Night sweats, hot flashes, and poor sleep are common and uncomfortable symptoms of menopause. They come about when the ovaries don't produce enough estrogen.

Estrogen helps to regulate a temperature center in the brain. When estrogen levels decrease, this internal thermostat doesn't always work the way it should. The body dilates blood vessels near the skin. This produces a warm sensation that is often followed by a chill. Up to 80% of women experience these hot flashes around the time of menopause.

Mild symptoms do not need treatment. Many women dress in layers and then remove or add clothes as needed to control their temperature. Some women find these steps helpful:

• Regular exercise
• Drinking plenty of water
• Avoiding foods and drinks that make the symptoms worse, such as red wine and caffeine)

Over-the-counter products sold to treat menopause symptoms include:

• Soy products
• Herbal preparations (for example, black cohosh)
• Ginseng
• Evening primrose oil

Keep in mind that safety has not been well established with many of these products you eat or drink. Most studies are small and have short follow up times. Some of these products may have estrogen-like effects. So if you should not use estrogen you should also avoid products with estrogen-like effects.

Acupuncture, stress management, and relaxation methods have also been recommended. However, none have shown a scientifically significant benefit in most well designed studies. To be scientifically significant the treatment would have to do better than a fake treatment (a placebo).

About Estrogen Therapy
Estrogen therapy is highly effective in treating hot flashes and night sweats but it is not safe or acceptable for everyone. Women should not use estrogen beyond about four years because the risk of breast cancer increases with longer use. Most women will not need treatment for more than one or two years. Symptoms usually go away with time.

When it is time to end estrogen treatment, it is best to taper the dose over several weeks. This may help control the return of symptoms.