Ask a nutritionist: what will help with my hot flushes?

As they go through menopause, many women will experience hot flushes, caused by changing levels of oestrogen in the body. In fact, a reported 75% of menopausal women experience hot flushes at some point. These sporadic and random sudden feelings of heat, redness, and sweating can spread through the entire body. At best, they can cause minor discomfort or embarrassment, and at their worst they can cause dizziness, heart palpitations, and be extremely distressing.

It is no wonder, then, that many women will seek some form of treatment for their hot flushes and other menopausal symptoms as they go through menopause. Many women will choose to take hormone replacement therapy, or HRT, which is proven to reduce hot flushes, along with helping many other symptoms of menopause. However, HRT is not safe for all women, or some may prefer not to take it.

In the first instance, there are plenty of minor lifestyle adjustments you can make to reduce the impact of your hot flushes, but if these don’t work for you, then what other options do you have? Anecdotally you will find reports of women using all sorts of supplements and herbs, claiming they have found the miracle cure. Nonetheless, scientific research on the efficacy and safety of these is scant. So, what do nutritionists recommend?

Are foods containing phytoestrogens helpful?

Angelique Panagos, a nutritional therapist based in London, says that while there are many foods and supplements that can help reduce hot flushes, “we are all biochemically individual, and what may work for one person may not work for another”. “I would recommend speaking to your GP and working with a nutritional therapist to work out a bespoke programme for you and your needs,” she says.

“While soy is high in phytoestrogens and isoflavones, which have shown positive results in some studies, it’s the quality of the soy, the amount, and the duration of eating it that play a big role.”

Nonetheless, she does point out there is some evidence that supports soy as having beneficial effects when it comes to reducing hot flushes, as it is high in phytoestrogens, plant compounds which bind to oestrogen receptors to subtly raise oestrogen levels. “While soy is high in phytoestrogens and isoflavones, which have shown positive results in some studies, it’s the quality of the soy, the amount, and the duration of eating it that play a big role,” she says. “I would recommend only having organic, fermented non-GMO soy as part of a varied diet, not the main component.”

On top of this, there is some evidence suggesting that the efficacy of soy on each woman depends on their gut microbes, so, unfortunately, while soy may work wonders at reducing hot flushes in some, for others it may bring about no noticeable improvements at all.

Vitamins

Plenty of sites claim that vitamins C and E can have a beneficial effect when it comes to menopause symptoms. Vitamin E is a fat-soluble nutrient that has antioxidant properties, and has been said to reduce stress and also have an anti-inflammatory effect. Nonetheless, scientific evidence is lacking when it comes to the benefits of vitamin E with regards to hot flushes.

However, “it can ease other symptoms of menopause such as dryness, and low mood”, says Sonal Shah, a member of Nutritionist Resource and a nutritionist at Synergy Nutrition. “Avocados, nuts and seeds, and green vegetables all contain vitamin E,” she continues. “And an oil based vitamin E supplement with mixed tocopherols (a mix of different vitamin E forms) can be taken to top up levels.”

“Generally speaking, I always prefer that my clients obtain their nutrients through food and use very specific supplements to close the gaps, where necessary.”

Others don’t recommend taking vitamin E supplements however, as it can be dangerous if you take too much of it, so it is worth consulting your doctor first. “It’s always better to get your nutrition from the foods that you eat,” says Katherine Bellchambers, a nutritional herbalist based in Nottingham. “However, if someone is very run-down supplements can be useful.”

Le’Nise Brothers, a registered nutritional therapist and women’s health coach, also recommends vitamin E for its anti-inflammatory properties, but only by consuming foods containing it. “Generally speaking, I always prefer that my clients obtain their nutrients through food and use very specific supplements to close the gaps, where necessary,” she says.

Vitamin C is an all-rounder, and is water soluble so needs to be taken daily, although it isn’t hugely difficult to get all the vitamin C you need from fruit and vegetables. It protects cells, and maintains healthy skin and blood vessels, although studies about its efficacy when it comes to hot flushes are lacking. However, according to Le’Nise, vitamin C can also be useful for adrenal support. “Adrenal support is very important for managing hot flushes, as menopausal women produce small amounts of oestrogen from the adrenal glands,” she says.

Le’Nise also recommends foods containing essential fatty acids, including omega 3. “These have been shown to reduce inflammation and support female hormone balance,” she says. “Oily fish and flaxseed are good sources.”

Herbal supplements

“I find that certain herbs taken in tablet or capsule form have helped my own clients with hot flushes and night sweats,” Sonal says, listing sage, red clover, and combination herbs available in supplement forms with black cohosh. However, she advises people consuming them read the label and speak to a doctor before taking them to ensure they are safe.

“The scientific research behind how these herbs reduce menopausal hot flushes is lacking,” Sonal adds. “But anecdotal evidence seems to show an improvement in the management of menopausal symptoms.” Scientists have speculated that phytoestrogenic components in the herbs, along with their antioxidant benefits, may play a part.

Katherine also recommends black cohosh, sage, and red clover. “Black cohosh helps balance the hypothalamic pituitary ovarian axis and in relatively small doses can nudge things back into balance sufficiently to reduce pulses of follicle stimulating hormone (FSH) and increase oestrogens enough to reduce flushes,” she says. She does highlight safety concerns regarding black cohosh, although adds that the evidence for harm is poor quality.

“It’s important to look after yourself. Rest, sleep, relaxation, moderate exercise and meditation are all key in keeping our hormones balanced. Food and lifestyle needs to be your starting point. You can’t override an unhealthy diet or lifestyle by taking supplements.”

Angelique warns against taking supplements or herbs without consulting with a nutritional therapist first, however. “Though there may be studies that back them up,” she says, “they are really potent and some can be contraindicated with certain medication.” Le’Nise agrees, stating that while herbs can be beneficial for some women, she always prefers to consider them on a case by case basis.

Lifestyle changes

If you’d rather avoid supplements, there is plenty you can do otherwise. “Cut down on red wine, chocolate, and mature cheese as they contain a chemical that can trigger hot flushes by affecting the brain’s temperature control centre,” says Sonal. “It is also wise to avoid spicy foods, as these can induce heat in the body too.” Instead, follow a healthy diet full of fruit, vegetables, whole grains, lean protein, and oily fish.

Katherine also recommends rest and relaxation. “Many women going through the menopause are chronically under-rested, and hot flushes really don’t help,” she says. “Regular mindfulness or meditation can be life changing and help your body to deal with the problem.”

Angelique agrees, adding that making basic lifestyle changes and eating a healthy diet need to form your starting point before you turn to herbs or supplements hoping for a miracle cure. “It’s important to look after yourself. Rest, sleep, relaxation, moderate exercise and meditation are all key in keeping our hormones balanced and in preventing spikes of cortisol,” she says. “Food and lifestyle needs to be your starting point. You can’t override an unhealthy diet or lifestyle by taking supplements.”

Whichever approach you wish to take, always make sure to discuss your options with your GP, and consult them before taking any supplements to ensure they are safe for you.

Featured image shows a woman eating a meal of salmon on rice and asparagus. The image is cropped so you can only see the plate of food and her hand holding the fork.

Page last updated June 2018