One of the things breast cancer survivors have to deal with is hot flashes. They can be heinous, and I have a lot of information here that may be helpful to you.

First of all – what causes a hot flash? We still aren’t certain about this, but this is the best explanation I’ve got for you.

Low Levels of Estrogen and a Wonky Thermostat

When the hypothalamus (located in your brain) senses a drop in estrogen levels, this confuses the hypothalamus, which among other things is your body’s “thermostat”, and makes it think  “This body is too hot!”

The brain responds to this by sending an all-out alert to your heart, blood vessels, and nervous system: “Get rid of this heat!”  The message is transmitted by the nervous system’s chemical messengers and the message is delivered instantly, causing your heart to pump faster, the blood vessels in your skin to dilate to circulate more blood to radiate off the heat, and your sweat glands release sweat to cool you off even more. You can feel a lot of anxiety while this is going on.

This heat-releasing mechanism is how your body keeps you from overheating in the summer, but when that process is triggered by a drop in estrogen, your brain’s response can make you very uncomfortable. Some women’s skin temperature can rise quite a few degrees during a hot flash.

All of this can cause you to be miserable: soaking wet in the middle of an important work meeting or in the middle of what might otherwise have been a good night’s sleep.

Other Triggers

There are many triggers (as you probably know if you’re going through hot flashes)!  Drinking alcohol (we only wanted one glass of wine, and now we’re paying for it!), a hot cup of coffee, eating something sweet or sugary, hot or spicy food, sitting in a sauna, going to a hot, tropical place, stress (just try having a heated debate and NOT having a hot flash!), a hot bedroom… I can get a hot flash just thinking about having a hot flash.

I was Prescribed an Anti-Depressant

When I spoke to my oncologist about the severity and frequency of my hot flashes (mine were brought on prematurely by my chemotherapy regimen for breast cancer), he wanted to prescribe me an antidepressant.  Apparently low dose antidepressants work by intercepting the chemicals in the brain that transmit the hot flash alarm.

Being a natural therapist, I declined, preferring to handle the matter naturally instead of creating a whole new problem for myself with antidepressant side effects.

In 2008, Henry Ford Health System oncologist Dr. Eleanor Walker, with the assistance of  acupuncturist Beth Kohn, conducted a study [1] with 47 breast cancer patients. These patients were all on Tamoxifen or Arimidex to reduce cancer recurrence. Hot flashes are a common side effect of these two drugs. Half of the women received acupuncture treatment and half were given the antidepressant venlafaxine (Effexor).

The study results found that “Both groups exhibited significant decreases in hot flashes, depressive symptoms, and other quality-of-life symptoms, including significant improvements in mental health from pre- to post-treatment. These changes were similar in both groups, indicating that acupuncture was as effective as venlafaxine. By 2 weeks post-treatment, the venlafaxine group experienced significant increases in hot flashes, whereas hot flashes in the acupuncture group remained at low levels. The venlafaxine group experienced 18 incidences of adverse effects (eg, nausea, dry mouth, dizziness, anxiety), whereas the acupuncture group experienced no negative adverse effects. Acupuncture had the additional benefit of increased sex drive in some women, and most reported an improvement in their energy, clarity of thought, and sense of well-being.” 

Enough said.  See below for more info on acupuncture.

7 Easy, Low Cost Tips for Hot Flashes

1. Spray mister with peppermint oil – keep it close to hand.  You just need a plastic or glass spray mister with a few drops of peppermint essential oil in filtered or distilled water. The peppermint oil is very cooling and the fan is absolutely divine. Instant relief.
2. Ice water – sip away at it all day, helps to keep you cool (make the ice yourself from filtered water).
3. Paper fold-up fans – I have one in my purse, and in every room in the house, tucked away in an accessible place.
4. Take a cool shower before bed.
5. Dress in layers – avoid wool, synthetics and turtlenecks. Go for cotton, rayon, linen, hemp – breathable and much cooler.
6. Eat a healthy diet – eat a diet loaded with whole grains, legumes, fresh vegetables (especially cruciferous veggies) and fruits, freshly ground flaxseed (added to salads, smoothies, oatmeal), cold-pressed olive oil, coconut oil.
7. Avoid these – sugar, alcohol, carbonated drinks (they deplete calcium from your body), caffeine (stimulates an already over-stimulated nervous system).

If all else fails, I usually stick my face in the freezer for a few seconds (LOL…)

Special Hot Flash Breathing Exercise

Try to do this twice a day for 10 minutes (it helps to set a timer). Women who do this exercise regularly not only experience fewer hot flashes but also reduced stress levels.

You can also do this when you first feel a hot flash coming on – stop what you are doing, find a quiet place, and practice this breathing exercise until you are feeling comfortable again.

• Sit in a comfortable, quiet place.
• As you breathe, keep your rib cage still. You will be lowering and raising your diaphragm (takes some practice) to empty and fill your lungs.
• Inhale for a count of  5, pushing your stomach muscles out at the same time.
• Exhale for a count of 5, pulling your stomach muscles in and up.
• Repeat this cycle of breathing until you feel cool, calm and relaxed or the 10 minutes is up.

Acupuncture and Traditional Chinese Medicine

Traditional Chinese Medicine (“TCM”) has a few centuries of tradition for treating hot flashes. Since there are all sorts of hot flashes (you know what I mean, there are hot flashes and then there are HOT FLASHES!), the Chinese have descriptions and remedies for all of them.

Before treating you, a TCM doctor will take a full history and will pay close attention to your tongue and your pulse.  With that information they can then determine whether you’re suffering from a “hot” menopause or a “cold” menopause and will treat you accordingly.  Treatment generally involves acupuncture and/or herbal medicine.

Acupuncture helps to move your CHI (aka Xi – your inner wind, energy, or spirit). Skeptical? Don’t be. I’ve tried it, it definitely helps.

Chinese herbs – common to most TCM herbal remedies for menopause is dong quai. I would recommend having your TCM doctor make up the herbal for you, don’t self-treat with Chinese herbs. Make sure if you have had breast cancer you tell your TCM doctor your complete history.

Western Herbs

Women have found many Western herbs effective in treating hot flashes over the centuries. They include evening primrose oil, hops, licorice root, red raspberry leaves, sage, spearmint, damiana, motherwort, chasteberry (also known as Vitex), black cohosh, and wild yam.

These herbal remedies can be very effective at reducing hot flashes but always consult your herbalist or naturopath and let your oncologist know what you plan to do.

Other Hot Flash/Menopause Remedies

I’ve tried Remifemin and a few other menopause formulas.  All of them seemed to help with frequency and intensity of hot flashes but each person is different, so see what works for you.

Hypnosis for Hot Flashes

The American School for Hypnosis has a great article on using hypnosis to treat hot flashes. Use the script that appears on this webpage and record this in your own voice on your phone or other device. See how you do. As they say, “What the mind can conceive the body can achieve.”

Biofeedback

I have read some discussion of biofeedback for relief of hot flashes but I don’t have any experience with it personally. I mention it here in case you’d like to do more research on it. It sounds like an interesting avenue to explore if nothing else I’ve listed above has worked for you. Good luck and let me know what helped you in the comments section.

References:

[1] Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial – https://pubmed.ncbi.nlm.nih.gov/20038728/

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