Some practical suggestions for coping with hot flushes include:

  • Keeping cool and avoiding possible triggers such as spicy foods, caffeine, smoking or stress.
  • Regular exercise may help improve some symptoms of the menopause, including hot flushes and night sweats, difficulty sleeping and mood changes; Physical activity that stresses the bones, such as running and walking, can help prevent osteoporosis. Physical activity can also help protect against heart disease and stroke.
  • Dress in layers, so that you can remove clothing when a hot flush begins. Use cotton sheets, lingerie, and clothing that allow your skin to breathe.
  • A healthy diet can help protect your body against some of the long-term effects of the menopause.
  • Drink a glass of cold water or fruit juice when a hot flush begins.
  • Keep a thermos of ice water or an ice pack next to your bed during the night.
  • Keep a diary or record of your symptoms to determine what might trigger your hot flushes.

Hormone Replacement Therapy (HRT)

Since the menopause is caused by declining levels of the hormone oestrogen, the main medical treatment is to reverse this decline through hormone replacement therapy or HRT.

Types of hormone replacement therapy

There are many different forms of HRT, which can be administered in many different ways, including creams, pills, skin patches or sub-cutaneous implants.  It can take a little while to find the most effective HRT preparation for an individual woman and you may need to try 2 or 3 to find one that suits you best.

The main formulations used in HRT are:

  • Oestrogen only
  • A mix of oestrogen and progesterone (as a synthetic version called progestogen)

Oestrogen only HRT is only recommended following a hysterectomy, while oestrogen combined with progestogen HRT is used for women who have not had a hysterectomy.

What are the risks of HRT?

HRT is not suitable for women with a history of hormone-related cancers, such as breast or ovarian cancer, or women who have had problems with thrombosis.

HRT has been associated with a number of health scares in the past, including increasing breast cancer risk. There is also an increased risk of endometrial cancer if progestogen is not taken as prescribed with oestrogen. These increased cancer risks return to normal within 5 years of ceasing HRT.

Despite these risks, current medical opinion is that the benefits outweigh the problems. Nonetheless, the hormone levels in HRT should always be kept to the minimum required, and women should stop taking HRT treatment as soon as possible after menopausal symptoms have finished. This may lead to a brief return of symptoms, which soon pass.

Post-menopausal screening

Because of the increased risks of breast and ovarian cancer, it is vitally important to attend screening clinics both while taking HRT and regularly in the post-menopausal years. Mammograms, breast examinations, ovarian cancer screening and cervical smears all give crucial early warning of any problems. These tests should begin around 3 months after the commencement of HRT and should be reviewed every 12 months.

Bone density scans are also recommended for post-menopausal women, since reduced oestrogen levels are known to accelerate the rate of bone density loss associated with osteoporosis.

There is also evidence to show that post-menopausal women have the same risk of cardiovascular disease as men of the same age as they are no longer protected by higher oestrogen levels. It is therefore important that women who are at high risk of cardiovascular disease and who experience symptoms such as chest pain or other signs of angina or a heart attack should have cardiac screening.