Managing Your Hot Flashes Without Hormones

This information will help you manage your hot flashes without using hormones. Hot flashes are caused by changes in hormone levels, which can happen in women and men. In women, they can be a natural part of menopause, or a side effect of cancer treatment or treatment to prevent cancer. In men, they are usually from treatments designed to stop the production of hormones.

Hot flashes usually begin as a feeling of warmth in your face, neck, chest, and back, which can spread to your entire body. Hot flashes can range from light warming and redness (flushing) to drenching sweats. Some people have 1 or 2 hot flashes a day; others have as many as 3 an hour. They can come on suddenly during the day and can interrupt your sleep at night. For some, they are a mild irritant. For others, they are much more bothersome.

While you won’t be able to completely prevent hot flashes, avoiding things that trigger them can be helpful, such as:

  • Smoking
  • Caffeine
  • Alcohol
  • Spicy foods

There are things you can do to manage hot flashes when they do come on, such as:

  • Wear absorbent, cotton clothing.
  • Dress in layers of lightweight clothing.
  • Adjust your thermostat to a comfortable temperature.
  • Use a room or hand-held fan.
  • Sleep near an open window.
  • Change the clothing you sleep in and bed linens to lighter fabrics.
  • Use a Chillow®, which is a personal cooling pillow that can help with sleep. (Search online to find stores near you that carry them.)
  • Avoid hot baths or showers in the 2 hours before going to bed.
  • Perform deep breathing exercises a couple times a day. Doing them right before you feel a flash coming on will help decrease its intensity, and studies show that breathing exercises can reduce the frequency of hot flashes by half. Here’s how to perform deep breathing exercises:
  1. Get into a comfortable position in a chair or in your bed. Raise your head as much as possible.
  2. Place one hand on your stomach, just below your ribs. If you are right handed, use your right hand; if you are left handed, use your left hand.
  3. Exhale completely through your mouth.
  4. If you can, close your eyes and inhale slowly and deeply through your nose. Feel your stomach push up on your hand. Imagine that air is filling your whole body from the bottom up.
  5. Pause for a couple of seconds. Then, exhale slowly through your mouth or nose. Try to exhale completely and imagine the air leaving your lungs, mouth, or nose.
  6. As you exhale, allow your body to relax and go limp—like a rag doll.
  7. Repeat the exercise 5 to 10 times.

Having a healthy lifestyle, such as exercising regularly and reducing your stress, can also help manage your hot flashes. There are also treatments that can help, such as:

  • Complementary and alternative therapies. Our Integrative Medicine Program offers many services that may help you manage hot flashes, such as acupuncture, meditation, and hypnosis. For more information, talk with your doctor or speak with someone from our Integrative Medicine Program by calling 646-888-0800.
  • Medication. If hot flashes are impacting your life and other things don’t help, you may want to talk with your doctor about trying medication. Hormone replacement is usually not an option for people who’ve had certain cancers. This is because many cancer treatments are aimed at lowering hormone levels. Instead, your doctor or nurse practitioner may suggest other medications, such as those listed below. Be sure to ask your doctor, nurse, or pharmacist about possible side effects.
    • Blood pressure medications, such as clonidine (Catapres®) or methyldopa (Aldomet®)
    • Antidepressants, such as venlafaxine (Effexor®), paroxetine (Paxil®), sertraline (Zoloft®), or fluoxetine (Prozac®)
    • Antiseizure medications, such as gabapentin (Neurontin®)

No herbal therapy has been proven to be effective against hot flashes, so we do not suggest the use of herbs for this purpose. While some people report that herbal remedies can help, it’s also possible that they could be harmful. If you’re considering herbal remedies, please visit MSK’s Internet site at There you’ll find information about what different herbs are used for and if studies have shown that it might work. Then, before taking any herbal remedies, talk about it with your doctor or nurse. Some herbal remedies can interfere with cancer treatments.

If you find that your hot flashes are impacting your day to day activities, talk with a member of your healthcare team. Together, you can select the approach that you think is right for you.