Natural Supplements vs HRT: Doctor’s Guide to Relieving Hot Flushes and Night Sweats During Menopause

Author
Buddhini Dolapihilla, MD, has over 6 years of expertise in clinical research. She is a medical doctor (MBBS), clinical research physician scientist, and enthusiastic academic writer. Dr. Dolapihilla enjoys imparting her medical expertise to women in order to better understand their health needs, particularly during a time of transition like menopause.

I. Introduction

Menopause is a natural part of a woman’s life, marking the end of reproductive age. It occurs when a woman’s body stops producing eggs, resulting in decreased levels of hormones such as oestrogen and progesterone. The average age of menopause is 51, but some women may experience it earlier due to various reasons like genetics, surgery, chemotherapy, or radiation. Menopause brings with it a host of symptoms such as hot flushes, night sweats, headaches, fatigue, and mood swings, which can have a significant impact on a woman’s quality of life.

One of the most common and bothersome symptoms of menopause is hot flushes. About 75% of women experience hot flushes during menopause, with a third of them being severely affected. Vasomotor symptoms (VMS) which include hot flushes and night sweats, can start in one or two years before menopause and persist for over 7 years, with some women experiencing them for up to 15 years^[1]. For a small proportion of women, hot flushes may never go away, even into their 70s or beyond.

As a result of these symptoms, women look for ways to relieve them, and two options are commonly used: natural supplements and Hormone Replacement Therapy (HRT). In the United States and the United Kingdom, 80% of postmenopausal women use herbal medicine, and 60% to 70% believe that these supplements eliminate their problems and are safe without side effects^[2]. In a recent survey, 95% of women said they would try alternative therapies before HRT because they think they are more natural and are worried about the health risks of HRT.

In this article, we will discuss the pros and cons of natural supplements and HRT, and their possible effects on women whether they are in perimenopause, menopause and post-menopause.

II. Natural supplements to relieve hot flushes and night

There’s a wide range of natural, menopause supplements available on the market that may help alleviate hot flushes and night sweats. The most common ingredients include: black cohosh, sage, evening primrose oil, flaxseed, and red clover.

Black cohosh

Black cohosh is an herb that has been used for centuries to alleviate menopausal symptoms.

Benefits:

1. Black cohosh reduces the frequency and severity of hot flushes in menopausal women. It is thought to work by mimicking the effects of oestrogen in the body, which can help to regulate body temperature and reduce the intensity of hot flushes^[3].
2. It also helps to improve vaginal dryness, which is a common symptom of menopause. It may do this by increasing blood flow to the pelvic area and stimulating the production of vaginal mucus^[3].
3. Black cohosh has been shown to improve mood in menopausal women. It may do this by regulating serotonin levels in the brain, which can help to reduce feelings of anxiety and depression^[3].

Side effects:

1. The most common side effects of black cohosh are gastrointestinal, including nausea, vomiting, and diarrhoea. These side effects are usually mild and go away on their own within a few days^[3].
2. Some people may experience dizziness and headache when taking black cohosh.
3. A small number of people may develop a skin rash after taking black cohosh. This side effect is usually mild and goes away on its own.
4. Liver damage: There have been rare cases of liver damage reported in people taking black cohosh. It is important to talk to a healthcare provider before taking black cohosh, especially if you have a history of liver problems^[4].

In summary, black cohosh may be a useful natural supplement for menopausal women experiencing hot flushes, vaginal dryness, and mood changes. However, it is important to be aware of the potential side effects, particularly those related to liver function.

Sage

Benefits:

1. Sage just as black cohosh reduces the frequency and severity of hot flushes in menopausal women^[5].
2. Additionally, sage has been shown to improve cognitive function in some studies. It may help to improve memory and concentration in healthy individuals as well as those with cognitive impairment^[6].
3. Traditionally, sage has been used to treat digestive issues such as bloating, gas, and indigestion. It may help to stimulate the digestive system and reduce inflammation in the gut.

Side effects:

1. Allergic reactions- Some people may experience allergic reactions to sage, including skin rashes, hives, and difficulty breathing^[5].
2. Seizures – it’s not recommended to take high doses of sage if you have epilepsy.

Side effects:

1. Allergic reactions- Some people may experience allergic reactions to sage, including skin rashes, hives, and difficulty breathing[5].
2. Seizures – it’s not recommended to take high doses of sage if you have epilepsy.

In summary, sage may be a useful herb for menopausal women experiencing hot flushes, as well as for improving cognitive function and treating digestive issues. However, as with any supplement, it is important to be aware of potential side effects and to consult with a healthcare provider before taking sage, especially if you have a history of health problems.

