Hot Flashes and Migraines Driving You Menopause Mad? Herbal Holistic Help is Here

Feeling hot under the collar? Suffering from pounding headaches? You’re not alone. Written by Dr. Sarah Bonza, MD, MPH, of Bonza Health, this feature dives into natural remedies that can help relieve the unpleasant symptoms many women experience during menopause. Dr. Bonza provides an inside look at how functional medicine can help women find comfort amid changing hormones, relying on time-tested botanicals and lifestyle changes over pharmaceuticals.

Hot flashes, night sweats, and migraine headaches can be bothersome symptoms of the menopausal transition. Menopause is a time of significant hormonal change for women with the decline in estrogen and progesterone mainly driving some less than pleasant, new, physical changes.

Perimenopause is the period of time before menopause officially starts, which is defined as 12 months without a menstrual period.

While menopause is inevitable, suffering from menopause is not.

Many women are surprised at how much menopause can shift the landscape of their health. Hot flashes can be distracting and uncomfortable, especially due to their unpredictable nature. Imagine being in the middle of a work meeting or presentation and suddenly feeling your heart rate start to elevate while your face turns beet red and sweat beads on your skin under your clothes!

Hot flashes that occur at night are called night sweats. Night sweats can be intense enough to interfere with sleep. Less than optimal sleep can cascade into a variety of other health issues such as mood changes, fatigue, brain fog, and even weight gain.

Migraines can range from being mildly annoying to severe enough to interfere with daily obligations and activities. Some migraine sufferers feel better lying down in a dark room for a couple of hours to all day.

Often women internalize the message that hormone-related symptoms are simply changes that one must endure.

What if vibrant health and comfort are possible, even amid big hormonal shifts?

Functional and alternative medicine paradigms aim to restore optimal health, relying on well-studied botanicals that have been used traditionally for centuries. Functional medicine also leans on nutritional science, utilizing diet and nutraceuticals to target specific symptoms. Lifestyle changes and individualized exercise plans complete the well-rounded approach of functional medicine.

Functional Medicine for Menopause

Functional medicine is a new paradigm of health that strives towards optimal health. Functional medicine draws from a broader toolkit than conventional medicine which relies strongly on pharmaceuticals. Functional medicine practitioners rely on botanicals, nutraceuticals, diet changes, lifestyle counseling, and occasionally pharmaceuticals.

Additionally, remedies are selected mindfully on a hierarchy of least invasive to most invasive. Functional medicine practitioners strive to recommend effective treatments that are minimal in side effects. These remedies align with the body’s inherent capacity to heal and tackle the root cause.

The beauty of the functional medicine approach is that these treatments often nourish overall health and address multiple symptoms at once.

Holistic Treatments for Hot Flashes

 The root cause of hot flashes is a work in progress in the research, but it’s believed to be caused by drops in estrogen that occur with menopause interacting with the part of the brain that controls internal temperature. This is called the hypothalamus.

Estrogen is on a rollercoaster during menopause, at first fluctuating wildly and then eventually bottoming out as menopause progresses. These changes in estrogen are thought to make the hypothalamus extra sensitive to slight changes in body temperature.

Many botanical medicines contain phytoestrogens, which mimic estrogen in the body and modulate estrogen receptors. Medicinal plants have a rich and long history of assisting with the menopausal transition. Several of the top studied and recommended herbs for menopausal women are as follows:

Black Cohosh

Black Cohosh is an herbaceous wildflower of the buttercup family native to Central and North America. The active compounds that reduce hot flashes are found in the root. Due to the slightly unpleasant smell of the plant, the Iroquois native American translation for Black Cohosh is “smells like a horse.”

A 2010 meta-analysis found this herb reduces hot flashes by approximately 26%. A more recent 2020 meta-analysis of 35 studies also found a significant reduction in hot flashes for women who supplemented this herb.

An added benefit of this herb is contains active compounds that act like serotonin, which can benefit mood.

Sage

Sage is a plant many are familiar with due to how common it is included in recipes. Sage is common in backyard gardens and has characteristically velvety smooth leaves.

