The dreaded hot flash can strike without warning. One moment you're fine, and the next you're engulfed in a wave of heat, particularly around your chest, neck, and face. Your skin reddens as if you're blushing, and you start to sweat, either a little or a lot. You might find yourself stripping off layers of clothing, feeling your heart race, and experiencing a surge of anxiety. Once the hot flash subsides, you're left feeling cold and reaching for those discarded layers as chills set in.
While these episodes are usually brief, lasting only one to five minutes, they can be incredibly uncomfortable and disruptive. Depending on their frequency and intensity, hot flashes can interfere with your daily activities and affect your overall quality of life.
Hot flashes can vary greatly—they might happen just a few times a week or as often as twice an hour, and they can range from mild to severe. When they occur at night, they're known as night sweats, which can disturb your sleep and even lead to insomnia.
Also called hot flushes or vasomotor symptoms, hot flashes are the most common sign of the transition to menopause and often the first indication of perimenopause. According to the Journal of Midlife Health, about 85% of menopausal women experience hot flashes, and around 55% notice them as their menstrual cycles become irregular. Although each woman's experience with menopause is unique, hot flashes typically become more frequent and intense as menopause approaches, peaking late in the transition before gradually declining.
Even after reaching menopause—the point when you haven't had a period for a year—hot flashes can persist for many years. Research from the Study of Women’s Health Across the Nation (SWAN) suggests that hot flashes and night sweats last, on average, about seven years, and can continue for 11 years or more. No matter how long they last, hot flashes are a bothersome and distressing part of the menopausal journey, impacting your overall well-being.
What are hot flashes?
Hot flashes are a type of temperature dysfunction commonly caused by changes in hormone levels before, during, and after menopause. Core body temperature normally remains within a specific range that fluctuates a bit throughout the day to keep organs working well. The body has numerous mechanisms to maintain this consistency. For example, you shiver when you are cold to raise your body temperature and sweat when too hot to cool down.
Researchers don’t know exactly why changes in hormones, especially estrogen, cause hot flashes. They think that changes in estrogen affect pathways and mechanisms in the body that help keep body temperature within the normal range.
What increases the risk of hot flashes?
Several risk factors can increase your risk of experiencing or having more frequent hot flashes. These include smoking and having a high body mass index (BMI). Race can also be a risk factor. Black women report having more hot flashes, while Asian women say they have them less frequently.
Risks associated with hot flashes
Research suggests hot flashes may be linked to cardiovascular disease. The SWAN study found that women with more frequent hot flashes had twice the risk of heart attacks, strokes, and heart failure.
While researchers aren’t sure whether treating hot flashes will reduce your risk of heart disease, having them could indicate that you are at a higher risk of heart disease. If you aren’t taking care of your heart health, midlife is a good time to change your lifestyle and ensure your blood pressure and cholesterol levels are in a healthy range. It’s particularly important to monitor and take care of your heart health during menopause because estrogen helps protect women from heart attacks and stroke while declining levels increase risk.
There are many things you can do to improve your heart health. Start by eating a Mediterranean-style diet, managing stress, and exercising regularly. Taking certain supplements may also help.
A review of studies on supplements that reduce cardiovascular risk published in the Journal of the American College of Cardiology concluded that “Supplementation with n-3 fatty acid, n-6 fatty acid, l-arginine, l-citrulline, folic acid, vitamin D, magnesium, zinc, α-lipoic acid, coenzyme Q10, melatonin, catechin, curcumin, flavanol, genistein, and quercetin showed moderate- to high-quality evidence for reducing CVD risk factors.” Green tea, flaxseed oil, magnesium, red yeast rice, and garlic may also help improve your heart health.
Top 10 Supplements for Hot Flashes
While some supplements support heart health during menopause, others can help manage hot flashes and night sweats. Here are ten of the best supplements for menopause and hot flash relief:
1. Black Cohosh
Black cohosh is a perennial plant native to North America, traditionally used to treat various health issues like menstrual irregularities, menopausal depression, night sweats, and hot flashes. In Chinese medicine, it’s used for fatigue, shortness of breath, and prolapsed uterus.
Black cohosh is a phytoestrogenic herb, meaning it contains plant compounds that mimic estrogen. Though its exact mechanism is unclear, it may modulate estrogen, affect serotonin, reduce inflammation, or act as an antioxidant.
A study involving 80 postmenopausal women showed that taking black cohosh for eight weeks reduced the number and severity of hot flashes and improved overall quality of life.
You can take black cohosh as a tincture, tablet, or capsule.
2. Vitex (Chaste Berry or Chaste Tree)
Vitex is a shrub native to the Mediterranean, Europe, and Central Asia. It has been used for centuries to treat female health issues like PMS, fibroid cysts, irregular periods, and menopausal symptoms. Historically, Hippocrates used it for injuries and inflammation, and Pliny the Elder used it to support menstruation and lactation.
Scientists believe Vitex affects hormone levels through the hypothalamic-pituitary-ovarian axis, which regulates female reproduction. A small trial involving 52 Korean women found that those who took Vitex for eight weeks experienced fewer hot flashes, less anxiety, and fewer overall menopausal symptoms compared to controls.
Vitex supplements are made from the seeds and fruit of the plant and are available as liquid extracts or capsules.
