"Non HRT help for hot flashes? I can’t take HRT, post partum DVT, and have been taking a mixture of herbal things for the last couple of years. Evening Primrose, St. John’s Wart, Star Flower and Black Cohosh.

Any other non HRT things I could try?

I’m back on some natural sleep aids such as Melatonin, and I’m still waking up and throwing the covers off, then shivering."

Hi Shanice, hot flashes are a fairly common experience for women going through menopause, but they are by no means easy to live with, Especially when they continue for years! As a woman moves through menopause her body starts to produce less estrogen and this drop in estrogen is what seems to cause these hot flashes. Luckily hormone replacement therapy (HRT) isn’t the only option.

There are a number of herbs, foods, and natural support options that can help to gently regulate these hormonal changes to reduce how intense and frequent your hot flashes are.

Since you’ve taken some great steps to helping reduce the intensity of your hot flashes, let’s quickly review what you’ve tried and then I’ll provide a more considerations.

Black Cohosh:
This is a wonderful herb for menopause! It’s been shown to not only reduce hot flashes and sweating (especially night sweats), but it can improve sleep and mood changes. One thing to note is that it takes a minimum of 3 months of daily use to see the full effect.

St. John’s Wort:
This seems to have the strongest impact on hot flashes and sleep. However, all the research is done on women who take it consistently for 2.5 years so this is a long-term support option. Also, St. John’s Wort has a lot of interactions with medications and supplements so ensure your health care provider has approved this for use.

Melatonin: This is one of my favourite ways to support menopause as it’s safe to take long-term and helps to regulate all of our hormones! Melatonin has been shown to not only improve hot flashes and insomnia but it can also help with weight management. One study showed that those who used melatonin had a reduction in fat mass and an increase in lean mass which not only helps to improve hot flashes but also helps to protect women from cardiovascular complications later in life.

So let’s chat about a few more things you can consider to help reduce your hot flashes.

a. Eat more plant-based foods . Increasing your vegetable intake can have such a profound effect on hot flashes that in one study, the women who were moved to a vegetarian diet refused to go off the diet after the study was complete because they had such a significant improvement in their symptoms! A wholly plant-based diet is not for everyone so start by trying to ensure that 1⁄2 of your plate is plant-based at every meal.

• Eat more soy . Soy has gotten a bad name over the years but the research continues to show that not only can soy reduce hot flashes but it also helps to protect against certain cancers! Ensure your soy is as unprocessed as possible. Tofu, edamame, and tempeh are all great options and can be easily added to meals. While you are trying to reduce your hot flashes consider adding soy to a meal daily, but long-term 2-3 times a week is often enough.
• Add ground flax to your food . Flax has been shown to reduce hot flashes by 50% when used daily! Make sure you buy whole flax seeds and grind them fresh for use each week as ground flaxseed goes rancid after a few days. Grind the seeds each week and store the powder in a sealed container in the fridge. You should be looking to add about 2 tbsp to your food every day.

a. Aerobic activity. Research has found that a vigorous walk (even for 15 minutes), 3-7 times a week can help to reduce hot flashes. This seems counterintuitive as exercise often makes us sweat more and feel warmer but because hot flashes are a vasomotor symptom (referring to our vasomotor centre, which controls blood pressure) improving our circulation actually lowers this both immediately and over time.

• Sage : This is easily consumed as a tea! Sage is a cooling herb that also has an
  effect on estrogen, which is why research has found that daily use not only improve the intensity of hot flashes but also the frequency! If hot tea is not what you need right now, brew it ahead and keep it in the fridge to drink cold.
• Valerian:
  This herb is often used for sleep but it has also been shown to reduce the intensity and frequency of hot flashes! Note that it can take about 4 weeks to see the full effect and as this is a calming herb, it’s best to take it at night.

• Hops : This is a fantastic compliment to valerian! Hops also has a sedative effect so is especially good for women whose hot flashes and sweating is disrupting sleep. But it also has an effect on estrogen, making it a great option for menopause support.

There are a lot of great options to help you manage your symptoms safely and effectively! The individualization of this kind of support can sometimes mean it takes a few tries to find a combination that works best for your body but knowing what options may be available to you is a big step in the right direction.