Disclaimer time again! As it reads in the title, I am writing this as I would a diary entry, and not as a prescriptive article. I am 46 years old and I am sharing MY OWN experience of peri-menopause. Yes, I do include informative bits and useful tips as much as possible as I am a qualified Naturopath and Medical Herbalist and I will try to keep things as simple as possible but, as I will repeat many times, every woman is different and will experience these or other symptoms very differently. So if you are reading this and something resonates, then please get in touch with a professional therapist for advice on the best treatment applicable to YOU!

So hot flushes! What are they? Why the hell am I feeling them now at 46 years of age and why can I not see or feel them coming?

Hot flushes have been characterised as a sudden feeling of warmth rising from the lower abdomen up through the chest and into the neck and head. It is often accompanied by red face, warm hands and feet, profuse sweating and increased heartbeat or palpitations. These can last anywhere from 2 – 30 minutes.

The way I experience them is as an intense heat in my chest and upper back and shoulders, with absolutely NO warning – in fact it happens quicker than I can realise it is happening – wtf! After which I feel sweat dripping down my chest and down my head (not to mention the scalp itchiness). It was not so much the ‘feeling of warmth’ that caught my attention but the sweat running down between my breasts. So much dripping in fact, that I unconsciously wiped it with my t-shirt, and yes you guessed it, a nice wet patch remained on my t-shirt – between my breasts – in the middle of a zoom consultation – and on more than once occasion – awesome! Urggghhhh

So naturally I ignored this for a few weeks while I blamed hot coffee, red wine, anger even – everything but what was fundamentally happening. My body is changing, and yes we are always changing, only now it is more profound, and just as I help my female patients in their hormonal balancing, it was time to start helping myself. So here comes the informative bit…..

From a Traditional Chinese Medicine (TCM) point of view, hot flushes are seen as a Kidney-Yin deficiency. Don’t worry, I am not going to get too technical here but just so you the reader is aware, there is a physiological context here that involves more than just hormone balancing. It involves complex mechanisms in our bodies which involve more than just our ovaries and uterus. Which is why a ‘one pill fits all’ approach does not work for all women. We all experience imbalance in different ways and when we look at our health from a ‘whole body’ point of view, we will be in a better position to understand what is going on and how best to start to heal. And it is more than just healing because I like to think of it as a ‘reset’ because as our hormones start to change, our bodies need to be supported in this process or as some are calling it, the transition.

So how can we best support our bodies through hot flushes? Lets first look at it from a nutrient point of view.

Firstly, look at B vitamins, specifically B6 and B12. Vitamin B6 has been shown to raise serotonin levels in our bodies which plays a role in oestrogen synthesis. The increased serotonin incidentally also helps ward off depression which can accompany hot flushes as this phenomenon starts to create a stressful state of mind. Vitamin B12 helps to break down oestrogen so that it can be excreted from the body once it has done its work (although it has many other functions in the body). More and more women in peri- and menopause are being diagnosed with B12 deficiency so it is important to get this tested especially if you are a vegan or vegetarian as most B12 comes from animal sources.

Next up is vitamin D and this will come up time and again in all articles to do with hormonal balancing as this vitamin is essential for optimal hormonal health. However, for the purpose of this article, vitamin D controls the production and activity of oestrogen and progesterone in order to maintain their balance. Additionally, oestrogen is said to increase the activity of the enzyme responsible for activating vitamin D. Therefore declining levels of oestrogen can lead to vitamin D deficiency as women transition into menopause.

Another important component here is vitamin E. Often overlooked but equally as important as vitamin D in hormonal balancing, and especially that of oestrogen which is the main hormone implicated in hot flushes. Studies show that vitamin E helps to alleviate the intensity and frequency of hot flashes as it said to stabilise oestrogen levels in the body. This is significant because as hormone levels start to change, the last thing we want is a yo-yo effect as this could result in oestrogen dominance (too much oestrogen than needed which is not broken down or controlled properly) which could, for example, result in breast cancer, commonly diagnosed in peri- and menopausal women.

Lastly but not least is magnesium. A mineral that is receiving heaps of attention (rightfully so) for its action on improving sleep quality, resilience to stress and reducing muscle cramps/restless leg syndrome. Luckily it has other functions and studies have shown that magnesium oxide in particular has been associated with a whopping 50% reduction in hot flushes. More studies are needed on this as there are quite a few different kinds of magnesium which causes a lot of confusion in supplementation.

Commonly overlooked in treating hot flushes (and other hormonal issues) is our thyroid. Thyroid hormones (specifically T3 & T4), as well as oestrogen affect the area of the brain responsible for regulating our temperature (Hypothalamus). Normally, if hot flushes are experienced in your 40’s then it is thought that oestrogen is responsible as it is ‘to be expected’ i.e menopause is coming! However, thyroid tests could prove worthwhile even if it is to rule out the involvement of the thyroid. There is actually a lot to be written here as I have found in quite a few of my female patients that blood works only reveal basic thyroid testing, namely just TSH unfortunately. This needs to be remedied as the thyroid is a super organ that works in synchronicity with many other processes in our bodies. So, if you do suspect that something else is at play with hot flushes, or any metabolic issue in your body, please trust your instinct and insist on a full blood work!

Now from a herbal perspective, there are quite a few that help with the treatment of hot flushes – yay! I am going to mention a few here that most women may already be aware of due to press coverage.

First is Black cohosh (or Sheng Ma in TCM) which is well known in the treatment of menopausal symptoms particularly hot flushes, vaginal dryness and depression. It tonifies our Qi (vital energy), balances hormones, is integral in the treatment of fibromyalgia to name a few indications. Ayurvedically, it helps to prevent bone loss after menopause.

Next is Red clover, another well known herb renowned for relieving menopausal symptoms, especially hot flushes and prevention of osteoporosis. In Ayurveda, it is believed to reduce tumours as it purifies blood and enhances circulation.

Another favourite of mine is Sage (Danshen in TCM), as it is not just a mere culinary herb but a powerful and all rounder with many health benefits. In Ayurvedic medicine it is used to protect against the symptoms of ageing (bonus!). In TCM, it is used to harmonise menopause, particularly hot flushes, fatigue, night sweats and irritability.

Now, as I mentioned in my previous article, these are just a few that I chose to mention as they are more commonly used and known with regard to peri- and menopausal symptoms, but there are others that are just as wonderful. It once again comes down to the individual needs of the person, as to how they are included in formulas etc.

Lastly, I just wanted to mention that there are a few companies that have capitalised (or tried to) on this knowledge and developed supplements containing ‘extracts’ of the above herbs and others claiming to be of benefit for peri-and menopausal symptoms. Unfortunately extracts are not the WHOLE herb or part of herb traditionally used, and so the question is “how effective are they?” – something to think about possibly? Therefore, if you would like to consider the complete use of herbs then please consult a trained Herbalist or Functional Doctor in order to get the best out of these healing plants.

Next up………THE RAGE (Oh yes!)……Oh and red wine! Hmmm