Non-Hormonal Help for Hot Flashes

Q. I am 51 years old and my doctor says I can’t take estrogen or other HRT because I am very prone to blood clots. Do you have any recommendations for natural remedies for hot flashes and insomnia?
The hot flashes for the past few weeks have been every 15 to 30 minutes, day and night. I’m not getting enough sleep and I am tired all the time. I work full time, so I need to be able to rest! Any information you can send would be greatly appreciated.
A. Although hormone replacement therapy (HRT) can be effective against hot flashes, it is not for everyone. Estrogen increases the chance of blood clots, so it is too risky for women like you. Even bio-identical hormones from natural sources could be dangerous.
There are other approaches, both natural and pharmaceutical. Antidepressants such as Effexor, Paxil or Pristiq can ease hot flashes, but they have many side effects and may be difficult to stop.
In Europe, doctors prescribe St. John’s wort together with black cohosh for hot flashes. A different herbal extract, Pycnogenol, may also be helpful for these symptoms. We are sending you our new Guide to Menopause for an in-depth discussion of ways to ease symptoms.