Weight Loss May Reduce Hot Flashes

Edit Subject

Losing weight may help overweight women to reduce hot flashes after menopause, a study suggests. The study included 338 women. Those who had been through menopause had an average age of 53. All were overweight or obese. They were recruited from a research study on a different topic. In a survey before the study began, about half of the women said they had hot flashes. The women were randomly assigned to two groups. One group was encouraged to sharply reduce calories and to exercise at least 200 minutes per week. These women met with experts to get advice. They also received sample menus. The other group received monthly group education classes. After six months, women in the first group had lost more weight. They also reported more improvements in hot flashes. The journal Archives of Internal Medicine published the study July 12.

What Is the Doctor's Reaction?

Several times a week I hear from patients about hot flashes (or hot flushes, as they are called in medical literature). Sometimes, I see women break into a sweat and fan themselves in my office. Other times, women describe waking up in a cold sweat, drenched in their beds.

For many women, hot flashes are a normal part of menopause. They are not dangerous, but they are uncomfortable. For some, they can cause sleep loss, misery and embarrassment.

Estrogen, a hormone, can help to control hot flashes. But, for other health reasons, most doctors no longer recommend hormone replacement therapy for most women. Therefore, it's always intriguing to find articles that suggest some sort of help for menopause symptoms. Heavier women have more estrogen in their bloodstream. But a new study finds that they may still have more bothersome hot flashes than women of normal weight.

The authors of this study looked at the impact of a weight loss program on women with hot flashes. The larger study was designed to see if weight loss helped urinary incontinence. But one small part of the study asked women about how bothersome hot flashes were for them. The women were all at least overweight, with a body mass index just over normal. Some were obese or even morbidly obese, with a body mass index double the normal.

The average age was nearly 54 for women with hot flashes. Some of the women were assigned to a weight loss program. It included changes in nutrition, exercise and behavior. After 6 months, 46% of those in the program reported improvement in their flushing symptoms. The authors then adjusted the numbers to account for other factors that might help hot flashes, including women who took estrogen and other drugs. Weight loss still was linked to improvements in hot flashes.

This is a small study. It has flaws, of course. Among them are that the study was really designed to look at urinary incontinence. Another is that hot flashes were measured only by the women's own reports. Still, the benefits of the weight loss program on hot flashes are intriguing. Weight loss is safe. It can make women more comfortable. It has potential.

What Changes Can I Make Now?

Hot flashes are a part of menopause for most, but not all women. No one knows exactly what causes them, but it probably has something to do with the decrease of estrogen in your bloodstream. They are not dangerous, but they are uncomfortable for some. A related condition is night sweats.

You can do some common sense things to help with this flashing.

• Drink plenty of liquids.


• Wear layers that you can peel off when you get a flash.


• Keep your home cool.


• Pay attention to triggers. For some women, alcohol, caffeine and some foods make the flashes worse.


• Don't smoke.

If your hot flashes are so distressing that they are reducing your quality of life, then talk to your doctor about medicine. Hormone replacement therapy is not right for everyone. However, it can be quite helpful with hot flashes for a short time in certain women. Other non-hormonal drugs can be helpful as well.

What Can I Expect Looking to the Future?

As our population ages, we are paying more attention to helping people age normally and healthfully. Studies like this are common. I hope that we will see larger studies that may help us determine treatment for common, uncomfortable conditions.

Primary care today is moving more toward team-based care and greater focus on lifestyle changes. I hope that more and more primary care practices will be able to help women and men with major behavioral programs like this one. Ideally, education, guidance and support should be part of the normal course of care.