3. Evening Primrose Oil
Evening primrose oil is derived from a plant native to the Americas, named for its yellow flowers that open at sunset. The oil is used for menopausal symptoms, PMS, high cholesterol, and inflammatory skin conditions like eczema and acne. Its phytoestrogenic properties may work by affecting estrogen receptors and increasing estrogen levels.
A randomized controlled trial published in the Journal of Menopausal Medicine found that women who took 1,000 milligrams of evening primrose oil twice a day experienced fewer and less severe night sweats, and shorter, less frequent, and less severe hot flashes compared to controls.
Another trial with 56 menopausal women aged 45 to 59 showed that taking 500 milligrams of evening primrose oil for six weeks improved the frequency, severity, and duration of hot flashes, although only the severity was significantly better compared to controls.
The same study that found black cohosh effective for hot flashes also concluded that evening primrose oil reduced the severity of hot flashes, but not their total number.
Evening primrose oil is typically available as a soft gel.
4. Red Clover
Red clover is a perennial found across Europe, Western Asia, Africa, North America, and South America. It’s used to treat menopausal symptoms like hot flashes, depression, anxiety, and vaginal dryness, as well as to lower cholesterol, promote weight loss, and improve skin, hair, and bone health.
While more research is needed, a review and meta-analysis indicated that red clover might reduce hot flash frequency. A randomized trial of 50 women taking a supplement containing red clover and other herbs (black cohosh, dong quai, milk thistle, American ginseng, and chaste tree berry) for three months saw a 73% reduction in hot flashes and a 69% reduction in night sweats.
Red clover can be taken as a capsule, tablet, or tea.
5. Maca
Maca is a cruciferous adaptogenic root vegetable from Peru. It’s known for its benefits in reducing menopausal symptoms such as hot flashes, vaginal dryness, and low libido, and also for improving memory, mood, blood pressure, and energy levels.
Maca is considered a superfood and can be added to baked goods, smoothies, and desserts. Fifty grams (about 2/3 cup) provides 7 grams of protein, 3 grams of fiber, 41% of your daily iron, 12% of your daily calcium, and over 200% of your daily vitamin C. It’s also available as capsules or tea.
A small trial showed that postmenopausal women taking maca experienced a significant reduction in hot flashes and sweating, along with improvements in mood swings, fatigue, stress, and libido.
6. Ginseng
Ginseng, used in traditional Chinese medicine, is praised for its health benefits. It helps with menopausal symptoms, reduces inflammation, regulates blood sugar, boosts energy, supports the immune system, and improves mood and memory.
A systematic review of 15 trials concluded that ginseng significantly reduces hot flashes and improves quality of life in menopausal women.
There are two main types: American ginseng and Korean red ginseng (Panax ginseng). Korean ginseng is generally more potent. Ginseng can be taken as capsules, tea, or tonic and is often included in energy-boosting supplements.
7. Valerian
Valerian, an herb from Europe and Asia, benefits menopausal women by reducing hot flashes and calming the nervous system, which can improve sleep disorders like insomnia.
A study found that women taking 255 milligrams of valerian capsules three times a day for eight weeks had a significant reduction in the severity and frequency of hot flashes.
Valerian is available as capsules, tinctures, or tea and is often combined with other calming herbs like hops and lemon balm.
8. Fennel
Fennel is a versatile plant that’s a vegetable, herb, and spice with a licorice flavor. Rich in phytoestrogens, fennel can be eaten raw or cooked, and the seeds can be used as a spice or in tea. Fennel seed capsules are also available.
Research shows that fennel supplements may help with hot flashes, anxiety, insomnia, and vaginal dryness. A trial of 90 women taking fennel capsules for eight weeks saw a reduction in menopausal symptoms. Another review found significant improvements in hot flashes, vaginal dryness, and sexual satisfaction.
A trial combining fennel and valerian showed that the extract relieved sleep disorders and reduced hot flash severity and frequency.
9. Soy
Soy products like tofu, tempeh, edamame, and protein powder can help reduce hot flashes. After age 50, women need more protein to maintain muscle mass, and soy is a good source.
Soy contains phytoestrogens, which mimic estrogen and may help reduce menopausal symptoms. A review found that phytoestrogens reduce hot flash frequency without serious side effects.
A 2018 trial showed that women consuming soy isoflavone for 12 weeks had fewer and less severe hot flashes. The WAVS study found that women on a low-fat, vegan diet with soybeans had fewer and less severe hot flashes, with 59% stopping moderate-to-severe hot flashes.
10. Fenugreek
Fenugreek, related to soy, is used in traditional Chinese and Indian medicine for various health issues. Extracts from the plant, which smell like maple syrup, are used in teas, soaps, spices, and cosmetics.
A study found that women taking 600 milligrams of fenugreek seed extract for 12 weeks had a significant reduction in hot flashes and night sweats, and improved quality of life compared to a placebo group.
Fenugreek seed is available as capsules or liquid extracts, and can also be used in tea or added as a powder to drinks.
Takeaway
If you're one of the many women dealing with menopausal symptoms like hot flashes and night sweats, know that you're not alone. Many effective, natural supplements can help manage these symptoms.
Before starting any supplements, it’s a good idea to check with your doctor, especially if you're on prescription medications or are pregnant. (Yes, pregnancy is still possible during the menopausal transition.)
For those experiencing hot flashes, besides trying supplements, consider incorporating more fruits and vegetables into your diet, exercising regularly, cutting back on caffeine and alcohol, avoiding spicy foods and those high in added sugars, quitting smoking if you do, managing stress, and dressing in layers.