Nutrition for Hot Flashes: Can Diet Help?

Menopause, the significant biological and psychological shift in a woman’s life, can represent the entrance into an age of more profound wisdom and freedom for a woman.  But this transition can feel less than idyllic if you are struggling with undesirable symptoms.

By definition, menopause is the point when a woman has not had her menstrual cycle for the twelve prior months.  However, symptoms that accompany the transition can last for many years before and after.[1]

While physiological responses to menopause vary from woman to woman, symptoms like hot flashes and night sweats tend to be the most common.[2]  One study found that hot flashes can last about ten years on average, so addressing them is vital to ensure your quality of life isn’t negatively affected.[3]

As women often turn to natural approaches to feel better before seeking out more complicated interventions, nutrition can be the first step.  Menopause is also related to an increased risk of chronic health concerns, so diet can provide a non-invasive approach that targets hot flashes while improving overall health.[4]

Why do women experience hot flashes and night sweats with menopause?

As mentioned, vasomotor symptoms like hot flashes and night sweats are the most common symptoms women experience in the menopause years.  They can last seconds or much longer, interrupting daily activities and significantly impacting sleep.  Some women have only mild, occasional hot flashes. In contrast, others struggle with more frequency, even up to twenty times a day[5].

While the causes of hot flashes are not entirely understood, researchers agree that they stem from a change in the body’s thermoneutral zone.  The thermoneutral zone is where your body temperature is comfortable, the fine line between sweating and shivering.[6]  As estrogen levels drop during the menopause years, this zone becomes smaller, so the slightest temp changes or stimuli can cause an overreaction.

Estrogen also supports the regulation of norepinephrine activity in the brain.  Norepinephrine acts as an excitatory neurotransmitter and hormone involved in the stress response, including increasing heart rate and blood flow.[7]  Elevated norepinephrine is associated with hot flashes as it may also impact the thermoneutral zone. 6

What role does nutrition play in hot flash management?

There are several important ways you can use diet and nutrition to support you through the menopause transition:

1. Maintain a healthy weight

A foundational way that diet can help is through weight management support.  This relationship is not well understood, but the effects may be because adipose (or body fat) tissue can disrupt normal temperature or hormone regulation.[8]

Several studies suggest that women with a higher body mass index (BMI) or greater percent body fat have severe hot flashes more often.[9]  Weight gain may also increase the incidence of hot flashes, but they are also reduced as a women reach a healthy weight.[10]

2. Follow an anti-inflammatory diet pattern

Studies show that inflammatory markers increase in the years following menopause, likely due to the loss of the anti-inflammatory benefits of estrogen.[11]  As inflammation can exacerbate symptoms, it’s suggested that women with higher markers also experience more hot flashes.5

As a result, an anti-inflammatory diet low in processed foods and high in fruits, vegetables, nuts, and seeds may be beneficial.  One study found that women who follow anti-inflammatory diet patterns are less likely to have menopause symptoms, including physical and mental concerns.  Oppositely, diets high in foods considered inflammatory like refined oils, processed meats, and sugar are linked to more reports of menopause symptoms, including night sweats and hot flashes.[12] [13]

Interestingly, the description of an anti-inflammatory diet in these studies is similar to the Mediterranean diet.  High in antioxidants and phytochemicals, the Mediterranean diet has been studied for its anti-inflammatory effect on many health conditions, including hot flashes.[14]  Researchers found that, along with increased fruit intake, the Mediterranean diet pattern is inversely associated with hot flashes. [15]

The Mediterranean diet is also high in omega-3 fatty acids from regular fish intake.  Omega-3 fatty acids support reductions in inflammation in the body.[16]  While the direct connection between omega-3 fatty acids and hot flashes is not black and white, the additional anti-inflammatory benefits may help.[17]  As many people don’t eat enough fish, supplemental omega-3 can help meet estimated needs.

3. Eat more plants

Eating more fruits, vegetables, and whole grains can help significantly reduce hot flashes, as seen in a study on women who followed a plant-heavy diet for a year.9  Women in this study also lost more weight than the control group because of the healthy diet changes.

