretty.
I was told the local indigenous tribes used to use chaste berry tea with the leaves. It grows wild in the Sacramento valley and foothills.
I used evening primrose oil - don't remember dosage, but it's fairly standard. Took one a day. Also used soy milk on cereal 3-4 times a week and used flaxseed oil - about a tablespoon a day. Went through menopause with 2 hot flashes and no other symptoms. A nurse friend told me about the evening primrose oil; it's fairly well known as being helpful for menopause. Report
Just a heads up all reading this blog...
I had terrible hot flashes so bad drove me crazy and night sweats just awful
I was told to try evening primrose --not one to believe in these types of remedies I took them with humour not expecting it to work...
Well it did I was shocked I started with 2 pills at night then weaned off to only 1 pill now I do not take them...never a hot flash again...well mild ones when I get stressed keep your stress level low..
Just my 2 cents..even if there is no data to prove it helps it helped me.. Report
I tried RemiFemin and it was horrible. It took a couple of weeks, but my hot flashes started coming with increased frequency - sometimes more than once an hour. The intensity was pretty much what I had been experiencing. Working out didn't seem to diminish the number of hot flashes. After a couple of months, I decided to stop taking RemiFemin and within days the number of hot flashes went down to maybe 1-2 a day AND the intensity went down. After stopping the product I noticed that doing a hard workout (had to be more intense than walking) would often eliminate hot flashes. Since this experience I've decided to just go with the flow and try to exercise vigorously 5 or more days a week. Report
I tried RemiFemin and it was horrible. It took a couple of weeks, but my hot flashes started coming with increased frequency - sometimes more than once an hour. The intensity was pretty much what I had been experiencing. Working out didn't seem to diminish the number of hot flashes. After a couple of months, I decided to stop taking RemiFemin and within days the number of hot flashes went down to maybe 1-2 a day AND the intensity went down. After stopping the product I noticed that doing a hard workout (had to be more intense than walking) would often eliminate hot flashes. Since this experience I've decided to just go with the flow and try to exercise vigorously 5 or more days a week. Report
I am in my mid 50's and use Remifemin too. It helps me tremendously. In my house they are called taking the "nice" pills since I also sometimes have erratic mood swings. However, I don't use it daily; only take it when needed.

What I did was try to find the triggers for my hot flashes - stress, not enough sleep, not drinking enough water, and not eating right (too much sugar/not so healthy carb laden foods) sets them off. When I go for a regular walks, do any kind of stress release (even grocery shopping or having 20 minutes to myself), and cut way back on sugary / carby foods, I get better sleep and a lot less hot flashes. Recently we moved cross country from very cold to very warm. I have less hot flashes here than there, so it obviously works for me. Occasionally I do have to take a pill, but when I stop to think about it, at least one or more of the "triggers" were pulled :) Report
Tried the herbs, what a big waste of money, these companies should be put out of business. Was better to just tough it out, in my opinion. Way too many companies out there lying to us as to what may or may not work, and no one does anything about them since they are just over the counter. Rip off! Report
I tried estroven and it worked ok for a while. I now use black cohosh and it seems to work much better. I also have been reducing caffiene in my diet. Report
For those of you who have noticed an improvement with an alternative treatment, could you post the dose of product that you took (the amount of herb, oil, homeopathic, phytoestrogen or supplement in the product, other ingredients in the product ingredient list, and number of doses per day). Also, please list any side-effects you may have experienced, how long it took to see a reduction in hot flashes, and any other treatments you may have used in combination.
Thank you!
Cathy Report
I have tried acupuncture for pain and for anxiety. I do like it very much. I need to make a few more appointments. Thanks. Also soy products really helped hot flashes. Report
As someone who had debilitating hot flashes-back-to back, all night and several during the day, I found that Black Cohash was a lifesaver for me. If I had any doubts that it was not the Black Cohash, all I'd have to do is go off of it for a few days, and WHAM-O, the flashes were back with a vengeance. Report
Thanks everyone for you comments. I just want to add that there are many other alternative remedies associated with hot flashes treatments, but the ones mentioned in this article were the most referenced and researched among alternative healthcare options.
I value your suggestions, so please feel free to post your experiences with alternative hot flash treatments.
Cathy Report
I use estroven and magnesium. Magnesium (the mineral in pill form) helps alot with hot flashes and it wasn't mentioned in the article. Report
I have been using Evening Primrose Oil for over a year because it stopped my severe hot flashes completely. Report
I am in peri-menopause now, and am not having any hot flashes, however I had started HRT because of the irregularity of my periods and was reminded that I should not take HRT longer than 5 years, when the side effects (possibly cancer-related) outweigh the benefits (heart protection). It was not did not change my periods so with my doctor's monitoring, I stopped taking it. I have not started an alternative to it because the information is too scant to make an informed decision. I continue to have irregular periods but only expect that to last through this year. In reading the comments, I do find that people using alternative supplements have varying degrees of success. Time to continue researching! Report
Thank you for a well balanced report. I'm very glad to see the results of meta-analyses for each of the 'treatments' outlined. Report
I've used acupuncture before, but not for hot flashes or any peri-menopausal symptoms. How many times is a person supposed to go to their practitioner before they see results ? that could get expensive if a person were suggested to go once a week.

As far as ginseng, I have started to drink ginseng tea because I've read studies that it might help improve a person's overall health and reduce stress. It certainly can't hurt and I do like a nice cup of tea.

I became vegan & without eating the hormones that are in meat I have no hot flashes. I had trouble with the synthetic estrogen found in most sunscreens, but when I quit using it & switched to wearing a wide brimmed hat they stopped. Report
I had a total hysterectomy at 48 and went on HRT the next day, and never had a "Hot Flash" ever, so I was very happy with that. Report
I never had a "Hot Flash" after I had my hysterectomy in 2004 during chemo. I have never taken any medications along this line. I am now 55 and feel great! Report
I tried Black Cohash and found that it did not help reduce the number of or the intensity of my hot flashes. Oh well. Report
I tried Black Cohash and found that it did not help reduce the number of or the intensity of my hot flashes. Oh well. Report
I tried Black Cohosh, Evening Primrose & PhytoEstrogens with very little results. Everyone's body responds differently to each remedy. Find the one right for you. Mine was homeopath tincture of Motherwort. It truly zapped the hot flashes. Great article Report
I have used Remifemin and it does help. With my family history I am hesitant to use anything that could increase my cancer risks. I am also using some guided imagery CDs and they help also. Report
50 years old and still having a regular period but want to read as much info as possible to be ready. Report
What about glycerhizza & serenoa? Report