Evening Primrose Oil

Benefits:

1. Evening primrose oil is often used to alleviate hot flushes, night sweats, and other menopausal symptoms. It contains gamma-linolenic acid (GLA), an omega-6 fatty acid that helps to regulate hormonal imbalances^[7].
2. Evening primrose oil has been shown to improve skin health, including reducing wrinkles and increasing skin hydration.
3. Some studies suggest that evening primrose oil may help to reduce the symptoms of rheumatoid arthritis, such as joint pain and stiffness^[8].

Risks:

1. Evening primrose oil may cause gastrointestinal side effects, such as stomach pain, nausea, and diarrhoea.
2. Evening primrose oil may have blood-thinning effects, which can increase the risk of bleeding and bruising.
3. In rare cases, evening primrose oil may trigger seizures in people with a history of epilepsy or other seizure disorders.

Flaxseed

Benefits:

1. Flaxseed contains lignans, which have a weak oestrogenic effect and may help to reduce menopausal symptoms such as hot flushes and vaginal dryness^[9].
2. Flaxseed has been shown to improve cardiovascular health by reducing inflammation and cholesterol levels.
3. Some studies suggest that flaxseed may have anti-cancer properties, particularly in breast and prostate cancer.

Risks:

1. Flaxseed may cause gastrointestinal side effects, such as stomach pain, bloating, and diarrhoea.
2. Flaxseed may interfere with certain medications, including blood thinners, hormone therapy, and some diabetes medications.
3. In rare cases, flaxseed may cause allergic reactions, including hives, swelling, and difficulty breathing.

Red Clover

Benefits:

1. Red clover contains isoflavones, which have a weak oestrogenic effect and may help to reduce menopausal symptoms such as hot flushes and night sweats.
2. Red clover may help to improve bone density and reduce the risk of osteoporosis in postmenopausal women.
3. Red clover has been shown to improve cardiovascular health by reducing cholesterol levels and inflammation.

Risks:

1. Red clover may cause gastrointestinal side effects, such as nausea, diarrhoea, and abdominal pain.
2. Red clover may have blood-thinning effects and increase the risk of bleeding in people with bleeding disorders or those taking blood-thinning medications.
3. Red clover may interfere with certain medications, including hormone therapy, blood thinners, and some chemotherapy medications.

III. Hormone Replacement Therapy (HRT)

Hormone Replacement Therapy (HRT) is a medical treatment in which a person is given hormones to supplement or replace the hormones that their body is not producing enough of on its own. HRT is commonly used to treat symptoms of menopause by replacing the hormones that are no longer being produced by the ovaries[10]. HRT can also be used to treat other conditions, such as hypogonadism, or to prevent osteoporosis.

The benefits of HRT can vary depending on the individual and the condition being treated, but some potential benefits include:

• Relief of symptoms of menopause, such as hot flashes, night sweats, vaginal dryness, and mood changes
• Prevention of osteoporosis and fractures in postmenopausal women
• Improved sexual function and libido
• Improvement in overall quality of life

However, HRT does come with some risks, which can also vary depending on the individual and the specific treatment. Some potential risks of HRT include:

• Increased risk of blood clots, stroke, and heart attack
• Increased risk of breast cancer (for certain types of HRT)
• Increased risk of endometrial cancer (if oestrogen is not balanced with progestin)
• Possible increase in risk of dementia (for certain types of HRT)
• Possible increase in risk of gallbladder disease

The type of HRT and the way it is administered can vary depending on the individual and the condition being treated. HRT can be taken in the form of pills, patches, gels, creams, or injections. The dosage and duration of treatment will also depend on the individual and their medical history. It’s important to discuss the risks and benefits of HRT with a healthcare provider to determine if it’s the right treatment option for an individual’s specific needs.

IV. Natural supplements vs HRT: A comparison

A. Pros and cons of natural supplements:

Pros:

• Natural supplements are generally considered safer than HRT as they are made from plant-based or herbal ingredients.
• They can help alleviate symptoms of menopause such as hot flashes, mood changes, and vaginal dryness.
• They may have additional health benefits, such as reducing the risk of heart disease, improving bone health, and boosting cognitive function.

Cons:

• The effectiveness of natural supplements may vary from person to person and from product to product, making it difficult to predict their effects.
• The regulation of natural supplements is not as strict as that of prescription drugs, which can make it difficult to know the quality and purity of the product.
• Natural supplements can interact with other medications and may not be suitable for everyone, especially those with certain medical conditions.

B. Pros and cons of HRT:

Pros:

• HRT is highly effective in reducing symptoms of menopause, such as hot flashes, vaginal dryness, and mood changes.
• HRT can also help prevent bone loss and reduce the risk of fractures.
• HRT is available in a variety of forms, including pills, patches, gels, and creams, making it easy to find a treatment option that works for an individual.