Those who lost weight also reported fewer symptoms.  Interestingly, women in the study who gained weight also experienced improvements in symptoms, suggesting that diet still helped independently from weight loss.

Eating less meat may also aid in menopause symptom support.  In one study, women who followed a vegan diet reported fewer vasomotor symptoms than women who consumed more meat.  This was especially true for those who ate more vegetables, suggesting that increasing vegetable intake can help even if you don’t completely remove meat from your diet.[18]  Higher intake of antioxidants is also associated with reduced menopause symptoms, especially hot flashes and night sweats.[19]  This is another reason why the Mediterranean diet may be so helpful

4. Consider unprocessed soy

Soy is controversial in the women’s health world because of its ability to act like estrogen in the body.  However, these phytoestrogens are weak compared to estrogen in the body and may benefit some women.[20]

Soy may support hot flashes through its influence on hormone receptors, helping to make up for the drop in estrogen levels that can lead to symptoms.[21]  Studies on supplementation are mixed, so more research is needed, but dietary intake of soy can be a valuable addition to your meals.  Eating moderate amounts of unprocessed soy foods like edamame and tofu while staying away from fake meats and cheese may positively support symptom management through the estrogen-like effects.[22]

5. Bump up folic acid intake

Folic acid, the B vitamin usually associated with healthy pregnancy outcomes, may also support the reduction of vasomotor menopause symptoms.  A clinical trial focused on menopausal women found that those who took supplemental folic acid for a month saw reductions in severity, duration, and frequency of hot flashes compared to the control group who took a placebo supplement.[23]

Folic acid is the synthetic form of folate, which is found in foods like dark green vegetables, beans, fruit, and nuts.  However, supplementation with folic acid may work because of its influence on norepinephrine.  Studies suggest that it acts similar to estrogen in the body by supporting reductions in the secretion of norepinephrine, which helps regulate the thermoneutral zone as mentioned above.[24]

Diet as a simple strategy for menopause support

Studies suggest that women who feel supported generally have a better experience throughout the menopause transition.  Nourishing yourself with a diet rich in healthy, anti-inflammatory foods is one way to accomplish this.[25]  Eating well also helps you feel better overall and more in control of your health.  Depending on the severity of symptoms, diet can be a simple way to address hot flashes and the health concerns associated with menopause.

Disclaimer: The information is for general education purposes only. These therapies are not substitutions for standard medical care and are not meant to be used by a patient alone. The Company assumes no liability for the author’s information, whether conveyed verbally or in these materials.  All presentations represent the opinions of the author and do not represent the position or the opinion of the Company. Reference by the author to any specific product, process or service by trade name, trademark, or manufacturer does not constitute or imply endorsement or recommendation by the Company.

Reference

[1] National Institute on Aging. “What Is Menopause?” Accessed April 13, 2021. http://www.nia.nih.gov/health/what-menopause.

[2] Avis, Nancy E., Sybil L. Crawford, and Robin Green. “Vasomotor Symptoms Across the Menopause Transition: Differences Among Women.” Obstetrics and Gynecology Clinics of North America 45, no. 4 (December 2018): 629–40. https://doi.org/10.1016/j.ogc.2018.07.005.

[3] Freeman, Ellen W., Mary D. Sammel, Hui Lin, Ziyue Liu, and Clarisa R. Gracia. “Duration of Menopausal Hot Flushes and Associated Risk Factors.” Obstetrics and Gynecology 117, no. 5 (May 2011): 1095–1104. https://doi.org/10.1097/AOG.0b013e318214f0de.

[4] Cheng, Chao-Chun, Ching-Yun Hsu, and Jen-Fang Liu. “Effects of Dietary and Exercise Intervention on Weight Loss and Body Composition in Obese Postmenopausal Women: A Systematic Review and Meta-Analysis.” Menopause (New York, N.Y.) 25, no. 7 (July 2018): 772–82. https://doi.org/10.1097/GME.0000000000001085.

