From the Guidelines
High-dose vitamin E (800 IU/day) is the most effective natural supplement for reducing hot flashes, although its use should be approached with caution due to potential increased risk of all-cause mortality at doses above 400 IU/day. When considering natural supplements for managing vasomotor symptoms, it's essential to weigh the potential benefits against the risks.
Key Considerations
- The efficacy and safety of most complementary and alternative therapies for menopausal symptoms are not well established, with many studies showing no benefit or significant risks [ 1 ].
- Black cohosh, for example, has been shown to be of no benefit in reducing hot flashes and may pose a risk of liver failure [ 1 ].
- Red clover has demonstrated some potential in reducing hot flash intensity and frequency but may increase the risk of perioperative bleeding [ 1 ].
Recommendations
- Vitamin E at a dose of 400-800 IU/day may be considered for managing hot flashes, given its limited efficacy shown in some studies [ 1 ].
- It is crucial to consult with a healthcare provider before starting any supplement regimen, especially for individuals with existing health conditions or those taking medications.
- Lifestyle modifications, such as avoiding triggers, staying cool, practicing deep breathing, and regular exercise, should be recommended alongside any supplement use.
- Given the potential risks and lack of strong evidence for most natural supplements, a cautious approach is warranted, prioritizing patient safety and monitoring for any adverse effects.
From the Research
Natural Supplements for Vasomotor Symptoms
Some natural supplements have been studied for their potential to help with vasomotor symptoms, such as hot flashes. These include:
- Black cohosh: The evidence on the efficacy of black cohosh for hot flashes is divided, with some benefits seen when compared with baseline, but not when compared with placebo 2, 3.
- Omega-3 fatty acids: Supplementation with omega-3 fatty acids, particularly ethyl-eicosapentaenoic acid (E-EPA), has been shown to reduce hot flash frequency and improve hot flash score relative to placebo 4. Omega-3 fatty acids may also play a positive role in the prevention of postmenopausal hot flushes 5.
Key Findings
- A systematic review of black cohosh use in women with or at risk of breast cancer found no significant impact on circulating hormone levels or proliferation in estrogen responsive tissues 2.
- A randomized clinical trial of E-EPA omega-3 fatty acid supplementation found that it reduced hot flash frequency and improved hot flash score relative to placebo 4.
- A review of dietary omega-3 fatty acids for women found that they may help prevent certain cancers, including breast cancer, and may also reduce the risk of postpartum depression and other conditions 5.
- A randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer found that it was not significantly more efficacious than placebo against most menopausal symptoms, including number and intensity of hot flashes 3.