One of the common and stressful symptoms of menopause is hot flushes. The episodic sensations of heat, intense sweating and flushing can recur with varying frequency and intensity. The hot flush may be accompanied by palpitations, anxiety, irritability, and even panic.
Hot flushes probably are triggered by a narrowing of the thermoneutral zone in the hypothalamus .
Hot flash affects work, social activities, leisure activities, sleep, mood, concentration, sexual activities, enjoyment of life, and quality of life in women  The prevalence rate of hot flashes has been reported to be up to 70% in postmenopausal women .
In the majority of women this process stops automatically, and without any treatment. However, symptoms of menopause continue up to 5 years after the onset in one-third of women and, even, they might continue up to 15 years in 20% of women .
Factors that contribute to hot flashes and other symptoms of menopause are:
• Low level estrogen primarily produced by ovaries. Menopause results in the loss of ovarian estrogen production and a consequent drop in circulating levels of estradiol. After menopause adrenal glands and other tissues mostly produce estrogen.
However, women with high estrogen levels or fluctuating estrogen levels also experience hot flashes. High level of estrogen in postmenopausal women could be due to a high level of xeno- or phytoestrogens.
• Estrogen clearance. Liver function. Estrogen is metabolized and cleared by the liver. It is critically important to clear the body from highly toxic metabolites. For example, estrogen metabolites, 4-hydroxylated catechol estrogen possess carcinogenic potential due to their ability to cause DNA damage  . Sluggish liver, congested with sugar, hormonal waste, chemicals, and toxins, is not able properly metabolized estrogen and toxic products remain in the body and damages body systems. Excessive estrogen's metabolites tend to deplete vitamins B6, B12, and folate, so supplementation is vital to clearing metabolite of estrogen.
• Estrogen metabolites elimination. Large intestine and kidney help to flush out estrogen and toxic products. The urine and the feces excrete estrogen waste. In case of constipation, the elimination pathway is blocked and toxic products accumulate in the bloodstream and provoke hot flashes.
• Glutathione level. Glutathione is the last step in detoxification of metabolites of estrogen. Excessive medications, hormone therapy, and exposure to environmental toxins such as heavy metals, cigarette smoke and excessive industrial air pollution result in high utilization and lower levels of glutathione. N-acetylcysteine and Vitamin C are essential in regards to glutathione synthesis.
• Nerve system and neurotransmitters. Reduction in estrogen concentrations could result in imbalances of serotonin and norepinephrine, resulting in the sensation of hot flush . Serotonin acts in opposition with norepinephrine. Serotonin called the happy chemical because it contributes to wellbeing and happiness. Norepinephrine plays a role in mood disorders such as depression, panic attack, anxiety, sweating, heart palpitation, sleeping problem. When estrogen levels fall dramatically during menopause, serotonin values become insufficient, and the activity of norepinephrine is increasing, which may lead to hot flashes in menopausal women .
According to the Women’s Health Initiative, many women find alternatives to traditional medicine more congruent with their values and lifestyles.
Diet: Lower sugar, the red meat, dairy & alcohol consumption, increase raw and steamed vegetable intake
Many botanicals are commonly used for menopause and menopause-related complaints. The most effective herbs to handle hot flashes are:
Lower sugar, the red meat, dairy & lcohol consumption, increase raw and steamed vegetable intake.
Omega-3 fatty acids
According of Canadian studies supplements of the omega-3 fatty acid may help to reduce the occurrence of hot flushes and symptoms of depression.
The investigators found that black cohosh shows excellent promise for relief of menopausal symptoms, primarily for the treatment of vasomotor symptoms (hot flashes) and possibly mood .
Dong quai (Angelica sinensis)
Dong quai is one of the most commonly prescribed Chinese herbs for problems unique to women. It is known as a “female tonic,” it is most widely used in multi-botanical formulations.
Chastetree (Vitex Agnus Castus)
The progesterone-like effect of Chastetree/Vitex has been verified by analysis of blood hormone levels, and examination of vaginal secretions. Most often, when Chastetree is used for menopause, it is in combination with black cohosh and other herbs.
Evening primrose (Oenothera biennis)
Evening primrose contains gamolenic acid, which is believed to reduce vasomotor symptoms .
Motherwort (Leonurus cardiaca)
Motherwort is another botanical found in many menopausal formulae and was typically combined with black cohosh as a “superior antispasmodic and nervine”
Valerian (Valeriana officinalis)
Valerian has been used for centuries unrest and nervous sleep disturbances.
St. John’s Wort (Hypericum perforatum)
St. John’s wort is one of the most heavily studied botanicals for treatment of depression. St. John’s wort is often combined with black cohosh for the treatment of menopausal symptoms (hot flashes, irritability, minor depression, mood swings, and insomnia) .
Yellow Maca (Gelatinized)
Maca is an exceptionally hardy root plant native to the Andean mountain plateaus of Peru. Maca significantly reduced both the frequency and severity of hot flushes and night sweats. Furthermore, studies on Maca are now showing a significant reduction in psychological symptoms, including anxiety, depression, and sexual dysfunction. As such, Maca tends to treat menopausal symptoms as a whole.
To prevent depletion vitamins B6, B12 and folates by toxic metabolites, these vitamins should be prescribed during menopause, as well as vitamin C.
Liver support supplements should be a part of the treatment plan of hot flashes.
Watch for GI track health. Avoid constipation with dietary fiber, detoxify and optimize the health of intestinal tract: increase your vegetable intake so that the waste can't bind in the large intestine.
Finding ways to eliminate hot flashes, which is one of the most common menopausal problems, is quite necessary to protect the mental and physical health of postmenopausal women and peaceful continuation of life.