[5] Thurston, Rebecca C., Joyce T. Bromberger, Hadine Joffe, Nancy E. Avis, Rachel Hess, Carolyn J. Crandall, Yuefang Chang, Robin Green, and Karen A. Matthews. “Beyond Frequency: Who Is Most Bothered by Vasomotor Symptoms?” Menopause (New York, N.Y.) 15, no. 5 (October 2008): 841–47. https://doi.org/10.1097/gme.0b013e318168f09b.

[6] Freedman, Robert R. “MENOPAUSAL HOT FLASHES: MECHANISMS, ENDOCRINOLOGY, TREATMENT.” The Journal of Steroid Biochemistry and Molecular Biology 142 (July 2014): 115–20. https://doi.org/10.1016/j.jsbmb.2013.08.010.

[7] Bylund, D. B., and K. C. Bylund. “Norepinephrine.” In Encyclopedia of the Neurological Sciences (Second Edition), edited by Michael J. Aminoff and Robert B. Daroff, 614–16. Oxford: Academic Press, 2014. https://doi.org/10.1016/B978-0-12-385157-4.00047-6.

[8] Al-Safi, Zain A., and Alex J. Polotsky. “Obesity and Menopause.” Best Practice & Research. Clinical Obstetrics & Gynaecology 29, no. 4 (May 2015): 548–53. https://doi.org/10.1016/j.bpobgyn.2014.12.002.

[9] Kroenke, Candyce H., Bette J. Caan, Marcia L. Stefanick, Garnet Anderson, Robert Brzyski, Karen C. Johnson, Erin LeBlanc, et al. “Effects of a Dietary Intervention and Weight Change on Vasomotor Symptoms in the Women’s Health Initiative.” Menopause (New York, N.Y.) 19, no. 9 (September 2012): 980–88. https://doi.org/10.1097/gme.0b013e31824f606e.

[10] Kapoor, Ekta, Maria L. Collazo-Clavell, and Stephanie S. Faubion. “Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management.” Mayo Clinic Proceedings 92, no. 10 (October 2017): 1552–58. https://doi.org/10.1016/j.mayocp.2017.08.004.

[11] Karim, Roksana, Frank Z. Stanczyk, Howard N. Hodis, Mary Cushman, Roger A. Lobo, Juliana Hwang, and Wendy J. Mack. “Associations between Markers of Inflammation and Physiological and Pharmacological Levels of Circulating Sex Hormones in Postmenopausal Women.” Menopause (New York, N.Y.) 17, no. 4 (July 2010): 785–90.

[12] Aslani, Zahra, Maryam Abshirini, Motahar Heidari-Beni, Fereydoun Siassi, Mostafa Qorbani, Nitin Shivappa, James R. Hébert, Mahshid Soleymani, and Gity Sotoudeh. “Dietary Inflammatory Index and Dietary Energy Density Are Associated with Menopausal Symptoms in Postmenopausal Women: A Cross-Sectional Study.” Menopause 27, no. 5 (May 2020): 568–78. https://doi.org/10.1097/GME.0000000000001502.

[13] Soleymani, Mahshid, Fereydoun Siassi, Mostafa Qorbani, Shahla Khosravi, Zahra Aslany, Maryam Abshirini, Ghazal Zolfaghari, and Gity Sotoudeh. “Dietary Patterns and Their Association with Menopausal Symptoms: A Cross-Sectional Study.” Menopause 26, no. 4 (April 2019): 365–72. https://doi.org/10.1097/GME.0000000000001245.

[14] Barrea, Luigi, Gabriella Pugliese, Daniela Laudisio, Annamaria Colao, Silvia Savastano, and Giovanna Muscogiuri. “Mediterranean Diet as Medical Prescription in Menopausal Women with Obesity: A Practical Guide for Nutritionists.” Critical Reviews in Food Science and Nutrition 61, no. 7 (April 12, 2021): 1201–11. https://doi.org/10.1080/10408398.2020.1755220.

