Many women in the perimenopause or menopause time of life face hot flashes or night sweats. They’re completely natural, the result of declining estrogen levels that accompany these life stages. Nevertheless, they can disrupt sleep and mood and cause fatigue and irritability. Before we touch on some botanicals to manage symptoms, let’s clarify what’s going on and the difference between night sweats, hot flashes and excessive sweating. 

Hot Flashes: an intense heat starts in your chest, rising to your neck and head. You may experience tingling in your fingers, racing heartbeat, or a flushed face.  Some “Flash” by quickly, some last 10 minutes or more – the average is 4 minutes.  

Night Sweats:  intervals of heavy sweating accompanying nighttime hot flashes, sometimes followed by chills and shivering that leaves you and your sheets drenched.

Excessive Sweating: heavy sweating not associated with a known fever causing illness such as a cold or flu, or the normal hormonal changes of menopause may be due to an underlying medical condition, such as endocarditis, hyperthyroidism, or generalized anxiety disorder. Check with your health care provider for an assessment.

Suggestions from a botanical practitioner’s perspective help alleviate the symptoms of hot flashes and night sweats:

Among the most commonly used botanical products are phytoestrogen-rich supplements (which may have estrogen-like effects) such as Soy, Red Clover (Promensil), and Hops (caution is advised if you have risk/history of ER-positive cancer). Black Cohosh (Remifemin) has long been used for menopausal symptoms, depression, and its muscle-relaxant properties.

Adaptogens play a significant role in hormonal regulation. My favourites, Ashwagandha and American Gingseng.  In recent studies, Schisandra has shown to significantly reduce hot flashes, sweating and heart palpitations in menopausal women (caution: may interfere with drugs metabolized by CYP3A or transported by P-gp).

Sage is another useful herb for its ability to inhibit excessive sweating.  Take as a tea alone or combined with Spearmint, Chamomile and Lavender to encourage relaxation. A Sage mist sprayed nearby can help relieve hot flash symptoms. 

The botanical practitioner will also recommend nervine and anti-depressant herbs to relieve accompanying symptoms such as sleep problems, mood swings, fatigue and irritability.

Improve sleep, combine equal parts of Chamomile, Lemon Balm, and Lavender bulk herbs. Steep 2 tsp in one cup boiling water covered, for 10 minutes. For insomnia, Valerian has a long history of use. One clinical trial showed much improvement in sleep quality with a Valerian/Lemon Balm combination.

Depression:  Used to treat mood disturbances for centuries, St. John’s Wort is a star in handling mild to moderate depression.  If depression’s accompanied by memory loss, SJW may be combined with other herbs such as Bacopa, Motherwort, Eleuthero and Rosemary. Avoid SJW if you are taking medications metabolized by CYP450, immunosuppressant medications, or for bipolar or other mood disorders.

If nothing you try brings relief, consider seeing an ND educated in natural, hormonal and pharmaceutical nonhormonal options.

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