A low-glycemic diet can reduce blood sugar fluctuations that trigger adrenaline surges. Diets low in sugar and high in plant protein can improve symptoms, especially night sweats.

Avoid adrenaline surge triggers such as stress, inadequate sleep, alcohol, and caffeine.

Medications that lessen adrenaline surges may help, such as Effexor (venlafaxine HCL), Brisdell (low dose paroxetine or Paxil), and some beta-blockers such as low-dose propranolol, a well-known medication often prescribed for stage fright.

The least invasive approach is with the mind-body connection, using focused thought, biofeedback, or breathing techniques to lessen adrenaline surges.

Over-the-counter plant-derived substances such as Estroven (soy and black cohosh), Promensil, or Genistein may help. These are called phytoestrogens. Scientific proof that they are effective is spotty, but it is generally accepted that in areas where dietary phytoestrogens are a common ingredient in the diet (such as in Asia), women report having fewer hot flashes.

Prescription plant-derived Fosteum, a medication approved by the FDA for low bone density, is a phyto (plant) estrogen and data from the manufacturer shows Fosteum may be very helpful for hot flashes in many women, as well as being good for bone health.

Foods high in plant or phytoestrogens such as nuts, nut butters, seeds, lentils, legumes, and some tubers can be helpful, not only to safely mimic estrogen, but also to stabilize blood sugar. Stabilizing blood sugar helps lessen adrenaline surges and keeps down abdominal fat.

Estrogen replacement is an option for some women as well in the form of hormone therapy. Low-dose estrogen therapy can markedly improve the incidence of hot flashes. While controversial, many women decide that the advantages of hormone therapy (improved bone density, lowered risk of type II diabetes, improved vaginal elasticity and relief of hot flashes) outweigh the risks that include blood clot formation, stroke, increased breast cancer risk (for dual hormone therapy), and gallbladder disease. Ask your clinician for direction; together you can decide what is best for you as there are many options. Most women can experience relief from hot flashes with one or more of these approaches.