Non-hormonal treatments for hot flushes

Hot flushes are one of the most common and troublesome effects of breast cancer treatment, especially for women who go through sudden menopause or take hormone therapy. Because hormone replacement therapy is usually avoided after breast cancer, non-hormonal treatments are the main options. The good news is that several approaches have evidence of benefit, and many women find a combination works best. Lifestyle measures come first: dressing in layers, keeping cool, avoiding personal triggers such as hot drinks, spicy food, alcohol and stress, staying active and keeping a healthy weight. Psychological treatments, particularly cognitive behavioural therapy and clinical hypnosis, have good evidence for reducing how much hot flushes bother people and can also improve sleep and mood. Several prescription medicines can reduce the number and severity of hot flushes. These include certain antidepressants used at low doses, some nerve pain medicines, and a blood pressure medicine, each with its own benefits and side effects. Newer medicines that act on the brain's temperature control centre have also been developed. Some antidepressants can interact with certain hormone therapies, so your oncologist will choose carefully. Acupuncture helps some women, though evidence is mixed. Herbal remedies and supplements have limited evidence and may carry risks, so always check before using them.

Start with simple measures

Cooling, trigger avoidance and relaxation help many women.

Medicines can help

If symptoms affect daily life or sleep, ask about prescription options.

Check interactions

Tell your team about all medicines and supplements you take.

Small changes can make hot flushes easier to manage, especially in hot Indian weather.

Dress in layers

Choose loose cotton clothing you can remove quickly.

Carry a fan

A small handheld or battery fan and cool water help during a flush.

Keep your environment cool

Use fans, air conditioning where available, and light bedding.

Know your triggers

Keep a diary to identify triggers such as tea, coffee, spicy food or alcohol.

Stay active

Regular exercise may reduce flushes and improves mood and sleep.

There is no single best treatment for hot flushes. The right choice depends on how severe your symptoms are, your other health conditions, the medicines you already take and what matters most to you.

How much flushes affect you

Mild flushes may be manageable with cooling and lifestyle changes. Frequent, severe flushes that disturb sleep, work or relationships often justify adding a medicine.

Your hormone therapy

Your oncologist will check for interactions, particularly if you take a tablet that blocks oestrogen, as some antidepressants can reduce its effect.

Other symptoms

If you also have low mood or anxiety, a medicine that helps both may be chosen. If night sweats and poor sleep are the main problem, a medicine taken at night may suit you.

Side effects you want to avoid

Tell your doctor if drowsiness, weight change or effects on blood pressure would be particularly difficult for you.

Starting low and reviewing

Medicines are usually started at a low dose and reviewed after a few weeks. If one does not help, another can be tried.

Keeping a symptom diary

Recording how many flushes you have and how severe they are helps you and your doctor judge whether a treatment is working.

Stopping treatment

Some medicines need to be reduced gradually rather than stopped suddenly. Ask your doctor before stopping.