Breathe Away Hot Flashes

They strike unexpectedly, heating up the face, neck and chest. The pulse races, the skin reddens and sometimes drenching sweats occur.

Hot flashes are the main signal of menopause in Western cultures, experienced by an estimated 80 percent of American women around the time their menstrual periods end. While some women have two or three flashes a day, others power surge as often as once an hour. Annoying and embarrassing in the daytime, they can awaken women at night -- contributing to the insomnia and moodiness that can be troublesome during this stage of life.

One of the treatments for hot flashes -- and many other health concerns associated with menopause -- is hormone replacement therapy. Yet these drugs are inadvisable for some women with a family history of certain kinds of cancer. Other women may be reluctant to take hormones due to concerns about side effects.

New Alternatives
So as the first of the 38 million female baby boomers reach menopause, the generation that pioneered natural childbirth is searching for nondrug treatments for hot flashes. One of the most promising treatments is called "paced respiration," an abdominal breathing technique adapted from yoga.

"Our studies show that slow, deep breathing can reduce the frequency of hot flashes by about 50 percent," says psychologist Robert Freedman, a professor of psychiatry and behavioral neurosciences at Wayne State University School of Medicine in Detroit. "Women who've been trained to use this technique as soon as they feel a flush coming on are often able to abort the flash or at least reduce its severity.

"The average breathing rate is 15 to 16 cycles (inhaling and exhaling) per minute," he notes. "But with training, women can slow their breathing down to seven or eight cycles per minute, which can significantly reduce the frequency and intensity of hot flashes."

Known in yoga as "belly breathing," the technique involves sitting quietly, focusing on the breath and slowly allowing air to completely fill the lungs right down to the abdomen. Many women discover that only their chest expands when they breathe, often because they've been taught to hold in their stomachs. One way to teach these shallow "chest breathers," to become deep abdominal breathers is to have them lie on their back and place a book on their belly. When they breathe deeply, the book will rise and fall.

Working with a yoga instructor is the most effective way to learn this technique says Freedman, who admits "we just don't know" why deep breathing can cool down hot flashes. Some experts point to the stress-reducing effect produced by the calming breath.

Other Techniques
Psychologist Alice Domar, director of the Center for Women's Health at Harvard Medical School's Mind/Body Medical Institute, says that many stress-reduction methods can help cool hot flashes. In her book, Healing Mind, Healthy Woman, she encourages women bothered by menopausal heat waves to try a variety of relaxation techniques -- including visualizing cool mountain streams and listening to relaxation tapes.

Regular aerobic exercise may also cool flashes. A widely-quoted Swedish study showed that women who exercised for one hour, three times a week experienced a significant decrease in the frequency of hot flashes. "I've had countless patients tell me that they walked their way through menopause," says physician Sadja Greenwood, an assistant clinical professor of obstetrics and gynecology at the University of California at San Francisco.

Nearly three-quarters of women responding to a recent survey in Runner's World magazine said running has made a difference in the way they've experienced menopause. More than 30 percent said it improved their mood, nearly 25 percent said it decreased their symptoms and about 12 percent said running helped them "feel better in general."

Regular exercise can help relieve many of the health problems women have in midlife -- from hot flashes to weight gain, sleep disturbances and psychological issues, says Greenwood who is chairman of the education committee of the North American Menopause Association.

"Exercise is the key ingredient that's missing in most women's midlife health," she says. "Unfortunately we live in a society where everyone wants a quick fix and a pill. But the first step should always be lifestyle modification, because regular exercise and proper diet can go a long way to helping make this life transition as healthy as possible."