It's a sudden surge of heat that shoots up the torso into the cheeks, a blush without the embarrassment, or a sweat-drenched shirt without the workout. Most menopausal women experience hot flashes, sometimes on a daily basis for years. Yet medicine still offers no proven remedies for treating them beyond hormone therapy, which carries the risk of breast cancer, stroke, and heart disease. But here's a bit of good news: Losing excess pounds through diet and exercise appears to significantly alleviate hot flashes or even eliminate them, according to a study published Tuesday in the Archives of Internal Medicine.
Researchers have known for some time that overweight women tend to have more frequent or severe hot flashes, though it's unclear why. Perhaps excess fat traps heat leading to more sweating and flushing to cool the body. Or perhaps obese women have "abnormalities in the way their blood vessels react to heat or stress," says study author Alison Huang. In the study, 338 hot flash sufferers with an average body mass index of 37 (215 pounds for someone who stands 5 feet, 4 inches tall) were randomly assigned to weekly weight loss counseling—including exercise instruction, a diet plan, and meal replacements like a Slimfast shake—or a control group that attended monthly nutrition seminars. The women who underwent intensive counseling lost an average of 17 pounds over six months compared to about 4 pounds for the control group, and they were more than twice as likely as the control group to report relief from their hot flashes. "In general, each 5-kilogram [11-pound] decrease in weight was associated with a 33 percent greater odds of improvement in hot flashes," says Huang, an assistant professor of medicine at the University of California, San Francisco. "This study provides good evidence that losing excess weight through diet and exercise can improve those hot flashes."
What about women plagued by hot flashes who aren't overweight? "I wouldn't recommend that they try to reduce their weight further," says Huang, since there's no evidence that weight loss would help them. Research indicates that certain antidepressants like selective serotonin reuptake inhibitors (Prozac, Paxil, Zoloft) and the anti-seizure drug gabapentin (Neurontin) could relieve symptoms in some women. Huang and her colleagues are currently conducting a study to see if slow breathing relaxation techniques provide adequate symptom relief. Research on dietary supplements like soy, black cohosh, and vitamin E have had for the most part disappointing results, while findings have been mixed for exercise and acupuncture, with some studies showing that they help and others showing that they don't. Of course, hormone therapy shouldn't be ruled out. The long-term risks of cancer and heart disease, says Huang, should be balanced against the immediate quality-of-life benefits. "If a woman has very severe hot flashes and few risk factors for heart disease or cancer, then trying hormone therapy may be a reasonable option."