Are you experiencing your own internal heat wave? Do you wake up at least once during the night in a sweat? Do you have to get out of bed, towel off, change clothes and then try to get back to sleep, only to experience a repeat performance? Do you have to prod your partner to move over a bit to avoid sleeping in the “wet spot.” (No, not the fun one.) Do your nights of interrupted sleep seem endless?  If so, you’re not alone, and this is not being caused by global warming.

According to the North American Menopause Society, about 75 percent of women report perimenopausal symptoms such as night sweats and hot flashes. If you’re one of them, you know it’s more than a seasonal heat wave. And you know that the symptoms — a flushed face, drenching sweat and rapid heart rate — will only be compounded as the numbers on the thermostat continue to climb. Before you move to the North Pole, let’s examine this common symptom a bit further.

What exactly is a hot flash?

During perimenopause and menopause, the body’s  levels of estrogen, progesterone and testosterone begin to fluctuate. When estrogen levels go down, they can trigger your body’s thermostat to send a signal that you are overheated. This causes your body to send out an all hands on deck alert: your heart pumps faster, the blood vessels in your skin dilate to circulate more blood to radiate heat, and your sweat glands release sweat to cool you even more. Like so much about the process of menopause, there is no “one size fits all” for the timing, duration, frequency or pattern of menopausal hot flashes.

So what does this hormonal meltdown feel like?

You may experience one or more of these:

• flashes of heat spreading over your skin
• skin flushed red or blotchy
• racing heartbeat like you’ve just run a 100-yard dash
• sweating a lot
• dizziness

These episodes:

• last from 30 seconds to 5 minutes
• occurring in upper or lower body
• occur during the day and/or night (night sweats)
• are infrequent (several per month) to frequent (several per hour)
• are followed by a feeling of being cold and clammy once the hot flash has passed

Fortunately, there are lots of options for treating hot flashes beyond wearing easy-to-strip-off layers, or attaching a small fan to your forehead. Since every woman is different, you will have to explore which options work best for you with your menopause specialist.

Options needing prescriptions:  

• Hormone Therapy
• Selective serotonin and serotonin norepinephrine reuptake inhibitors (SSRIs and SNRIs). These drugs are often prescript for the treatment of depression and anxiety, but they also can work in alleviating hot flashes and night sweats.

Non prescription options:

It’s helpful to be aware of some of the typical hot flash instigators. You can try eliminating these triggers one at a time to see if that helps alleviate your symptoms. For example, reduce your alcohol intake and caffeine (especially before bed), and cut back on spicy foods. All of these things may increase or worsen hot flashes.

Try a Mediterranean Diet.  According to a study in the American Journal of Clinical Nutrition, menopausal women who most closely follow a diet rich in produce, pasta, and red wine are about 20 percent less likely to suffer hot flashes and night sweats.  (This isn’t an excuse to rush out and eat a huge plate of spaghetti! I don’t know about you, but fusilli doesn’t look so good on my hips.)

Acupuncture, yoga, and meditation may also help.

Soy, anyone?  There is lots of conflicting information about soy. I spoke to Dr. Gordon Saxe, M.D., Ph.D., Research Director and Preventive Medicine Physician at the UCSD Center for Integrative Medicine and co-developer and Medical Director of the UCSD Natural Healing & Cooking Program, and got the skinny on soy! If you are interested in integrating soy into your diet, take the time to read my two interviews with him: Part I and Part II.

Some women find help with black cohosh. You can find this ingredient in Remifemin, an over-the-counter product available at many pharmacies. Dr. Elena Ratner, Assistant Professor of Obstetrics, Gynecology, and Reproductive Sciences at the Yale Cancer Center, recommended it to her breast cancer patient Vicki, whose treatment threw her into menopause. “Hot flashes started full on for me … and I immediately went on Remifemin…. The hot flashes are about 98 percent gone.”

As of 2014, we have a new product that has come to the U.S. called Relizen, which is made in Sweden from pollen extract and has been used successfully in Europe for more than 15 years.

Exercising increases your endorphin levels, usually adding to a feeling of well-being; it also helps reduce stress levels and supports general wellness. Any of the typical remedies for de-stressing your life, like biofeedback and even massage, might help keep those temperature spikes under control.

“All exercise, ranging from housework to running marathons, impacts menopause in a positive way,” says Dr. Diana Bitner, MD, a North American Menopause Society Certified Menopause Practitioner & Physician and board-certified OB/GYN. “My patients who exercise on a regular basis have fewer menopause symptoms as well as improved body chemistry—lower cholesterol, better sugar control, less weight gain, and stronger bones. Women who exercise have better sleep, better mood, and better quality of life.”

The reason: “A higher body mass index (BMI) as well as a higher body fat percentage both increase hot flashes and night sweats in menopause, lead to poor sleep, low energy, bad moods, and can cause a poor self-image,” Dr. Bitner says. “I talk to my patients about belly fat as a furnace that makes them hot and tired.” So get rid of it!

Remember, when you find yourself going from 0 to 90 (degrees) in 30 seconds, keep a cool head, call your menopause specialist, and don’t sweat it! Relief is on the way!