Cons:

• HRT comes with some risks, including an increased risk of blood clots, stroke, heart disease, breast cancer, and endometrial cancer.
• HRT may not be suitable for everyone, especially those with a history of certain medical conditions.
• HRT requires regular monitoring by a healthcare provider to ensure that it is working effectively and to monitor for any potential side effects.

When considering whether to use natural supplements or HRT, there are several factors to take into account:

• Severity of symptoms: If an individual is experiencing severe symptoms of menopause, HRT may be a more effective treatment option than natural supplements.
• Medical history: Certain medical conditions, such as a history of breast cancer or blood clots, may make HRT a less suitable option, in which case natural supplements may be a better alternative.
• Personal preference: Some people may prefer to use natural supplements over HRT because they are more comfortable using natural products, while others may prefer the reliability and effectiveness of HRT.
• Cost: Natural supplements are generally less expensive than HRT, which may be a factor for some individuals.
• Quality of life: Ultimately, the decision between natural supplements and HRT should be based on what will improve an individual’s quality of life and manage their symptoms effectively while minimizing risks. This should be discussed with a healthcare provider to determine the best course of treatment.

V. Combining natural supplements

Combining natural supplements with HRT can provide additional benefits to menopausal women. For example, some natural supplements such as black cohosh, red clover, and soy help to reduce hot flushes and other menopausal symptoms that are not adequately controlled by HRT alone. In addition, some supplements such as calcium and vitamin D may help to improve bone density and reduce the risk of osteoporosis in menopausal women, which is a common concern.

However, combining natural supplements with HRT can also pose risks. Some natural supplements may interact with HRT or other medications, which can lead to adverse effects. For example, St. John’s wort, which is often used to treat depression, can reduce the effectiveness of HRT and increase the risk of breakthrough bleeding[11]. In addition, some supplements such as black cohosh and soy may have oestrogenic effects in the body, which can increase the risk of breast cancer or other hormone-sensitive cancers in women who have a history of these conditions.

To combine natural supplements with HRT safely, it is important to talk to a healthcare provider first. They can help to determine which supplements may be appropriate based on your individual needs and medical history. In addition, it is important to follow the recommended dosages and avoid taking more than the recommended amount. Also, keep track of any side effects or changes in symptoms, and report them to your healthcare provider immediately. It is also important to continue with regular check-ups and screenings, such as mammograms and bone density tests, to monitor for any changes or complications.

VI. Recommendation

There is a wide choice of supplements for women in menopause. It’s always recommended to speak with your healthcare provider first, be aware of the side effects of the supplement and medication and the possible problems that may arise from combining various treatments.

If you are looking for a natural supplement to help relieve menopausal symptoms, consider trying Fenomeno Hot Flush Tamer. This product contains sage, which has been shown to reduce the frequency and severity of hot flushes in menopausal women. It is also formulated with other natural ingredients, such as alfalfa and natural vitamin E to help support your overall health during menopause.

VII. References

1. Hamoda, H., et al., The British Menopause Society & Women’s Health Concern 2020 recommendations on hormone replacement therapy in menopausal women. Post Reproductive Health, 2020. 26(4): p. 181-209.
2. Ebrahimi, A., et al., Investigation of the role of herbal medicine, acupressure, and acupuncture in the menopausal symptoms: An evidence-based systematic review study. J Family Med Prim Care, 2020. 9(6): p. 2638-2649.
3. Castelo-Branco, C., et al., Black cohosh efficacy and safety for menopausal symptoms. The Spanish Menopause Society statement. 2022. 38(5): p. 379-384.
4. Teschke, R., et al., Black cohosh hepatotoxicity: quantitative causality evaluation in nine suspected cases. 2009. 16(5): p. 956-965.
5. Bommer, S., P. Klein, and A. Suter, First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes. Adv Ther, 2011. 28(6): p. 490-500.
6. Martini, N.J.J.o.P.H.C., Sage. 2022. 14(1): p. 89-90.
7. Kazemi, F., et al., The Effect of Evening Primrose Oil Capsule on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial. J Menopausal Med, 2021. 27(1): p. 8-14.
8. Joe, L.A. and L.L. Hart, Evening primrose oil in rheumatoid arthritis. Ann Pharmacother, 1993. 27(12): p. 1475-7.
9. Colli, M.C., et al., Evaluation of the efficacy of flaxseed meal and flaxseed extract in reducing menopausal symptoms. J Med Food, 2012. 15(9): p. 840-5.
10. Langer, R.D., et al., Hormone replacement therapy – where are we now? Climacteric, 2021. 24(1): p. 3-10.
11. Zabłocka-Słowińska, K., et al., Interactions between preparations containing female sex hormones and dietary supplements. Adv Clin Exp Med, 2014. 23(4): p. 657-63.