What are over-the-counter (OTC) options for managing hot flashes?

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Last updated: June 9, 2025View editorial policy

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From the Guidelines

Over-the-counter options for managing hot flashes include lifestyle modifications, such as maintaining a cool environment, dressing in layers, and avoiding triggers like spicy foods, caffeine, and alcohol, as well as considering cognitive behavioral therapy (CBT) or acupuncture, which have shown promise in reducing hot flash symptoms 1. When considering over-the-counter options, it's essential to prioritize approaches that have shown efficacy in reducing hot flash frequency and intensity.

  • Lifestyle modifications, such as weight loss, exercise, and smoking cessation, may help alleviate hot flashes, as suggested by studies 1.
  • CBT has been shown to reduce vasomotor symptoms in the general population and in cancer survivors, making it a viable option 1.
  • Acupuncture has also been found to be a safe and effective option for managing vasomotor symptoms in women with cancer or female survivors, with some studies suggesting it is equivalent to or better than drug treatment 1.
  • While some supplements, such as black cohosh and vitamin E, have been studied for their potential to reduce hot flash symptoms, the evidence is limited, and their effectiveness is not well established 1. It's crucial to start with one approach at a time to determine what works best for individual symptoms and consider consulting a healthcare provider if symptoms are severe or persistent.

From the Research

Over-the-Counter Options for Hot Flashes

There are several over-the-counter (OTC) options that may help manage hot flashes, including:

  • Black cohosh: Studies have shown that black cohosh is safe and effective for reducing menopausal symptoms, primarily hot flashes and possibly mood disorders 2.
  • Phytoestrogen extracts: Soy foods and red clover may have a minimal effect on menopausal symptoms but have positive health effects on plasma lipid concentrations and may reduce heart disease 2.
  • Omega-3 fatty acids: Supplementation with omega-3 fatty acids, particularly eicosapentaenoic acid (E-EPA), has been shown to reduce hot flash frequency and improve quality of life 3, 4.
  • St. John's wort: This herbal supplement has been shown to improve mild to moderate depression in the general population and may be effective for mood disorders related to the menopausal transition 2.

Considerations

It's essential to note that while these OTC options may be helpful, they may not be as effective as hormone replacement therapy (HRT) for managing hot flashes 5, 6. Additionally, it's crucial to consult with a healthcare provider before starting any new supplements, especially if you're considering taking them in combination with other medications.

Available Options

Some of the available OTC options for hot flashes include:

  • Dietary supplements: Black cohosh, soy isoflavones, and omega-3 fatty acids are available in supplement form.
  • Herbal remedies: St. John's wort and other herbal supplements may be available in tea or capsule form.
  • Vitamin and mineral supplements: Some vitamins and minerals, such as vitamin D and calcium, may help alleviate hot flashes.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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