Hot flashes can make your life miserable, but luckily in most cases, they do go away on their own, usually within six months to a year. Of all the alternative remedies, black cohosh is the best studied, but as you've learned, it doesn't work for all women. A number of other options are available, none of them fool-proof but all worth trying:
- Soy foods: As you may know, soy foods contain plant estrogens, and Japanese women whose diets contain a lot of soy don't suffer the way western women do from hot flashes. Although we have no proof that soy is the reason (other elements of the Japanese diet and lifestyle may play a role), eating soy foods may help. I suggest two helpings daily of whole soy foods such as tofu, tempeh, edamame (green soy beans in the pod) and miso.
- Promensil: This is a dietary supplement that combines the plant estrogens genistein, biochanin, daidzein and formononetin. The manufacturer claims that four clinical studies have shown that the product can reduce the frequency and severity of night sweats. I'm not sure it is as safe as black cohosh, but it may be worth trying.
- Low doses of bio-identical estrogen: Believed safer and more natural than traditional estrogen replacement therapy, these drugs have a chemical structure that closely approximates a woman's natural estrogen. The prescription drug Estrace is a bio-identical estrogen, and you also can get customized formulations prepared by special compounding pharmacies recommended by your physician.
The supplements dong quai, vitamin E and evening primrose oil can also help relieve menopausal symptoms but, like black cohosh, they don't work for everyone.
On the conventional medicine front, a Mayo Clinic study recently found that the anti-seizure drug gabapentin relieved the frequency of hot flashes by 66 percent and also lessened their intensity. More research is needed to confirm these results, but the investigators said that in the meantime, the drug is a reasonable alternative for women with hot flashes resistant to other treatments. The most reliable remedy is estrogen replacement, which you might want to consider on a short-term basis if nothing else helps.
Andrew Weil, M.D.
Dosage Update, October, 2004
In order to provide the most up-to-date health information, I review my recommendations on a regular basis. As the fields of nutrition and health advance, my recommendations will change to reflect the best science and new findings. My recommendations for daily vitamin E are to take 400-800 IU of natural mixed tocopherols, or at least 80 mg of natural mixed tocopherols and tocotrienols.
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