Learning to Cope With Hot Flashes

Carole was 52 when she first experienced hot flashes. They came and went a few times each week and didn’t wake her up at night. “It was nothing,” she says of those early hot flashes. “Little did I know what I was in for.”

As her periods became more erratic and then stopped a year later, her symptoms grew worse. She started having hot flashes every 1 to 2 hours, day and night. Carole also was diagnosed with prediabetes, thyroid disease, high cholesterol, and osteopenia (reduced bone density).

The diagnoses came as a surprise. “I had never smoked, I had low blood pressure my whole life, and I had average or lower BMI (body mass index),” says Carole, who lives in suburban Chicago. “I was active and healthy before menopause, and even now I walk 20-plus miles a week.”

Today, the 59-year-old continues to have frequent hot flashes, though she has found ways to cope with them and her other health problems. In this edited interview, she discusses what she’s tried and how she’s stayed positive throughout it all.

ACOG: Are you surprised that your hot flashes have continued this long?

Carole: I thought I would have them for 2 or 3 years, but we’re going on 8 years and they’re still happening. Some days I get them once an hour, and other days every 2 hours. Sometimes I won’t have one for 3 hours and I notice that.

ACOG: What do your hot flashes feel like? What do you do when they happen?

Carole: I know when one is coming on because I get an anxious feeling, like a mini panic attack. I know in about 60 seconds I will feel hot flushing, and in 120 seconds it will be over. Counting to 120 gives me a sense of how long I need to wait and gives me a sense of calm. My doctor said that she looks at hot flashes as a power surge. It’s an intense burst of power and if you wait long enough, it subsides. So I count through my power surges.

ACOG: Have you tried any medication to manage the hot flashes?

Carole: In 2015 I tried a plant-based supplement. I took it for 9 months, but it made no difference. I also tried magnesium powder, but that didn’t help either. In 2017, my endocrinologist recommended I try something else, because I was waking up every hour and she said I needed to sleep more. The lack of sleep could be one reason for my prediabetes. I took the lowest dose possible of an antidepressant, and it helped my hot flashes by about 20 to 30 percent. I was sleeping 4 hours at a time instead of 2 hours or less. But after 2 years the antidepressant stopped making a difference, so I stopped taking it.

ACOG: What else have you tried to cope with hot flashes?

Carole: Yoga has helped me. It calms my mind in general. I’ve recently tried a meditation technique called yoga nidra. It’s 90 minutes on my back with guided mediation. After the first time I tried it, I slept 6 hours straight!

I also stay away from alcohol, and that seems to make a slight difference with hot flashes. And it’s 64 degrees in my bedroom. My husband bundles up because we have a cold house. I also dress in layers, especially in winter, so I can take off my sweater and have a T-shirt underneath.

ACOG: How are you treating the other medical issues?

Carole: For the osteopenia, I’ve added vitamin D supplements to my diet, and I eat a lot more calcium-rich foods. For prediabetes, I’ve changed to a low-carb diet, with few potatoes, rice, or pasta. I’m not overweight and I eat well, but my father and other relatives have diabetes, so I expect to develop diabetes at some point.

When I was first diagnosed with hyperthyroidism, I tried medication, but it didn’t work. After three tries with the medication, I went through radioactive thyroid treatment and now I’m on thyroid replacement medication. I don’t know if all this happened because of menopause, but I was diagnosed after my periods stopped.

ACOG: How do you reflect on all of this? How do you feel about going through menopause, given how difficult it has been for you?

Carole: I look at the years before and after menopause as a stage in life. In some ways I’m blessed, because I’m working and doing what I want to be doing, and in some ways it’s an annoyance. I like to look at all the issues I’ve faced around menopause as relatively minor, because my life for the most part is going on as I want it, and I’m as engaged and active as I want to be.

Do I want more undisturbed sleep? Absolutely! This will pass, at some point, and then there will be something else, and who knows what that will be. But I do look forward to not having hot flashes.

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This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.