[15] Herber-Gast, Gerrie-Cor M, and Gita D Mishra. “Fruit, Mediterranean-Style, and High-Fat and -Sugar Diets Are Associated with the Risk of Night Sweats and Hot Flushes in Midlife: Results from a Prospective Cohort Study.” The American Journal of Clinical Nutrition 97, no. 5 (May 1, 2013): 1092–99. https://doi.org/10.3945/ajcn.112.049965.

[16] Calder, Philip C. “Omega-3 Fatty Acids and Inflammatory Processes: From Molecules to Man.” Biochemical Society Transactions 45, no. 5 (October 15, 2017): 1105–15. https://doi.org/10.1042/BST20160474.

[17] Mohammady, Mina, Leila Janani, Shayesteh Jahanfar, and Mahsa Sadat Mousavi. “Effect of Omega-3 Supplements on Vasomotor Symptoms in Menopausal Women: A Systematic Review and Meta-Analysis.” European Journal of Obstetrics, Gynecology, and Reproductive Biology 228 (September 2018): 295–302. https://doi.org/10.1016/j.ejogrb.2018.07.008.

[18] Beezhold, Bonnie, Cynthia Radnitz, Robert E. McGrath, and Arielle Feldman. “Vegans Report Less Bothersome Vasomotor and Physical Menopausal Symptoms than Omnivores.” Maturitas 112 (June 2018): 12–17. https://doi.org/10.1016/j.maturitas.2018.03.009.

[19] Abshirini, Maryam, Fereydoun Siassi, Fariba Koohdani, Mostafa Qorbani, Shahla Khosravi, Mehdi Hedayati, Zahra Aslani, Mahshid Soleymani, and Gity Sotoudeh. “Dietary Total Antioxidant Capacity Is Inversely Related to Menopausal Symptoms: A Cross-Sectional Study among Iranian Postmenopausal Women.” Nutrition (Burbank, Los Angeles County, Calif.) 55–56 (November 2018): 161–67. https://doi.org/10.1016/j.nut.2018.04.014.

[20] Taku, Kyoko, Melissa K. Melby, Fredi Kronenberg, Mindy S. Kurzer, and Mark Messina. “Extracted or Synthesized Soybean Isoflavones Reduce Menopausal Hot Flash Frequency and Severity:  Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Menopause (New York, N.Y.) 19, no. 7 (July 2012): 776–90. https://doi.org/10.1097/gme.0b013e3182410159.

[21] Zaheer, Khalid, and M. Humayoun Akhtar. “An Updated Review of Dietary Isoflavones: Nutrition, Processing, Bioavailability and Impacts on Human Health.” Critical Reviews in Food Science and Nutrition 57, no. 6 (April 13, 2017): 1280–93. https://doi.org/10.1080/10408398.2014.989958.

[22] Borrelli, Francesca, and Edzard Ernst. “Alternative and Complementary Therapies for the Menopause.” Maturitas 66, no. 4 (August 2010): 333–43. https://doi.org/10.1016/j.maturitas.2010.05.010.

[23] Bani, Soheila, Shirin Hasanpour, Leila Farzad Rik, Hadi Hasankhani, and Seiedeh Hajar Sharami. “The Effect of Folic Acid on Menopausal Hot Flashes: A Randomized Clinical Trial.” Journal of Caring Sciences 2, no. 2 (June 1, 2013): 131–40. https://doi.org/10.5681/jcs.2013.016.

[24] Ewies, Ayman AA. “Folic Acid Supplementation: The New Dawn for Postmenopausal Women with Hot Flushes.” World Journal of Obstetrics and Gynecology 2, no. 4 (November 10, 2013): 87–93. https://doi.org/10.5317/wjog.v2.i4.87.

[25] Hoga, Luiza, Juliana Rodolpho, Bruna Gonçalves, and Bruna Quirino. “Women’s Experience of Menopause: A Systematic Review of Qualitative Evidence.” JBI Evidence Synthesis 13, no. 8 (August 2015): 250–337.