How to prevent menopausal hot flushes this summer

Hot flushes are a common symptom of perimenopause and menopause and for some women, they can continue for several years post menopause. They can be experienced as a sudden feeling of intense heat, a tingling, red or flushed face, sweating, and other symptoms including dizziness, nausea, heart palpitations and even chills. Night sweats are simply hot flushes that occur at night.

As we head into summer, hot, sunny days can make flushes worse for midlife women but fear not, there’s actually a lot you can do to prevent the hot weather from increasing their intensity.

Why do hot flushes happen in menopause?

Without getting too technical, hot flushes in menopause are thought to be caused by a narrowing of the thermoneutral zone in the brain, which is the range of temperature the brain considers to be normal. This narrowing of the thermoneutral zone is thought to be caused by changes in oestrogen levels as women go through perimenopause and menopause. Falling oestrogen levels also affect levels of serotonin and noradrenaline which affect the hypothalamus, the part of the brain involved in temperature regulation.  As the zone gets narrower, the brain’s ability to regulate body temperature is reduced and even a tiny change in temperature can trigger the body to make an adjustment with sweating or shivering.

Noradrenaline is one of our stress hormones, and this is why managing stress is so important for preventing hot flushes. The more stressed you are, the more likely you are to experience a hot flush. Stress is one of the main reasons women continue to experience hot flushes for several years post menopause.

What are common triggers for hot flushes?

It can be really helpful to keep a diary of when your hot flushes occur to help you identify any food or drinks which could be triggering them. However, the main triggers for menopausal hot flushes include:

·      Low oestrogen

·      Stress

·      Blood sugar imbalance / insulin resistance

·      Dietary triggers such as spicy foods, sugar, alcohol, caffeine, hot drinks

All women have different triggers for hot flushes and their management therefore needs to be personalised. HRT can be very beneficial as replacing the lost oestrogen and progesterone helps to stabilise the brain’s thermoneutral zone and support brain energy. Speak to your GP if you would like to explore this option.

So, how can you stay cool this summer?

Here are my top diet and lifestyle recommendations for managing menopausal hot flushes:

1. Watch the sugar and high-carb foods

Eating too many carbohydrates and too much sugar is a contributor to so many menopause symptoms, including hot flushes. Changes in levels of oestrogen mean that your body handles starchy carbs like potatoes, rice, pasta, bread, pastries and anything at all with sugar in it, differently. As a result, your body produces more insulin than it needs to in response to eating this kind of food, and eventually this causes problems with insulin signalling in the body, known as insulin resistance. Lowering sugar and carbohydrates is often an effective strategy for reducing hot flushes. You can do a really simple HbA1c test at home to check your recent blood sugar levels, contact me if you’d like to find out more.

2. Ditch the booze

Alcohol causes the blood vessels near the skin’s surface to dilate, which can trigger hot flushes. That chilled glass of wine on a hot day may seem like a good idea but unfortunately, it’s likely to be making the problem worse. Many of the women I work with find that when they stop drinking alcohol, the hot flushes significantly reduce or even disappear. Why not give it a try for a couple of weeks and see if it helps you? There are some great alternative drinks to alcohol now such as CBD drinks, 0% sparkling wine or spirit alternatives such as Seedlip, so you don’t have to feel like you’re missing out!

3. Mind the caffeine 

In a similar way to alcohol, caffeine causes vasodilation as well as triggering the release of noradrenaline – a double whammy for hot flushes! An afternoon cuppa will also DEFINITELY reduce the quality of your sleep, whether you feel it or not, because of the length of time it takes for the caffeine to leave your body (up to 12 hours!) Hot drinks generally can be a trigger for hot flushes as they raise our body temperature, triggering the brain’s thermostat which as we know, is more sensitive during menopause.

4. Do some gentle exercise

Studies have shown strength training (such as exercising with weights) and yoga to be helpful in managing hot flushes. Cold water swimming may also be helpful through its ability to reduce stress, calm the nervous system and constrict blood vessels.

5. Reduce your stress

Stress is a major contributor to hot flushes due to the release of noradrenaline, dilation of blood vessels and its effect on blood sugar levels. Reducing stress is always the hardest lifestyle factor to address but try to find ways of managing stress which work for you. Some ideas include meditation, breathwork, yoga, being outside in nature, doing something you enjoy and relaxes you or connecting with others.

6. Keep your cool at night

Try to keep your bedroom as cool as possible to prevent night sweats and promote sleep. Leave the curtains closed during the day to prevent the room heating up, open the curtains and windows wide in the evening, use a light-weight duvet or thin sheet (silk sheets and pillowcases are cooler than cotton) or invest in a fan to keep your space cool. You could also invest in a chill pad to put under your mattress.

7. Hydrate!

Few women drink enough water and it’s even more important in hot weather. Women lose moisture more quickly in menopause so make sure you’re drinking a minimum 2 litres of water a day.

8. Include phytoestrogens in your diet

Some women find eating a diet high in phytoestrogens (plant oestrogens) can help to reduce hot flushes and in Asian countries where women consume much higher levels of phytoestrogens such as soy, hot flushes are relatively rare. Phytoestrogen foods include soy, edamame, flaxseed, garlic and cruciferous vegetables.

9. Supplements

Many supplements have been proposed to be helpful for hot flushes including sage, black cohosh, magnesium, taurine, maca and reishi mushrooms. Always work with a practitioner to ensure you’re taking a quality supplement at the correct dosage and to also ensure safety, as some herbs are contraindicated with medical conditions and medications.

10. Complementary therapies

Try other therapies which can be beneficial such as acupuncture, reflexology or CBT.

I also advise wearing loose clothing and layers that can easily be removed during a hot flush, and carry a handheld fan with you at all times so you're prepared when a hot flush strikes. You can also get fans that sit around your neck which can really help you keep your cool this summer.