Turn down the heat of hot flashes
Date published: 4/25/2004
 

FOR MANY WOMEN, the sudden sweating becomes a familiar interruption of work, sleep and life in general. Hot flashes, a hallmark of menopause, may bother women for six months to four decades, sometimes more than a dozen times daily. 

There are a variety of treatments, from drugs to deep breathing, vitamin E and soy. Nearly half of menopausal women try alternative and nutritional therapies, according to a report released by the U.S. Centers for Disease Control and Prevention last year.

Drugs ease heat 
Hormone therapy with estrogen and progesterone, though extremely effective, is linked to higher rates of breast cancer, heart disease, stroke and dementia. Still, many physicians recommend hormones for certain women.

Other drugs are also available, including newer antidepressants. One drug, Effexor, reduces hot flashes by up to 60 percent, while hormones cut flashes by 90 percent, according to the Mayo Clinic in Minnesota. Women can ask their doctors which hormones or drugs, if any, are appropriate.

Commonsense approaches 
For mild flashes, you don't need drugs. Keep your body cool by avoiding hot foods and drinks and dressing in layers, advises the North American Menopause Society. The society also says research shows that avoiding caffeine, quitting smoking and starting to exercise regularly can reduce hot flashes. 

Breathing prevents flashes 
Another option is "paced respiration," medical jargon for deep breathing, which can cut flashes by 50 percent, according to several clinical trials.

The average person inhales and exhales about 16 times a minute. But if you breathe eight or fewer times a minute and concentrate on breathing deeply into your belly rather than shallowly into your chest, you can stop hot flashes just as they start. 

To see if you are doing it right, loosen your belt and lie on your back with a book set over your belly button. If you're breathing deep into your abdomen, the book should rise and slowly fall. Try inhaling while silently counting from one to four, then exhaling to a silent count of eight.

This type of breathing is also called diaphragmatic breathing and is taught in yoga classes, not for hot flashes but as a way to increase endurance and relaxation. 

Cooling nutrients 
There isn't as much scientific evidence backing the effectiveness of foods and vitamins in reducing hot flashes.

Vitamin E and soy may help. Vitamin E is safe and nontoxic for almost everyone, as are moderate amounts of soy foods such as tofu and tempeh, but it's unclear whether soy supplements, which are more concentrated than foods, are safe for women who have survived hormone-sensitive cancers. That's because cancers of the breast, ovaries and uterus can grow in response to estrogen, and soy supplements contain large amounts of plant estrogens. Some researchers theorized that the plant estrogens would block human estrogen from working, thus protecting against cancer, but others worry the natural chemicals could stimulate existing cancer cells.

Scientists aren't sure if black cohosh, another supplement taken for hot flashes, contains plant estrogens. It's sold in local stores under the name Remifemin. 

Last year, researchers at a National Institutes of Health Center in Chicago suggested that black cohosh works like an antidepressant, not like estrogen, but they studied rats, not human beings.

Other herbal supplements I looked at did not have convincing evidence. 

For now, vitamin E seems the safest bet, being nontoxic for almost everyone except people taking a blood-thinning medication called Coumadin. If your doctor agrees, try taking 800 International Units of vitamin E daily for up to four months. 

When buying vitamin E, choose the natural form, called D-alpha-tocopherol. Another form of the vitamin, L-alpha-tocopherol, is useless.

Supplements are necessary, because it's hard to get enough vitamin E from foods to prevent hot flashes. The best food source that I know is wheat-germ oil, and one tablespoon has 30 IU of vitamin E. This meets the federal government's daily value for vitamin E but is 26 times less than the amount shown to reduce hot flashes.

Still, it doesn't hurt to eat vitamin E-rich foods, such as wheat germ, hazelnuts, sunflower seeds, almonds, peanut butter, avocados and sweet potatoes.

JENNIFER MOTL welcomes reader questions via her Web site, brighteating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.