Sitting in the restaurant, warmth suddenly spread through my body. Beads of sweat formed on my head. I was helpless as rivulets coursed down my neck and over my forehead. I thought my head would explode! Excusing myself, I retreated to the bathroom, but it was less air conditioned than the restaurant. No relief!

In a while the sweating ceased, my shirt dried, and dinner went well. My fiancée and I announced our plan to marry. Mostly, our daughters wondered what took us so long to decide what they knew months ago. My sweating had been nothing more than a brief distraction. Their concern focused on dad’s embarrassment, not the physical event.

The bottom line.
Of course, hot flashes occur more commonly in women, but in my experience the response by men to a woman becoming flush is similar to how my fiancée and daughters responded to my flash.

When it comes to menopause, like most things in life, your attitude is everything. Hot flashes — along with the other physical and emotional changes that accompany menopause — are a stepping-stone to the second half of your life journey.

Society tends to focus on the negatives. Your challenge is to be atypical. Embrace your body and its changes. Then, don't be surprised when others do as well.

Need help? Talk to your doctor about prescription drugs to ease the transition. Complementary and alternative treatments are popular but controversial.

Complementary Options to Manage Hot Flashes
Here’s a summary of the evidence for complementary treatments to help manage hot flashes (sometimes called a hot flush).

Behavioral modification

• The Menopause Society recommends lifestyle changes as first-line therapy (e.g., wear loose clothing, sip cold drinks, avoid spicy food, and maintain a lower room temperature).

Relaxation (paced breathing, mindfulness, hypnosis)

• Most studies are positive, but results are based on small numbers of patients and a variety of relaxation techniques and evaluation tools.
• Preliminary data on hypnosis are encouraging, but more study is needed.
• In cancer patients, short-term benefits are reported with mindfulness-based stress reduction.

Black cohosh (Cimicifuga racemosa)

• Older studies from the 1980s suggested black cohosh was beneficial.
• Newer studies don't support these results.
• Therefore, its use is controversial, with some experts believing black cohosh is effective for relieving hot flashes in early menopause.
• Caution, rare cases of hepatitis have been reported, although an association with black cohosh is not proven.

Phytoestrogens (e.g., soy, isoflavones from red clover, and lignan)

• A review of 30 studies of various phytoestrogens found no evidence of reduced frequency or severity of hot flashes.
• However, a review of isoflavones found a slight-to-modest reduction in the number of hot flashes.
• One study of red clover found it was less effective than placebo.
• Phytoestrogens aren’t recommended, but this could change as research continues.

Dehydroepiandrosterone (DHEA)

• DHEA is not recommended for the majority of postmenopausal women.
• However, DHEA supplementation may be beneficial in women with the lowest levels of DHEA and when osteoporosis is a problem.

Yoga

• Several studies show benefits, while others do not.
• Further research is needed to confirm the reported benefits for hot flashes.

Supplements and techniques lacking scientific support for treating hot flashes

• Acupuncture
• Dong quai (Angelica sinensis)
• Evening primrose oil (Oenothera biennis)
• Exercise to reduce stress
• Ginseng (Panax ginseng)
• Vitamin E
• Wild Yam (Dioscorea villosa)

Consider this a starting point for discussion with your healthcare provider.

Remember, failure to control hot flashes doesn’t mean that these treatments might not be helpful to control other symptoms of menopause. More on these treatments and prescription drug therapy may be found here.