A Swiss study evaluated the effects of sage over 8 weeks and found a 46% reduction in mild hot flashes with an even greater effect for moderate and severe hot flashes.

Recently a 2023 meta-analysis that included around 300 subjects found sage reduces the severity, frequency, and duration of hot flashes.

The medicinal benefits are found in the leaves, which can be consumed in a capsule or as a tea.

Licorice

Licorice is an extraordinary botanical medicine with many medicinal applications. Licorice grows as a fern however the medicinal benefits are found within the root of the licorice plant.

A clinical study compared the effect of licorice on menopausal symptoms to hormone replacement therapy. While hormone replacement therapy had a more significant effect on severity, the effect of licorice was comparable. Additionally, licorice appeared to reduce the duration of hot flashes more significantly than HRT.

Licorice is also an excellent herb for controlling blood sugar and cutting cravings for carbohydrate-heavy foods. Since menopause can decrease glucose control, licorice is a great choice for managing the metabolic decline associated with menopause.

Siberian Rhubarb

Many are familiar with rhubarb from the red rhubarb stalks in early summer strawberry and rhubarb cobbler.

Other than being a culinary plant, rhubarb also has outstanding medicinal properties for women dealing with hot flashes. Siberian Rhubarb is rich in phytoestrogens which soothe menopausal symptoms resulting from drops in estrogen.

In fact, a study of 109 women supplemented with Siberian Rhubarb for 12 weeks experienced significantly fewer hot flashes and night sweats than women given a placebo.

Pycnogenol

Pycnogenol is a patented extract of French maritime pine bark. When supplemented for 8 weeks, researchers observed 38 women experienced a reported 56% reduction in menopausal symptoms according to post-treatment patient questionnaires.

An additional benefit that was noted was pycnogenol appeared to lower inflammatory markers. Since estrogen and progesterone help bolster the immune system, this added benefit of pycnogenol can theoretically help prevent age-related chronic disease in women.

Pycnogenol also minimizes fine lines and wrinkles, which many women begin to notice ramp up during menopause. Estrogen and progesterone plump and firm skin, and as these hormones decline botanicals such as pycnogenol can encourage graceful aging.

Folate

B vitamins are water-soluble vitamins essential for many body processes. B vitamins can only be derived from the diet and are not produced in the human body naturally. Studies show women who supplement with folate for at least two weeks experience a reduction in hot flashes.

B vitamins are also excellent for boosting energy, which is why they are often in high amounts in energy drinks. Menopause can be associated with a drop in energy levels, therefore B vitamins are an excellent choice for fatigue.

Holistic Treatments for Migraines

Migraines have a lengthy list of possible triggers. Examples include certain foods, psychological stress, weather changes, fluorescent lights, dehydration, and many more. For women, migraines can also accompany hormonal changes such as menopause.

Often women who experience migraine with the menopausal transition also experience migraines with their menstrual cycle. Unfortunately, often perimenopause will ramp up migraines in these women.

The good news is the remedies mentioned above that act on hormones can help relieve hormone-driven migraines.

However, there are a couple of additional options for migraine sufferers.

Butterbur

 The American Headache Society gave the botanical Butterbur a class A recommendation for the prevention of migraines headaches. Butterbur is a wetland marsh-dwelling shrub. Its leaves were once used to wrap around and preserve butter, hence the name Butterbur.

Several studies estimate that Butterbur decreases the frequency of migraine attacks by 48–60%.

Butterbur contains active components that are thought to relax blood vessels in the brain. Since hormones influence the dilation and constriction of blood vessels, Butterbur is thought to improve hormonal migraines indirectly in this way.

Feverfew

Feverfew is an herb native to Asia and the Balkans that produces daisy-like flowers.

Feverfew works similarly to Butterbur through an active compound called parthenolide, which prevents migraine through its relaxing effect on blood vessels and anti-inflammatory activity.

The American Academy of Neurology/ American Headache Society recommends Feverfew as a consideration for patients for migraine prevention.

All of the recommendations above should be initiated under the guidance of a medical doctor. Botanicals and nutraceuticals can interact with prescribed medications or be contraindicated for certain medical conditions and therefore should only be started under medical guidance.