Hot flashes – a herbal perspective

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Qualified Medical Herbalist Anita Ralph discusses natural ways to control hot flashes. Well-tolerated, safe and highly effective, can medicinal herbs and food plants provide natural relief for you?

Hot flashes are a common symptom experienced by many women at menopause. The patients I see in my clinic describe feeling symptoms ranging from mild heat to something like a raging inferno. They sometimes occur with palpitations – a feeling that the heart is beating fast or more forcefully. This is a clue to the complex hormonal causes of hot flashes that involve ‘stress hormone’ production, and they can start several years before actual menopause is reached, because they are a response to change.

Hot flashes may be the result of other health problems in the body – so it is important to discuss your symptoms with your health practitioner to make sure of the cause of your flashes. However, flushing and sweating of any cause is a response to production of hormones released in response to different types of stress.

Herbal medicine – natural help for hot flashes

Herbal medicine has many potential solutions to this disruptive symptom and is most effective to direct treatment at the root cause. Herbal medicines contain beneficial compounds, but herbs do not work exactly as ‘natural drugs’. It operates in that interesting area somewhere between food and medicine, and so it is often very safe to use. Menopause is a normal period of transition allowing the body to change from decades of menstruation (and the hormones that are necessary for menstruation) back to a state of relative hormonal calm. It is that transition that requires us to be flexible.

This means if we are struggling with mental or physical stress; we may have less capacity to cope with the changes required. Improving capacity to cope and improving general health are key areas of concern for the medical herbalist,  so we can often help with menopause even when other strategies have failed.

Menopause is partly about the reduction in the production of estrogen from our ovaries, and this is often given as a reason for hot flashes. We can produce all of the hormones we need post-menopausally, if we are in optimal health, and other parts of our body have a role to play with successful menopause.

Dietary modifications: a natural alternative to HT?

Some medicinal herbs and some food plants are known to contain compounds similar to (but not the same as) estrogen. Increasing these foods into everyday dietary choices can improve hot flashes for some women for whom low estrogen levels are very obvious. These women may have been long-term users of the contraceptive pill, or had conditions such as endometriosis or fibroids leading to raised levels of estrogen.

Excellent plant sources of these so-called ‘phytestrogens’ (phyto means plant) include pulses, beans and lentils, and also linseed – sometimes called flax seed. These natural sources of estrogen can help reduce menopausal symptoms but do not stimulate the estrogen receptors that are involved in breast cancer, in fact they may often block them.

Practical ways to help yourself

Adding foods such as beans and lentils into your diet at least three times per week, and 1-4 teaspoons of ground flaxseed most days will provide good natural sources of the raw materials from which our body can make safe estrogen-like compounds.

Pulses and linseed help with the elimination of waste products from the body which can also help hormone balance, and they are sources of soluble (soft) fiber, a natural prebiotic that will also support the liver, and microbiome (ecosystem of friendly gut organisms).

Plant sources of estrogen have to be processed by our digestive system to be useful. Your liver can make different types of estrogen, though it needs raw materials from our diet – or from herbal medicines. It’s the liver itself that has to transform what we have eaten into something useful – or not!

If we also have digestive or liver problems, we may have more difficulty in manufacturing our own estrogens which can lead to worsening of symptoms of menopausal change.

Happier gut, fewer flashes

A medical herbalist will want to address any digestive problems because this will also improve the efficacy of any herbal medicine taken! Herbal teas such as chamomile and fennel seed have soothing calming and healing effects on the digestive lining. This can send calming messages to the brain and nervous system that can for some women help reduce the experience of hot flashes. The digestive effects of the two herbal relaxants will also improve our ability to make those post-menopausal estrogens naturally.

Keeping our microbiome (ecosystem of friendly gut organisms) intact, will help our body manufacture post-menopausal estrogens. If you are experiencing frequent infections around menopause (recurrent infections including urinary tract infections can be a problem associated with menopausal changes), getting help that avoids antibiotic use will make it easier for the body to perform its role at menopause.

Looking at the hormonal system

During menopause, our whole hormonal system is adapting and changing. There are changes in your reproductive organs, but also your thyroid (which controls your metabolism) and your adrenal glands (which produce hormones including adrenaline that work as ‘chemical messengers’ in the body).

Herbalists can support these areas of your body using herbs called ‘adaptogens’. As every person is different, it’s best to seek help to find the right combination for you. However, there are some options that easily available, and very supportive, so suitable for you to try at home.

Oats can be taken as a food (porridge or oat milk), and they can also be used as a ‘tea’ of the oat flower and stalk (before the seed has formed). This herbal tea of oat flower, sometimes called milky oats or oat straw, acts like a ‘tonic’, it is delicious and is gluten free. Oats have a mild adaptogenic effect but are not over-stimulating, so they are ideal for some people at menopause.

Is your body trying to tell you something?

To recap, hot flashes are symptoms of a deeper interruption to what should be a natural process of adaptation. Finding natural solutions to stress, chronic pain, inflammation or infections will help. This may be the first time you have taken reviewed your health as a whole. Avoiding antibiotics and restoring your gut function and your gut microbiome will also help.

What to expect if you consult a medical herbalist

Herbal medicine can provide essential support at this time and can be tailor-made to your needs. If you see a qualified medical herbalist, you will have several carefully selected herbs in your prescription, and some dietary suggestions also tailored to you, so that you can have a robust, flexible and reliable approach to your own symptoms. A consultation is an opportunity to look at your health as a whole, and reflect on what your body needs. It is possible to help our body with the process of adaptation at menopause using safe, healthy and reliable herbal medicines.

Next steps and handy resources

Herbs and natural medicines – though generally very safe and well tolerated – can be incredibly powerful, so it’s really important to research and choose your practitioner carefully. Look for:

Did you know? A fully qualified medical herbalist trains for 4 years – and studies the same medical sciences as a medical doctor.

About Anita Ralph

Anita harnesses the powerful medicine of plants and foods to provide a natural alternative – or complement – to pharmaceutical medicines. She runs her own busy herbal consultancy, inspires the next generation as a teacher of herbal medicine, and works alongside our lead gynecologist to offer a holistic approach to women’s healthcare through the Gynae Expert practice. A practicing medical herbalist since 1990, Anita is a member of the National Institute of Medical Herbalists and the College of Practitioners of Phytotherapy and has a masters degree in herbal medicine.

Read Anita’s full biography here


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Anita Ralph

Anita Ralph


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