Hot Flushes and Night Sweats during The Menopause

Hot flushes are defined as transient sensations of heat, sweating, flushing, anxiety, and chills that last between one and five minutes . They are probably the most aggravating symptom of menopause and they are also the most common. When they happen at night, they are generally called night sweats and as the name suggests, you can wake up to find yourself over heated and in a clammy sweat. Hot flushes and night sweats can be mild and tolerable, or severe and unbearable.

It is thought as oestrogen declines in the body, temperature regulating system in the brain fluctuates, causing hot flushes. I was lucky to escape hot flushes during the daytime, but I regularly overheated at night. That left me sleep deprived, irritable and exhausted for a couple of months on and off through menopause.

Unfortunately, some women can suffer for years with their own internal version of global warming!

Lifestyle changes can certainly help. Coping mechanisms include meditation, yoga, tai chi, and massage, promoting more restful sleep and waking hours. Dressing in light cotton night clothes and sleeping under layered bedclothes that can easily be removed are a must.

I know one woman who went to bed with a packet of frozen peas tucked under her pillow so when she flipped her pillow, she had a cool headrest when night sweats were really bothersome.

More than 80 per cent of Western women experience hot flushes during menopause. This is at odds with our Asian counterparts where only 20 per cent of women in Japan and China report having hot flushes. This is thought to be largely connected to their traditional food regime which contains copious phyto-oestrogen-rich, soya-based foods. Typically, they consume somewhere between ten and twenty times the amount of soya isoflavones per day than we do.

Phyto-oestrogens occur naturally in plant foods. They are structurally like human oestrogen. When eaten regularly, and in sufficient quantities, they can start to have mild oestrogen-like effects, which are useful as oestrogen levels decline during menopause.

For some women these effects could be sufficient to help relieve menopausal symptoms, particularly hot flushes. According to the British Dietetic Association, it is worth knowing that:

  •  It can take two to three months to release the benefits of plant oestrogens.
  • Plant oestrogens seem to work better for some women than others, which might be down to differences in gut bacteria.
  • Consuming plant oestrogens several times a day appears to be more effective compared to consuming one larger dose.
  • Foods containing plant oestrogens (such as soya and linseeds) are also heart friendly so it’s worth trying to include calcium-enriched soya products like milk, yoghurts, soya and linseed bread or edamame beans two to three times each day.

There are three main types of plant oestrogens; isoflavones, lignans, and coumestans.

Isoflavones are phenolic compounds with a chemical structure similar to that of oestradiol. They are present in several vegetables, mainly in legumes such as soya, white and red clover, alfalfa and beans.

One recent study on isoflavones pointed to scientific evidence of isoflavones’ beneficial effect on bone health. This is important for the prevention and treatment of osteoporosis.

The evidence also suggests that isoflavones could help reduce the risk of breast and endometrial cancer, but further studies are needed to confirm these results.

Finally, isoflavones can help reduce hot flushes associated with menopause. However, the research in this field is so far limited by significant variability among studies .

Foods containing plant oestrogens:

  • Isoflavones (genistein, daidzein, glycitein and equol) are mainly found in soya beans and soya products, chickpeas and other legumes, nuts and nut butters and wholegrains.
  • Lignans (enterolactone and enterodiol) are primarily found in seeds and seed oils (such as linseed oil) and legumes.
  • Coumestans (coumestrol) can be found in alfalfa and clover.


A special mention for isoflavone-rich soya foods:

Soya beans are the main dietary source of isoflavones, with a large glass of soya drink (250ml) providing approximately 25mg of isoflavones. However, not all soya foods contain isoflavones, with some processing methods removing 80 to 90 per cent of isoflavones.

Recent studies suggest it is wise to consume foods naturally rich in isoflavones, both in regular and moderate quantities. And yes, even women with breast cancer can enjoy tofu and soya/edamame beans.

Consuming 40mg of isoflavones daily, equivalent to two glasses of soya milk or 100g soya mince, may help reduce the frequency of hot flushes by 20.6 per cent and their severity by 26.2 per cent. In addition, consuming soya foods may also help lower the risk of heart disease, which is doubled for women after menopause .

Isoflavone supplements also consistently alleviate menopausal hot flushes provided they contain enough of the predominant soybean isoflavone, genistein.

The key take-away 📝:

Small lifestyle changes can make the symptoms of menopause more tolerable. While hormone replacement therapy is used to help control severe menopausal symptoms, many women cannot take HRT, and others choose not to. Whether HRT is right for you is a discussion you can have with your doctor. But don’t forget diet and lifestyle changes can help all women to manage symptoms associated with menopause. Choose to eat phyto-oestrogen rich foods such as edamame/soya beans (and foods made from them), chickpeas, nuts and linseed as part of a healthy, balanced diet. A dietary supplement can help too.

Isoflavone content of selected foods:

Food

Total isoflavones (milligrams per 100 grams)

Miso soup

1.52

Natto

82.29

Pistachios

3.63

Red clover

21

Soybeans, green, raw (includes edamame)

48.95

Soy cheese, American

17.95

Soy cheese, cheddar

6.87

Soy chips

54.16

Soy protein drink

81.65

Soy sauce made from hydrolysed vegetable protein

0.10

Soy sauce made from soy and wheat (shoyu)

1.18

Soy yogurt

33.17

Tofu, firm, cooked

22.05

Tofu, fried

34.78

Veggie burger

6.39

 

References:

Bansal, R., and Aggarwal, N. ‘Menopausal Hot Flashes: A Concise Review’. J Midlife Health. 2019 Jan-Mar;10(1):6-13. doi: 10.4103/jmh.JMH_7_19. PMID: 31001050; PMCID: PMC6459071


Bansal R, Aggarwal N. ‘Menopausal Hot Flashes: A Concise Review’.


Gold, E.B., Sternfeld, B., Kelsey, J.L., et al. ‘Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40–55 years of age’. Am J Epidemiol. 2000; 152:463–473.


The British Dietetic Association (2019). ‘Food Fact Sheet’ [online]. Available at: https://www.bda.uk.com/uploads/assets/da7a32fc-4ab3-42e1-b2573359e81471d0/Menopause-food-fact-sheet.pdf (accessed: 30 August 2021).

Gómez-Zorita, S., González-Arceo, M., Fernández-Quintela, A., Eseberri, I., Trepiana, J., and Portillo, M.P. (2020) ‘Scientific Evidence Supporting the Beneficial Effects of Isoflavones on Human Health’. Nutrients. Dec 17;12(12):3853. doi: 10.3390/nu12123853. PMID: 33348600; PMCID: PMC7766685.


Gómez-Zorita, S., González-Arceo, M., Fernández-Quintela, A., Eseberri, I., Trepiana, J., and Portillo, M.P. (2020) ‘Scientific Evidence Supporting the Beneficial Effects of Isoflavones on Human Health’.


The British Dietetic Association (2019). ‘Food Fact Sheet’ [online]. Available at: https://www.bda.uk.com/uploads/assets/da7a32fc-4ab3-42e1-b2573359e81471d0/Menopause-food-fact-sheet.pdf (accessed: 30 August 2021).

Mark Messina, (2014). ‘Soy foods, isoflavones, and the health of postmenopausal women.’ The American Journal of Clinical Nutrition, Volume 100, Issue suppl_1, pp. 423S–430S.


‘Isoflavone content of selected foods.’ Harvard Health Publishing [online]. Available at: https://www.health.harvard.edu/newsletter_article/isoflavone-content-of-selected-foods (accessed: 30 August 2021).

Menopause

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